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First line drugs for Parkinsons Disease
If <65 or advanced stages w/ L-Dopa
- Dopamine Agonists (Neuroprotective) 1) Ropinerole
- 2) Pramipexole
- S/E Low BP, compulsive disorder, nausea, confusion, sleep attacks.
- 3) ApomorphineRescue drug/ need trimethobenzide for emesis4) RotigotineTransdermal patch/ For restless leg syndrome
- 3) Bromocriptine
- 4) Perogolide
- S/E fibrosis & thick valves
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First line drug for Parkinsons Disease
- L-DOPA w/ Carbidopa
- MOA: precursor for dopamine, protection from AA decarboxylase in periphery
- S/E: Nausea, vomiting, postural HTN
- Fluctuations within 5 years
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COMT- inhibitors
- 1) Tolcapone (periphery & central)
- 2) entacapone (periphery/ S/E liver issues)
- MOA: helps wearing off phenomenon
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MAO-B Inhibitors
- Neuroprotective
- 1) Segeline (low dose)
- 2) Rasagiline
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Glutamate Inhibitor
- 1) Amantadine
- For drug induced dyskinesias
- S/E Not for epilepsy or psychiatric
- 2) Memantine
- Blocks from excess glutamate
- Also for Alzheimers
-
Cholinesterase Inhibitors
Alzheimers treatment
- 1) Doneprezil
- 2) Tacrine
- 3) Benzodiazepines
- MOA: Inc Ach to delay progression
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Atypical anti-anxiety Drug
- 1) Busipirone
- MOA: 5-HT1 agonist
- For depression
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Atypical Anti-depressants
- 1) Buproprion
- MOA: Dopamine- Norepinephrine reuptake inhibitor
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Multiple Sclerosis drugs
- 1) Interferons beta(first Line)
- binds type 1 interferon receptors & prevents antigen presentation
- 2) Glatiramer acetate(capoxone)[first line]
- Inc regulatory T cells and suppress inflammation
- 3) Glucocorticoids
- No matrix metalloproteinases
- Blocks leukocytes and phospholipase
- 4) Natalizumb
- Suppress leukocyte into CNS
- 5) Fingolimod
- Restricts lymphocytes into lymph nodes
- No autoreactive cells into CNS
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