1st line for Parkinsonism
Levodopa:
| Mechanism of Action | Effects | A/Es (For both) |
|---|---|---|
| Increase dopamine availability |
Converted to dopamine by the enzyme AADC in striatal dopaminergic terminals | Superior motor benefits compared to dopamine agonists
Improves disability → prolongs ability to be independent
‣ don’t often improve | • ‣ (w/t Carbidopa) • ‣ • ‣ (ANS dysfunction) • ‣ → ‣ risk • ‣ if stopped abruptly
Higher dose/longer duraton: ‣ ‣ |
Carbidopa
| Class | Mechanism of Action | Effects |
|---|---|---|
| (Peripheral) Decarboxylase Inhibitors |
Carbidopa, ‣ | Peripheral carboxylase inhibitors (work on stopping effect of AADC).
Minimize peripheral S/E | Minimize ‣
Increased dopamine availability to CNS |
AADC: Aromatic L-amino acid decarboxylase