Disorders of Movement

Question 1

SE of L-DOPA
CNS
PNS

Answer 1

CNS:

• Dyskinesia (too much movement),
• psychosis,
• reduced prolaction, -compulsive behaviour

Side effects in PNS:

• hypotension,
• nausea (CTZ)

Question 2

Carbidopa

Benserazide

Answer 2

DOPA decarboxylase inhibitor

Question 3

Entacapone

Answer 3

COMT inhibitor (PNS only)

Question 4

Tolcapone

Answer 4

COMT inhibitor (PNS and CNS)

Question 5

Domperidone

why do you use it?

Answer 5

D2 receptor antagonist (PNS only)

you use D2 agonists to inhibit the inhibition of movement (by indirect pathway); but D2 agonists also cause nausea and vomitting due to D2 receptors on CTZ

Question 6

Bromocriptine/Ropinirole

give what with it?

Answer 6

D2 receptor agonist (CNS and PNS)

Domperidone!

Question 7

Benzhexol/Atropine/Benztropine

Answer 7

mAChR antagonist – block actions of Ach in striatum to reduce tremor

Question 8

apomorphine

Answer 8

D1 and D2 receptor agonist

Question 9

what drug to treat huntingtons?

Answer 9

d2 antagonist- to prevent inhibition of indirect pathway

tetrabenazine

Question 10

drug to treat tourettes?

Answer 10

haloperidol