ALL Pharmacology Medications Study Guide_ Updated Spring 26.
Module 02 – Neurological System Medications
Chapter 24 – Antiparkinsonian Agents
Dopaminergic Agents (Dopamine Agonists)
Drugs Route Therapeutic Actions Contraindications, Adverse Effects
Interactions, & Cautions
carbidopa-levodopa PO Carbidopa decreases - Known allergy - Peripheral Dopamine
(Duopa, Rytary) metabolism of levodopa in GI - Angle-closure Reactions (palpitations,
tract → increase amount that glaucoma fainting, anorexia,
crosses blood/brain barrier - Lactation nausea)
amantadine (Gocovil, PO Antiviral that increases - MAOIs - Systemic Dopamine
Osmolex ER) release of dopamine; - Levodopa: Effects (tachycardia,
dopaminergic agents nonselective MAOIs, hypertension, decreased
apomorphine (Apokyn, Apomorphine- Binds to post-synaptic iron salts, TCAs, GI motility, urinary
Kynmobl) SQ receptors and is approved for phenytoin retention)
bromocriptine (Parlodel) “off” episodes - Rasagiline: tyramine- - Bone marrow depression
pramipexole (Mirapex, Rotigine- TD rich foods, St. John’s - Hepatic dysfunction
Mirapex ER) Indication: Can be used to Wort, meperidine,
ropinorole (Requip, Requip treat restless leg syndrome acetaminophen
XL) - Malignant melanoma
rotigine (Neupro) Dopamine receptor agonists - Caution: CV disease,
rasagiline (Azilect) PO Dopamine agonist; increases bronchial asthma, hx.
dopamine in synapse Peptic ulcer, UTI obx,
Inhibits MAO type B; initial psychiatric disorders,
monotherapy or in pregnancy
conjunction with levodopa
, Anticholinergic Agents (Cholinergic Blocking Agents)
Drugs Route Therapeutic Actions Contraindications, Interactions, Adverse Effects
& Cautions
benztropine (Cogentin) PO Blocks cholinergic - Known allergies - CNS effects: disorientation,
receptors - C/I: narrow-angle confusion, memory loss,
diphenhydramine glaucoma, GI/GU obx, agitation, nervousness,
(Benadryl) PO, IV, Associated with adverse prostatic hypertrophy dizziness, lightheadedness
IM effects - C/I: - Anticipated peripheral
trihexyphenidyl tachycardia/arrhythmias, anticholinergic effects: dry
Not as effective as hypo/hypertension, mouth, nausea, vomiting,
PO levodopa but can be pregnancy/lactation (only paralytic ileus, constipation
used as adjunct therapy if benefits outweigh risks) - Tachycardia, hypotension
- Hot environments; reflex - Urinary retention/hesitancy
Decrease salivation, sweating blocked → heat - Photophobia and blurred
spasticity, and tremors exhaustion/stroke vision
- Interacts with other - Decreased sweating
anticholinergics and
antipsychotics (can lead to
paralytic ileus)
Adjunct Therapy
entacapone (Comtan) tolcapone (Tasmar) safinamide (Xadago) selegiline (Eldepryl)
Therapeutic Action Increases plasma COMT inhibitor to increase “off” episodes Used with carbidopa-
concentration & plasma levels of levodopa levodopa after patients
Used in conjunction with duration of levodopa Inhibits MAO-B have shown signs of
carbidopa-levodopa Associated w/ liver deteriorating response to
Inhibits COMT enzyme damage; C/I in liver disease Blocks sodium and calcium treatment
Use barrier contraceptives that destroys dopamine channel
Stalevo- levodopa, Entacapone > Tolcapone
carbidopa, entacapone Inhibiting glutamate release
, Chapter 30 – Adrenergic Agonists (Sympathomimetic)
Alpha- and Beta-Adrenergic Agonists (affect both alpha- and beta-receptors)
Drug Route Indications Therapeutic Contraindications, Adverse Effects
Actions Interactions, & Cautions
dobutamine (generic) IV treatment of heart Effects mediated C/I: CV effects
failure; increase by the adrenergic - Hypersensitivity/alle - Arrhythmias,
myocardial receptors in target rgy HTN,
contractility organs: - Pheochromocytoma palpitations,
dopamine (generic) IV treatment of shock HR increases, (overload of angina, dyspnea
ephedrine (Akovaz, IV treatment of bronchi dilate, catecholamines)
Corphedra, Emerphed) hypotensive episodes blood vessel - Tachyarrhythmias, GI effects
in setting of constricts, eye V-Fib - Nausea,
anesthesia; stimulates pressure - Hypovolemia vomiting,
release of decreases, - Halogenated constipation
norepinephrine glycogenesis, hydrocarbon general
epinephrine IV, SQ, treatment of pupils dilate, anesthetics SNS effects:
(Adrenalin, IM, hypotension w/shock; increase in Caution: - Headache,
Adrenaclick, Auvi-Q, nebulizer, prolong effects of sweating - PVD sweating, anxiety,
Epipen, Primatene nasal regional anesthetic; (atherosclerosis, piloerection,
Mist, Symjepi) drops, primary treatment for Raynaud, diabetic sensitivity to
ophthalmic bronchospasm; endarteritis) light
fluid produce local - Pregnancy/lactation
vasoconstriction; Interactions: Hypokalemia (release of
emergency treatment - Tricyclic aldosterone = loss of
of allergic reactions; antidepressants potassium)
anaphylaxis - MAOIs - Muscle cramps
norepinephrine IV treatment of acute - Other drugs that
(Levophed) hypotensive status cause HTN
pseudoephedrine PO OTC; treat cold
(Sudafed, Suphedrin) symptoms
Module 02 – Neurological System Medications
Chapter 24 – Antiparkinsonian Agents
Dopaminergic Agents (Dopamine Agonists)
Drugs Route Therapeutic Actions Contraindications, Adverse Effects
Interactions, & Cautions
carbidopa-levodopa PO Carbidopa decreases - Known allergy - Peripheral Dopamine
(Duopa, Rytary) metabolism of levodopa in GI - Angle-closure Reactions (palpitations,
tract → increase amount that glaucoma fainting, anorexia,
crosses blood/brain barrier - Lactation nausea)
amantadine (Gocovil, PO Antiviral that increases - MAOIs - Systemic Dopamine
Osmolex ER) release of dopamine; - Levodopa: Effects (tachycardia,
dopaminergic agents nonselective MAOIs, hypertension, decreased
apomorphine (Apokyn, Apomorphine- Binds to post-synaptic iron salts, TCAs, GI motility, urinary
Kynmobl) SQ receptors and is approved for phenytoin retention)
bromocriptine (Parlodel) “off” episodes - Rasagiline: tyramine- - Bone marrow depression
pramipexole (Mirapex, Rotigine- TD rich foods, St. John’s - Hepatic dysfunction
Mirapex ER) Indication: Can be used to Wort, meperidine,
ropinorole (Requip, Requip treat restless leg syndrome acetaminophen
XL) - Malignant melanoma
rotigine (Neupro) Dopamine receptor agonists - Caution: CV disease,
rasagiline (Azilect) PO Dopamine agonist; increases bronchial asthma, hx.
