6.2.2 Movement Disorders Flashcards
What are the common types of tremors?
Postural, action, rest
Rx with primidone, propanolol
What is chorea?
Non-sustained, arrhythmic, ballistic (agonist, antagonist, agonist) movements
What is the mainstay in treatment of Parkinson’s dz?
Carbidopa/Levodopa
What is the MOA of COMT inhibitors?
Inhibits catechol-O-methyltransferase, which reduces COMT breakdown of dopamine
This increases the bioavailability of levodopa
What is the primary abnormality in Parkinson’s disease?
Slow and selective loss of substania nigra dopaminergic neurons
Why are MAO-B inhibitors typically given?
To reduce motor flucuations and increases on time as an adjunct to levodopa (5-10 mg/day)
What is the MOA of dopamine agonists?
Stimulate postsynaptic dopamine receptors directly
What is dystonia?
Sustained abnormal involuntary movements; either focal or generalized
Draw out the flowchart of the abnormal involuntary movements
What is the MOA of LDOPA?
A precursor to dopamine that can cross the BBB, get converted into dopamine, and be stored in nigral neurons
What are the primary clinical signs of akinetic rigid syndrome?
Bradykinesa/akinesia
Increased tone: rigidity
Postural instability
What are movement disorders?
A group of disorders affecting the ability to produce and prevent movement
What is myoclonus?
Brief shock-like movement
What are the clinical features of parkinson’s disease?
Rest tremor, rigidity, bradykinesia and postural instability in later stages of disease
autonomic dysfunction
neuropsychiatric disturbances (sometimes related to rx)
What is the difference between Parkinsonism and Parkinson’s disease?
Parkinsonism (akinetic rigid syndrome) is the clinical triad of akinesia, rigidity, and postural instability. Parkinson’s disease is the most common cause of Parkinsonism, but not eveyone with Parkinsonism has Parkinson’s disease.
Common diseases with chorea?
Hemi-ballismus, essential chorea, Huntington’s, post streptococcal (autoimmune)
What is the MOA of carbidopa? Why is it used?
Prevents peripheral conversion of levodopa to dopamine through inhibiton of dopamine decarboxylase (DDC)
Usage increases the amount of levodopa (1% -> 5-10%) that crosses the BBB
What is the MOA of MAO-B inhibitors?
Irreversible inhibitor of monoamine oxidase, type b (MAO-B) resulting in decreased formation of free radicals derived from oxidative metabolism of dopamine
What are tics? What are the two common dz’s with tics?
Suppressible and with an urge to move; Tourette’s syndrome and Adult onset Tic disorder
What are the two COMT inhibitors?
Entacapone and tolcapone
How are Parkinsonism and akinetic rigid syndrome related to one another?
They are synonymous
What are the names of the two MAO-B inhibitors
Selegiline and Rasagiline
