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The variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms
off and on phenomenon
This AED can induce its own metabolism, causing lower-than-expected drug levels after several weeks.
What is carbamazepine (Tegretol)?
This AED must be titrated very slowly over several weeks to avoid a rash that can progress to Stevens-Johnson syndrome.
What is lamotrigine (Lamictal)?
This dopamine replacement drug must be spaced away from protein and can cause dyskinesias, orthostatic hypotension, and neuroleptic-malignant–like syndrome if stopped abruptly.
levodopa
This ergot-derived dopamine agonist carries a BBW for fibrosis.
What is bromocriptine (Parlodel)?
this drug has dietary reactions with protein & is to be given 30 minutes BEFORE protein rich meals. It is only reserved for patient with severe parkinson symptoms
contraindication include- non-selective MAOIs (htn crisis), acute angle glaucoma.
NEVER ABRUPTLY STOP- could cause neuroleptic malignant syndrome
levodopa-carbidopa
Aplastic anemia and agranulocytosis are BBW side effects of this iminostilbene AED.
What is carbamazepine (Tegretol)?
This AED, used for tonic-clonic and partial seizures, can cause emotional swings, hostility, and acute psychosis in some patients.
What is levetiracetam (Keppra)?
This drug class blocks the enzyme that breaks down catecholamines and is used to prolong the action of levodopa.
What are COMT inhibitors (e.g., tolcapone, entacapone)?
These drugs, with the suffix -capone, reduce the wearing-off phenomenon by prolonging levodopa’s duration of action.
What are entacapone and tolcapone?
This AED binds to the GABA receptor, is used for generalized tonic-clonic seizures, has a therapeutic range of 10–40 mcg/mL, and carries a BBW for suicidal ideation.
barbituate; phenobarbital
This AED is used exclusively for uncomplicated absence seizures and works by blocking thalamic calcium channels.
What is ethosuximide (Zarontin)?
This highly protein-bound AED enhances GABA neurotransmission and carries risks of hepatotoxicity, pancreatitis, weight gain, and thrombocytopenia.
What is valproic acid (Depakote)?
Carbidopa-levodopa cannot be taken with this class of antidepressants due to risk for hypertensive crisis; a washout period is required.
non selective MAOIs
This COMT inhibitor requires LFTs every 2 weeks due to a BBW for acute liver failure.
tolcapone
This hydantoin delays sodium influx, can cause gingival hyperplasia, hirsutism, and Dilantin facies, and is only compatible with normal saline when given IV.
phenytoin
This gabapentinoid, structurally similar to GABA, is often used for neuropathic pain rather than seizures.
gabapentin
Stopping any AED suddenly can trigger this life-threatening emergency involving repeated seizures without recovery.
status epileptecus
This antiviral drug increases dopamine release and inhibits reuptake, and is also used to treat levodopa-induced dyskinesia.
amantadine
This dangerous complication of anticholinergic PD drugs includes hyperthermia, flushed skin, mydriasis, hallucinations, and urinary retention.
What is anticholinergic toxicity?
This IV AED requires a filter, must be given through a large vein, and is highly irritating to the vasculature.
phenytoin
This AED, closely related to gabapentin, is used for postherpetic neuralgia and fibromyalgia.
What is pregabalin (Lyrica)?
When giving valproic acid, these two labs must be monitored routinely.
What are LFTs and platelet count?
This nonergot dopamine agonist is first-line for younger PD patients and also treats restless leg syndrome.
pamiprexole
This vitamin reduces the effectiveness of levodopa.
vit b6