1 Parkinson's

Question 1

Patients with Parkinson’s disease have ________ dopamine

Patients with Schizophrenia have _______ dopamine

Answer 1

Parkinson’s- too little

Schizophrenia- too much

Question 2

In Parkinson disease there is specific alterations in ____________ in the ____________ which is involved in ________ and regulation of ________ function.

Answer 2

In Parkinson disease there is specific alterations in dopamine in the basal ganglia which is involved in coordination and regulation of motor function.

Question 3

True or false: Dopamine crosses the blood brain barrier

Answer 3

Dopamine does not cross the blood- brain barrier, but the immediate precursor to dopamine can… L-dopa

Question 4

True or false: Levodopa can cross the blood brain barrier

Answer 4

True

Question 5

What are the pharmacokinetics of L-dopa?

Answer 5

• Administered orally, in daily doses

• Absorption – GI tract and rapidly
converted into dopamine.

• Distributed throughout body in the
liver, intestinal mucosa, kidneys and
skeletal muscle.

Question 6

What percentage of L-dopa makes it to the brain before it is converted to dopamine and cannot go past the blood brain barrier?

Answer 6

Less than 1%

Question 7

What is carbidopa?

Answer 7

Carbidopa is a drug that inhibits the conversion of L-dopa to dopamine in the periphery.

Question 8

Carbidopa + L-dopa =?

Answer 8

Sinemet

Question 9

What are the side effects of L-dopa therapy?

Answer 9

• Gastrointestinal problems:
• Cardiovascular problems: increased HR with activity
• Postural hypotension
• Dyskinesias
• Behavioral Changes; anxiety, depression
• Diminished response to L-dopa: with
prolonged use. wait to use it
• Fluctuations in response to L-dopa. “on-off” phenomenon.

Question 10

• Theory: with hold L-dopa until symptoms progress to _________ _____ ________ .

Answer 10

• Theory: with hold L-dopa until symptoms progress to impaired motor function.

Question 11

• Theory: give _________ _______ instead of L-dopa in initial treatment of Parkinson

Answer 11

• Theory: give dopamine agonists instead of L-dopa in initial treatment of Parkinson