Medicine & USMLE

Entacapone / Tolcapone

520 views
Neuro Drugs
  1. Anticholinergic Syndrome
  2. Cholinergic Crisis
  3. Benztropine / Trihexyphenidyl
  4. Pyridostigmine, Neostigmine, Edrophonium
  5. Donepezil
  6. Memantine
  7. Scopolamine
  8. Levodopa, Carbidopa
  9. Selegiline / Rasagiline
  10. Entacapone / Tolcapone
  11. Propofol
  12. Halothane / Flurane
  13. Opioids
  14. Succinylcholine
  15. Lidocaine
  16. Ergotamine
  17. Triptans
  18. Pregabalin
  19. Gabapentin
  20. Ramelteon

Summary

Drugs ending in -capone, like entacapone and tolcapone, are used to treat Parkinson disease. These drugs can cause orthostatic hypotension as a side effect, so it’s important that patients taking these drugs get up slowly to avoid dizziness and falls. These drugs can also cause orange urine discoloration, but this is an expected and harmless side effect that is NOT a reason to stop taking the drug.

Key Points

  • Entacapone (Comtam), Tolcapone (Tasmar)
    • Mechanism
      • Catechol-O-Methyltransferase (COMT) inhibitor
        • Inhibits an enzyme that inactivates dopamine, thus increasing the amount of dopamine in the brain
    • Clinical Uses
      • Parkinson’s Disease
        • Used alongside levodopa/carbidopa, so that a smaller dose of levodopa can be used
    • Side Effects and Adverse Reactions
      • Orthostatic hypotension
        • Rise slowly to avoid sudden dizziness
      • Orange urine discoloration
        • An expected, harmless side effect
      • Hepatotoxicity (tolcapone only)
        • Monitor liver enzymes