Antiparkinsonians

Question 1

What is the first line treatment in an older adult with Parkinson’s disease significantly affecting quality of life?

Answer 1

Dopamine precursor (L-Dopa) with decarboxylase inhibitor -
Co-Careldopa (Levodopa + Carbidopa)
aka Sinemet

Question 2

Precursor of dopamine?

Answer 2

Levodopa

Question 3

MOA: Dopamine agonist (non-ergot)

Answer 3

Ropinirole

Question 4

MOA: MAO-B inhibitor

Answer 4

Rasagiline

Question 5

MOA: COMT inhibitor

Answer 5

Entacapone

Question 6

Two common side effects of all dopaminergic drugs?

Answer 6

Nausea and postural hypotension

Question 7

Which of the anti-Parkinson drugs causes sleepiness, hallucinations, oedema, fibrosis, and confusion (in addition to nausea and postural hyptension)?

Answer 7

Dopamine agonists such as Ropinirole

Question 8

Excessive and involuntary movements (dyskinesias) are most associated with which Parkinson’s drug?

Answer 8

Levodopa

Question 9

A particular problem with ______________ is the wearing-off effect, where symptoms worsen towards the end of the dosage interval

Answer 9

Levodopa

Question 10

Which anti-emetic should be avoided in patients taking Dopaminergic drugs?

Answer 10

Metoclopromide

Question 11

What drug class should be avoided in patients taking Dopaminergic drugs?

Answer 11

Anti-psychotics

Question 12

Treatment of early PD with little impact on quality of life?

Answer 12

Levodopa
Non-ergot dopamine agonist (Ropinirole) or
MAO-B inhibitor (Rasagiline)

Question 13

Treatment of early PD with significant impact on QoL?

Answer 13

Levodopa

Question 14

Adjunctive treatment for PD?

Answer 14

Dopamine agonist (Ropinirole)
MAO-B inhibitor (Rasagiline)
COMT inhibitor- Entacapone

Question 15

Treatment recommendation for dyskinesia?

Answer 15

Amantadine

Question 16

Treatment of postural hypotension?

Answer 16

Fludrocortisone

Question 17

How long does it take for Levodopa to reach full effect?

Answer 17

12 weeks