CNS 1: PD and MS

Question 1

6 major neurotransmitters in CNS

Answer 1

glutamate, norepinephrine, serotonin, acetylcholine, dopamine, GABA

Question 2

Acetylcholine function and clinical relevance

Answer 2

-triggers mus contraction and stimulates the excretion of certain hormones

-Alzheimer’s

Question 3

Dopamine function and clinical relevance

Answer 3

-involved with movement and posture

-PD and dopamine overactivity causes psychosis (Schizophrenia)

Question 4

GABA function and clinical relevance

Answer 4

-inhibitory NT; contributes to motor control and vision; regulates anxiety

-treats epilepsy and Huntington’s disease

Question 5

Glutamate function and clinical relevance

Answer 5

-excitatory NT

-associated w/ AD

Question 6

Norepinephrine function and clinical relevance

Answer 6

-attentiveness, emotions, sleeping, learning; sympathetic actions

-mania and depression

Question 7

Serotonin function and clinical relevance

Answer 7

-regulates body temp, sleep, mood, appetite, and pain

-imbalance = depression, suicide, impulsive behavior, aggressiveness

Question 8

Primary pathological mechanisms and NT associated with PD

Answer 8

loss of nigrostriatal dopamine

loss of dopaminergic neurons presence of Lewy bodies in substantia nigra, reduces activation of motor cortex

Question 9

Clinical symps of PD

Answer 9

TRAP

SOAP
-sleep disturbances, other misc symps (nausea, fatigue, speech, pain, dysesthesias, vision, seborrhea), autonomic symps, psychological symps

MAD
-motor fluctuations, akathisia, dyskinesia

Question 10

5 generic names for PD drugs

Answer 10

-dopamine agonists
-dopamine precursor and related agents
-monoamine oxidase (MAO) inhibitors
-catechol-o-methyl-transferase (COMT) inhibitors
-amantadine

Question 11

5 specific drugs for PD

Answer 11

levodopa, carbidopa, ropinirole, tolcapone, selegiline

Question 12

Levodopa MOA

Answer 12

dopamine precursor

Question 13

Levodopa SE

Answer 13

GI upset, arrhythmias, dyskinesias

Question 14

Carbidopa MOA

Answer 14

Dopa decarboxylase (DDC) inhibitor

Question 15

Carbidopa SE

Answer 15

GI upset, arrhythmias, dyskinesias

Question 16

Ropinirole MOA

Answer 16

Dopamine D2 agonist

Question 17

Ropinirole SE

Answer 17

hallucinations, OH, dyskinesias

Question 18

Tolcapone MOA

Answer 18

Catechol-o-methyl transferase (COMT) inhibition

Question 19

Tolcapone SE

Answer 19

dyskinesias, acute liver failure

Question 20

Selegiline MOA

Answer 20

monoamine oxidase-B (MAO-B)

Question 21

Selegiline SE

Answer 21

serotonin syndrome

Question 22

4 clinical forms of MS

Answer 22

Relapsing-remitting, secondary progressive, primary progressive, progressive relapsing

Question 23

Describe relapsing-remitting

Answer 23

-early 20-30s; women 2:1
-better prognosis
-most will develop secondary progressive MS

Question 24

Describe secondary progressive

Answer 24

could represent different, advanced stage of relapsing-remitting MS

Question 25

Describe primary progressive

Answer 25

-late 30-40s; men as likely as women -worse prognosis: supporting equipment avg 6-7 years

Question 26

Describe progressive relapsing

Answer 26

steadily worsening w/ clear acute relapses w/ or w/o recovery

Question 27

3 key pathological hallmarks of MS

Answer 27

-demyelination causes axonal damage -loss of myelin slows and disrupts signal transmission -repeated damage leads to axonal destruction and permanent loss of function

Question 28

8 disease modifying drugs used for the tx of MS

Answer 28

-avonex -betaseron -copaxone -gilenya -tecfidera -novantrone -ocrevus -tysabri

Question 29

9 drugs used for symptomatic mgt of MS associated symptoms

Answer 29

-amantadine -methylphenidate -baclofen -dantrolene -tizanidine -oxybutynin -prazosin -gabapentin -pregabalin

Question 30

drugs used for tx of acute MS relapses (not sure if the answers are right)

Answer 30

-IV injection of corticosteroids; methylprednisolone -oral prednisone -adrenocorticotropic hormone (ACTH)?

Question 31

Goal for rehab when a pt is on drug holiday

Answer 31

-maintain pt mobility, ROM, CV fitness

Question 32

What type of sessions may be needed for MS pts

Answer 32

shorter and more frequent; accommodate pt's fatigue levels

Question 33

4 common SE of MS drugs

Answer 33

muscle weakness, fatigue, dizziness, heat sensitivity