21 - movement disorder and tremor

Question 1

Parkinsons has been covered in another deck

But Give some classes and Egs of drugs used?

Answer 1

L dopa
carbidopa

Pyridoxine: aka B6, a cofactor in the conversion of L-DOPA to dopamine

Dopamine agonists (pramipexole, bromocryptine): monotherapy in early disease and as levodopa adjunct.

Monoamine oxidase inhibitors: (selegiline) can be used for earlier treatment before L-DOPA. Dietary restrictions. Also used for depression

Anticholinergic agents (benztropine): usually used for tremor

Question 2

Side effects of L dopa ? What can happen with sudden withdrawal ?

Answer 2

Hypotension, arrhythmia, nausea, hair loss, confusion, vivid nightmares, hallucinations, psychosis,

Sudden withdrawal can provoke neuroleptic malignant syndrome.

Question 3

Traid in hungtingtons chorea?

Answer 3

movement disorder,
cognitive defects
emotional and behaviour disturbance.

Question 4

Cause of hungtingtons

Answer 4

loss of neurons in the basal ganglia

Question 5

Mx of movement disorder in huntingtons

Answer 5

tetrabenazine

Question 6

Type of tremor in benign essential tremor ? Supressed by what?

Answer 6

Action and postural tremor not resting tremor (kinetic)
Genetic component.
Suppressed by alcohol

Question 7

Drugs causing a tremor?

Answer 7

Anti epileptics,
Anti depressants
Stimulants
Mood stabilisers
Amiodraone, procainamide
Acyclovir
Beta agonists

Question 8

What is wilson’s disease? Inheritance?
Sx?
Mx?

Answer 8

Copper chelation disease. AR inheritance.

Neuronal changes are permanent.

Psych and liver illness. Also a cause of parkinsonism and RTAcidosis
Everyone remembers Kayser-Fleischer rings.

Penicillamine. Liver transplant may be needed.