dopamine in synapse Peptic ulcer, UTI obx,
Inhibits MAO type B; initial psychiatric disorders,
monotherapy or in pregnancy
conjunction with levodopa
, Anticholinergic Agents (Cholinergic Blocking Agents)
Drugs Route Therapeutic Actions Contraindications, Interactions, Adverse Effects
& Cautions
benztropine (Cogentin) PO Blocks cholinergic - Known allergies - CNS effects: disorientation,
receptors - C/I: narrow-angle confusion, memory loss,
diphenhydramine glaucoma, GI/GU obx, agitation, nervousness,
(Benadryl) PO, IV, Associated with adverse prostatic hypertrophy dizziness, lightheadedness
IM effects - C/I: - Anticipated peripheral
trihexyphenidyl tachycardia/arrhythmias, anticholinergic effects: dry
Not as effective as hypo/hypertension, mouth, nausea, vomiting,
PO levodopa but can be pregnancy/lactation (only paralytic ileus, constipation
used as adjunct therapy if benefits outweigh risks) - Tachycardia, hypotension
- Hot environments; reflex - Urinary retention/hesitancy
Decrease salivation, sweating blocked → heat - Photophobia and blurred
spasticity, and tremors exhaustion/stroke vision
- Interacts with other - Decreased sweating
anticholinergics and
antipsychotics (can lead to
paralytic ileus)
Adjunct Therapy
entacapone (Comtan) tolcapone (Tasmar) safinamide (Xadago) selegiline (Eldepryl)
Therapeutic Action Increases plasma COMT inhibitor to increase “off” episodes Used with carbidopa-
concentration & plasma levels of levodopa levodopa after patients
Used in conjunction with duration of levodopa Inhibits MAO-B have shown signs of
carbidopa-levodopa Associated w/ liver deteriorating response to
Inhibits COMT enzyme damage; C/I in liver disease Blocks sodium and calcium treatment
Use barrier contraceptives that destroys dopamine channel
Stalevo- levodopa, Entacapone > Tolcapone
carbidopa, entacapone Inhibiting glutamate release
, Chapter 30 – Adrenergic Agonists (Sympathomimetic)
Alpha- and Beta-Adrenergic Agonists (affect both alpha- and beta-receptors)
Drug Route Indications Therapeutic Contraindications, Adverse Effects
Actions Interactions, & Cautions
dobutamine (generic) IV treatment of heart Effects mediated C/I: CV effects
failure; increase by the adrenergic - Hypersensitivity/alle - Arrhythmias,
myocardial receptors in target rgy HTN,
contractility organs: - Pheochromocytoma palpitations,
dopamine (generic) IV treatment of shock HR increases, (overload of angina, dyspnea
ephedrine (Akovaz, IV treatment of bronchi dilate, catecholamines)
Corphedra, Emerphed) hypotensive episodes blood vessel - Tachyarrhythmias, GI effects
in setting of constricts, eye V-Fib - Nausea,
anesthesia; stimulates pressure - Hypovolemia vomiting,
release of decreases, - Halogenated constipation
norepinephrine glycogenesis, hydrocarbon general
epinephrine IV, SQ, treatment of pupils dilate, anesthetics SNS effects:
(Adrenalin, IM, hypotension w/shock; increase in Caution: - Headache,
Adrenaclick, Auvi-Q, nebulizer, prolong effects of sweating - PVD sweating, anxiety,
Epipen, Primatene nasal regional anesthetic; (atherosclerosis, piloerection,
Mist, Symjepi) drops, primary treatment for Raynaud, diabetic sensitivity to
ophthalmic bronchospasm; endarteritis) light
fluid produce local - Pregnancy/lactation
vasoconstriction; Interactions: Hypokalemia (release of
emergency treatment - Tricyclic aldosterone = loss of
of allergic reactions; antidepressants potassium)
anaphylaxis - MAOIs - Muscle cramps
norepinephrine IV treatment of acute - Other drugs that
(Levophed) hypotensive status cause HTN
pseudoephedrine PO OTC; treat cold
(Sudafed, Suphedrin) symptoms
