Role of COMT inhibitors as Anti-parkinsonisms
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Transcript of Role of COMT inhibitors as Anti-parkinsonisms
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The Role of COMT inhibitors as
Anti-Parkinsonisms
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الله بسمالرحيم الرحمن
By\Hasnaa Ahmed Salama
Alexandria Faculty of Medicine
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Points to discuss :1) Function of COMT enzyme.2) How COMT inhibitors work.3) Preparations : Entacapone ,Tolcapone , Stalevo.4) Adverse effects.
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COMT Substrates L-Dopa + Catecholamines
COMT 3-OMD
SAM SAH
COMT inhibitors
xDopamine
DDCDDCI x
Mechanism ??
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Then,how they work?!
1. L-dopa degradation.
2. L-dopa in the blood.
3.+DDCI L-dopa in the blood.
Note Always taken with L-dopa, as they have no effect alone.
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Preparations….Entacapone
TolcaponeStalevo
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Entacapone ( Comtan®)200 mg 8/day
L-dopa Carbidopa(DDCI)
a great Reduction in the manifestations of
parkinsonian syndrome.
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Contraindications :1) Hypersensitivity.
2) Isocarboxazid (MAOI) Possible hypertensive.
3) sympathomimetics their effect & toxicity.
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Tolcapone ( Tasmar®) 100&200 mg
3/day
Structurally and pharmacologically related to Entacapone but…. It causes
Liver toxicity
Monitor liver functions
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Stalevo(LCE)
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1-Diarrhea. 2- Vivid dreams and visual hallucinations. 3- Drowsiness. 4- Urine discoloration (orange). 5- Dyskinesias. 6- nausea and vomiting. 7-Tolcapone liver toxicity.
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