Parkinson's therapy

L-DOPA
	
	MOA: dopamine precursor
	Tox: nausea, orthostatic hypotension, hallucination, wearing off, on-off phenomenon, ?accelerated disease

Sinemet TM
	
	L-DOPA (dopamine precursor) + carbidopa (AADC inhibitor that doesn't cross BBB)
	PK: CR formulation prevents dyskinesia associated w/ excessive peak doses

Madopar TM
	
	L-DOPA (dopamine precursor) + benserazide (AADC inhibitor that doesn't cross BBB)
	PK: CR formulation prevents dyskinesia associated w/ excessive peak doses

-capone
	
	Tolcapone, entacapone
	MOA: COMT inhibitor (extends t1/2 of L-DOPA)

Dopamine agonists
	
	Pramipexole, bromocriptine, pergolide, ropinirole
	MOA: name says it all
	Less effective than L-DOPA but no chronic side effects
	Good Rx for early mild PD
	Controversial prophylaxis for PD
	Tox: nausea, somnolence, hallucination, orthostatic hypotension

Anticholinergics
	
	Benzotropine, trihexyphenidyl, diphenhydramine
	No role in modern Parkinson's therapy

Amantadine
	
	MOA: weak anticholinergic, weak DA releaser, weak Glu blocker (unclear mechanism in PD)
	Synergizes with L-DOPA

Selegine
	
	MOA: MAO-B inhibitor
	Controversial prophylaxis for PD

Coenzyme Q10
	
	Controversial prophylaxis for PD

Surgery
	
	MOA: inactivation of GPi and SN via ablation or high-frequency stimulation
	Rx advanced prominent tremor PD and sinemet-induced dyskinesia