3 neurology

know what ion blocker each drug is but nothing more for mechanism

Epilepsy control agents

Carbamazepine

Lamotrigine

Topiramate

Gabapentin

Ethosuximide

Phenobarbital

Levetiracetam

Valproic acid

medications to treat seizure onset

Diazepam

Midazolam

Lorazepam

Phenobarbital

Valproic acid

Levetiracetam

Antiparkinsonian agents

Dopamine precursors and dopamine receptor agonists:

• Levodopa / Benserazide

• Carbidopa

• Pramipexole

  COMT inhibitors

• Entacapone

• Tolcapone

  MAO inhibitors

• Selegiline

  Centrally acting cholinoblocker

• Trihexifenidil

  NMDA receptor antagonists

• Amantadine

Parkinsons disease - A disturbed balance between dopamine inhibitory and ACh activating effects on GABA-ergic neurons. → on nigrostriatal tract → tremor, bradykinesia, rigidity and postural instability

TC, A

TC-tonic-clonicform, increased muscle tone with twiching

A-Absence (just loose contiousnes)

valproic acid

anticonculsant effect (control of epilepsy), mood stabilization

indication: generalized (TC,A) and focal epilepsy, status epilepticus, bipoar.

Side effect: teratogenic activity, (special care with women of childbearing potential)

(Blockade of voltage-dependent Na + and Ca2 + channels in neurons, inhibits GABA transaminase (prolongs GABA activity).)

Ethosuximide

anticonvulsant effect (control of epilepsy)

indication: generalized epilepsy (A)

(blockage of Ca2 channels in neurons)

Lamotrigine

anticonvulsant activity (control of epilepsy), mood stabilization

indication: generalized (TC,A) and focal epilepsy, bipolar

(Blockade of voltage-dependent Na + and Ca2 + channels in neurons,)

Carbamazepine

anticonvulsant activity (control of epilepsy), mood stabilization, co-analgic

indication: generalized (TC), focal epilepsy, bipolar, neuropathic pain

(Blockage of voltage-dependent Na + channels in neurons,)

Gabapentin

anticonvulsant effeect (control of epicleps, coanalgesic effect)

indication: focal epilepsy, neurophatic pain (diabetes neuropathy, postherpetic neuralgia), chronic pain syndrome

(Structural analogue of GABA Inhibition of voltage-sensitive Ca2 + channels,)

Levetiracetam

Binds to synaptic vesicle protein 2A (SV2A) on glutamatic synapse, affects neurotransmitter exocytosis

Indication: generalized (TC) and focal epilepsy, status epileticus

Topiramate

blocks: Kainate/AMPA, Na & ca channels, GABA-A on glutamate receptor

indication: generalized (TC) and focal epilepsy

Phenobarbital

antiepileptic control and treat

anticonulsant and status epilepticus,

GABA agonist

ind: focal epilepsy TC

Carbidopa, benserazide

DCI - peripheral levodopa inhibitors of metabolism

dont cross blood brain barier

Indication: reduce dopamine-induced gastrointestinal & cardiovascular side effects. Parkinsons disease, parkinsonism

Side effect Neuroleptic malinant syndrome (if ended quickly), develop motor complications, develp ‘‘wearing off’’ (involuntery movment)& ‘‘on-off’’ (bradykinesia)

(Dopamine Prodrugs: L-DOPA + decabroxylase inhibitors (DCI)

By converting L-dopa to dopamine in the nigrostriatal tract, restores neurotransmission in Corpus striatum reduces EPS )

Pramipexole

Dopaminergic agents Non-selective agonists of striatal dopamine D2 receptors

Selegiline

➢ MAO-B inhibitors

Entacapone (does not cross BBB) Tolcapone (Crosses BBB)

COMT inhibitors

indication: parkinson, hyperprolactineamia

Trihexyphenidyl

➢ Cholinolytic agents

As a central actiong M1 choline blocker blocks Ach-induced EPS

indication: parkinsonism, correction of EPT induced by antipsychotic agents

(Dopamine acts as an ACh antagonist in certain regions of the CNS. In the event of dopamine deficiency in the nigrostriatal tract, ACh is one of the neurotransmitters that mediate EPS)

Amantadine

NMDA receptor antagonists

indicaion: parkinsons disease

(NMDA receptor blockade suppresses glutamatergic activity,promotes dopamine synthesis and secretion, inhibits dopamine presynaptic reuptake)

Memantine

Anti-dementia agents, NMDA receptor antagonists

indication alzheimers dementia

Donepezil

Anti-dementia agents, Acetylcholinesterase inhibitors

Rivastigmine (also inhibition of butyrylcholinesterase)

side effect: cholinergic hyperactivation

IA: : Medicines with anticholinergic properties (1st generation histamine receptor blockers, tricyclic antidepressants)

indication alzheimers, vascular dementia, parkinsons demetia