Name the main drug.
Entacapone
Describe the mechanism of action.
Inhibition of catechol-O-methyltransferase (COMT) → ↓ peripheral metabolization of L-DOPA to 3-O-methyldopa (3-OMD) → ↑ availability
Tolcapone also prevents central COMT from breaking down dopamine to 3-methoxytyramine (3-MT) by crossing the blood-brain barrier → ↑ dopamine effect → ↓ demand for L-DOPA and longer therapeutic effect for each dose
What kind of drug is it?
COMT inhibitors
Describe the indication of entacapone.
If L-DOPA loses effect or motor symptoms fluctuate during L-DOPA therapy
List side effects.
Gastrointestinal side effects
Dyskinesia and psychiatric symptoms (e.g., hallucinations or confusion)
How effective is COMT inhibitor monotherapy?
COMT inhibitor monotherapy is ineffective; therefore, it should always be combined with L-DOPA and carbidopa.
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