ANTIMUSCARINIC AGENTS • BenztropineAntagonist at M receptors in basal ganglia Reduces tremor and rigidity •littleeffectonbradykinesiaParkinson’s disease Oral•Toxicity: Typical antimuscarinic effects—sedation, mydriasis, urinary retention, constipation, confusion, dry mouth • Biperiden, orphenadrine, procyclidine, trihexyphenidyl: Similar antimuscarinic agents with CNS effects • Haloperidol, fluphenazine, other neuroleptics, olanzapine: Dopamine receptor blockers, sometimes helpful • Clonidine, guanfacine: Effective in ~50% of patients; see Chapter 11 for basic pharmacology • Phenothiazines, atypical antipsychotics, clonazepam, carbamazepine: Sometimes of value
Amantadine Generic, Symmetrel
Benztropine Generic, Cogentin
Bromocriptine Generic, Parlodel
Carbidopa/levodopa Generic, Sinemet, Parcopa, Rytary
Carbidopa/levodopa/entacapone Generic, Stalevo
Entacapone Generic, Comtan
Levodopa Dopar, others
Orphenadrine Generic, various
Penicillamine Cuprimine, Depen
Pergolide * Permax, other
Pramipexole Generic, Mirapex
Ropinirole Generic, Requip, Requip XL
Trihexyphenidyl Generic, Artane, others *Not available in the USA.
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