7 Parkinson's

Question 0

Depression is caused by

Answer 0

NA neurone loss in locus corrulus.

Question 1

3 neurological changes in development

Answer 1

Presence of Lewy bodies
Neuronal death in pars compacts of substantia nigra
Loss of pigmented neurone in the brain stem

Question 2

Postural instability, dysphasia and REM sleep disturbance CAUSED BY

Answer 2

degeneration of cholinergic neurones

Question 3

Non motor symptoms 5

Answer 3

Depression
Phycomimetic
Dementia 
Sleep disturbance
Autonomic - symptomatic support for constipation, uriniary retention

Question 4

First line treatment for PD dementia?

Answer 4

Rivastigmine

Question 5

antipsychotic licensed for PD

Answer 5

Clonazepine

Question 6

Tx for depression

Answer 6

MAOB - ropinerole and pramipexadole

Maybe SSRI TCAs depending on pt and interactions

Question 7

Metabolic precursor of dopamine

Answer 7

Levodopa

Question 8

Levodopa is always combined with

Answer 8

Peripheral decarboxylase inhibitor

Reduced GI side effects

Question 9

Duodopa

Answer 9

Soluble levodopa administered via small bowel percunatious route

Question 10

Advantage of Duodopa

Answer 10

Reduces motor fluctuations

Question 11

What might cause impulse control disorders

Answer 11

DA

Question 12

Dopamine agonists

Answer 12

Stimulate pre and post synaptic dopamine receptors

Eg. Ropinerole

Question 13

COMT eg

Answer 13

Entacapone

Question 14

COMT function by

Answer 14

Inhibiting degredation of dopamine

Question 15

Disadvantages of COMT

Answer 15

Dyskinesias

Question 16

Eg of MAOB

Answer 16

Selegaline

Question 17

How MAOB work

Answer 17

Prevent break down of dopamine in the striatum

Delay onset of motor complications

Question 18

Amantadine

Answer 18

Is a NMDA receptor agonist

Induces presynaptic dopamine release

Question 19

Disadvantage of MAOB

Answer 19

Hallucinations

Question 20

Disatvantage of amantide

Answer 20

Toxic confusional state

Question 21

Antichlinergics are used for

Answer 21

Moderate effect in reducing tremor

Question 22

Eg of anti cholinergic

Answer 22

Amitrytiline

Question 23

Apomorphine

Answer 23

Non selective dopamine agonist

Improves dyskinesias

Question 24

What do give for l dopa induced nausea

Answer 24

Domperidone | Also take your l dopa with food ... Later in pd you may need it before food to maximise absorption

Question 25

Pharmacist role in pd meds on ward 7

Answer 25

- stock wide rage of PD meds - visual aids (get it on time wash bag) - start ward rounds with critical meds - pt have option to control own meds - audit - med rec - education

Question 26

PD pt under going operation

Answer 26

- continue oral meds until anaesthetic - place at start if the day for predictability - know the effects of the anaesthetic in the disease - domperidone ins preferable antiemetic - post op, can hey still absorb enteral?

Question 27

What if the pt is missing more than one dose?

Answer 27

Rotigatine patch.

Question 28

Apomorphine given via

Answer 28

Sub cut

Question 29

Swallowing difficulties

Answer 29

Do not omit dose SALT assessment Soluble, crushable, patch forms avail. Monitor for changes

Question 30

Dispersive tabs have....

Answer 30

Faster and shorter duration of action

Question 31

Where is Levo dopa absorebed

Answer 31

The jejunum (care if enteral feed terminates there)

Question 32

What class is rotigatine

Answer 32

DA

Question 33

COMT only work...

Answer 33

With l dopa... They prolong the effect

Question 34

What class is amatidine

Answer 34

Antiviral

Question 35

Dyskinesias are as a result of

Answer 35

Levo dopa, not the disease

Question 36

First line for the youngd

Answer 36

MAOB or DA

Question 37

What do we take in the morning an why?

Answer 37

MAOB like selegaline. | It's an amphetamine so you won't sleep

Question 38

Why is MR not used in the day

Answer 38

Dependent on food so very variable

Question 39

Options for end of l dopa dose

Answer 39

Reduce dose but increase frequency? 8/day if he wants Add a COMT (entacapone) Keep a dispensable madopar on you

Question 40

Apomorphine is for people

Answer 40

Whose control is very bag. Eg 2 hour dosing