Doctor Carabeo - Drugs for Parkinsonism

Question 1

Pathophysiology of Parkinson’s Disease

Answer 1

REDUCTION of DOPAMINE in the basal ganglia of the brain wherein normal balance of cholinergic and dopaminergic neurons is lost

Question 2

PARKINSON’S DISEASE is common among people between ____ and _____ years old and
men and women are equally affected

Answer 2

45 to 65

Question 3

2 Goals of Therapy for Parkinson’s disease

Answer 3

1. INCREASE activity of DOPAMINE by giving dopaminergics

2. BLOCKING the action of ACETYLCHOLINE by giving anticholinergics

Question 4

Anticholinergics are contraindicated in patients with _____ or with a_________.

Answer 4

narrow angle glaucoma
urinary retention

OVERHEATING may occur in patients taking anticholinergics

Question 5

Elderly patients taking anticholinergic agents may experience paradoxical reactions like _______, _________, _________.

Answer 5

excitement, confusion, irritability

Question 6

DRUG is often STARTED AT LOW DOSE because of the increased sensitivity of the aged patient to these medications.

Answer 6

Levodopa – carbidopa

Question 7

ELDERLY patients taking LEVODOPA are at risk for _____

Answer 7

confusion

Question 8

Matching type
Mechanisms of Action
1.	Amantadine, Entacapone 
2.	Levodopa, Levodopa – Carbidopa 
3.     Bromocriptine, Pergolide, Ropinirole 

a. stimulation of dopamine release (indirect acting):
b. increasing brain levels of dopamine (replacement)
c. direct stimulation of dopaminergic centers (direct acting):

Answer 8

1. stimulation of dopamine release (indirect acting): amantadine,
   entacapone
2. increasing brain levels of dopamine (replacement): levodopa,
   levodopa – carbidopa
3. direct stimulation of dopaminergic centers (direct acting):
   bromocriptine, pergolide, ropinirole

Question 9

Does Levodopa cross blood brain barrier?

Answer 9

Yes (kaya delikado)

Question 10

precuser of Dopamine

Answer 10

Levodopa

Question 11

ONLY available form ng LEVODOPA

Answer 11

Oral form

Question 12

Contraindication of LEVODOPA

Answer 12

1. hypersensitivity
2. narrow – angle glaucoma
3. history of melanoma
4. psychotic patients

Question 13

Drug interaction of LEVODOPA and VITAMIN B6

Answer 13

enhance extracerebral metabolism of levodopa causing decreased levels leading to decreased therapeutic effect

Question 14

LEVODOPA should not be given with this drugs or this condition because of risk of HYPERTENSIVE CRISIS

Answer 14

MAOI or within 2 weeks of discontinuance

Question 15

Drug that prevents peripheral breakdown of levidopa

and limits “on and off” phenomenon.

Answer 15

Carbidopa – Levidopa

Question 16

Which stage of Parkinson’s disease is AMANTIDINE most effective

Answer 16

early stages of Parkinson’s disease

Question 17

Therepeutic use of AMANTIDINE aside from Antiparkinson use

Answer 17

Antiviral (Influenza A)

Letter A
Amantidine

Question 18

3 CONTRAINDICATIONs OF AMANTIDINE

Answer 18

1. hypersensitivity
2. lactating women
3. children below 1 year old

Question 19

Adverse reaction on AMANTIDINE

Answer 19

LIVEDO RETICULARIS, CHF, leukopenia

Question 20

A dopamine AGONIST drug that is used for patients with PARKINSON, ACROMEGALY GALACTORRHEA and AMENORRHEA

Answer 20

BROMOCRIPTINE

Question 21

4 Contraindication of Bromocriptine

Answer 21

hypersensitivity
PREGNANCY
ISCHEMIC HEART DISEASE
UNCONTROLLED HYPERTENSION

Question 22

Drug that is a pure D2 receptor agonist

Answer 22

ROPONIROLE

Question 23

Drug that is recalled in 2008 because of CRYSTAL FORMATION on the patches

Answer 23

ROTIGOTINE - crystal formation

ROPONIROLE - pure D2 receptor agonist
wag malito sa dalawa

Question 24

An ergot derivative drug that directly stimulates D1 and D2 receptors. No longer available because it is associated wth the development of VALVULAR HEART DISEASE

Answer 24

Pergolide

pERGOlide( ERGOT drug)
VALVULAR HEART DISEASE

Question 25

Drug that acts on D3 receptors

Answer 25

Pramipexole D3 Pergolide (D1 and D2 receptors)

Question 26

Drug that is used for DRUG-INDUCED EXTRAPYRAMIDAL REACTIONS and is contraindicated in children less than 3 years old and patient with GLAUCOMA

Answer 26

Benztropine

Question 27

Drug that is a SELECTIVE IRREVERSIBLE INHIBITOR of MAO B. and use for patients with FLUCTUATING RESPONSE to LEVODOPA.

Answer 27

SELEGILINE given with food

Question 28

Drug that is more potent than SELEGILINE

Answer 28

RESAGILINE

Question 29

Combined use LEVODOPA and NON-selective MAOI causes ______

Answer 29

Hypertensive Crisis

Question 30

Drugs that PROLONGS the action of LEVODOPA by DIMINISHING its PERIPHERAL METABOLISM and causes ORANGE discoloration of urine

Answer 30

TOLCAPONE | ENTECAPONE

Question 31

Drug that is effective in TEMPORARY reliefof OFF PERIODS of AKINESIA

Answer 31

APOMORPHINE