Anti-parkinsonism

Question 0

disease in decreased dopamine? disease in increased dopamine?

Answer 0

decreased dopa - parkinsons disease

increased dopa - schizophrenia

Question 1

parkinsons disease is also known as?

Answer 1

paralysis agitans

a neurodegenerative disease caused by degeneration of dopaminergic neurons in the substantia nigra

Question 2

what are the primary signs of Parkinson Disease?

Answer 2

remember.. its a TRAP!!
tremors
rigidity
akinesia
postural instability

Question 3

drug induced parkinsonism is a reversible condition caused by?

Answer 3

1. typical antipsychotics
2. reserpine
3. MPTP

Question 4

The drug of choice for Parkinson’s disease and a dopamine precursor drug

Answer 4

levodopa

Question 5

what is the MOA of carbidopa?

Answer 5

inhibits peripheral metabolism via dopa decarboxylase

Question 6

Levodopa is contraindicated in patients with?

Answer 6

history of psychosis

Question 7

complication that can occur when levodopa is used with MAOI

Answer 7

Hypertensive crisis

Question 8

parkinsonian phenomena wherein there is alternating periods of improved mobility and akinesia over a few hours to days during treatment

Answer 8

on-off phenomena

Question 9

parkinsonian phenomena wherein there is deterioration of drug effect in between doses

Answer 9

wearing off phenomena

due to progressive destruction of nigrostriatal neurons with disease progression

Question 10

Examples of dopamine agonists

Answer 10

Partial agonists

1. Bromocriptine - at D2 receptors
2. Pramipexole - at D3 receptors
3. Apomorphine - at D3 receptors; antagonist at 5-HT and alpha adrenoreceptors

Question 11

drug of choice for hyperprolactinemia

Answer 11

bromocriptine

Question 12

unique side effect of bromocriptine

Answer 12

erythromelalgia

pulmonary fibrosis

Question 13

dopamine agonist also used for restless leg syndrome

Answer 13

pramipexole

Question 14

antiparkinson drug used for off-periods of parkinsons disease

Answer 14

apomorphine

Question 15

what drug has side effects such as compulsive gambling, hypersexuality, overeating, uncontrollable tendency to fall asleep?

Answer 15

Pramipexole!!

Question 16

contraindications of pramipexole

Answer 16

active peptic ulcer
psychotic illness
recent myocardial infarction

Question 17

apomorphine has a high propensity for this side effect. premedication of what drug is needed to prevent it.

Answer 17

Severe nausea

prevented by TRIMETHOBENZAMIDE

Question 18

antiparkinson drug - MAO B inhibitor

decreasing degradation if dopamine

Answer 18

Selegiline, rasagiline

Question 19

Selegiline causes agitation, delirium, and death if combined with what drug?

Answer 19

Meperidine

Question 20

COMT inhibitor

Answer 20

entacapone

Question 21

COMT inhibitor that acts both periphery and CNS

Answer 21

Tolcapone

entacapone only works at the periphery

Question 22

entacapone is used at what specific parkinsonian phenomena

Answer 22

wearing-off phenomena

Question 23

unique side effects of entacapone

Answer 23

Orange urine, hepatotoxicity (tolcapone), NMS, rhabdomyolysis

usual SE : dyskinesia, GI distress, postural hypotension

Question 24

A drug that works as antiparkinsonism drug and an antiviral

Answer 24

amantadine

Question 25

a patient with parkinson’s disease has noted mottled, bluish discoloration of extremities. what is the probable drug that caused it?

Answer 25

amantadine

livedo reticularis

Question 26

what drugs can cause livedo reticularis?

Answer 26

remember.. A man reads fHM and GQ
Amantadine
Hydroxyurea
Minocycline
Gemcitabine
Quinidine

Question 27

antiparkinson drug also used for EPS caused by antipsychotics

Answer 27

Benztropine / biperiden (akineton)

Question 28

a condition described as perioral tremors and what is its drug of choice?

Answer 28

Rabbit syndrome

DOC: benztropine

Question 29

what is the mechanism of action of benztropine?

Answer 29

anticholinergic

decrease the excitatory actions of cholinergic neurons in the striatum by blocking MUSCARINIC teceptors