Drugs For Parkinsons Disease (24)

Question 1

Parkinsons disease affects

Answer 1

Dopamine producing neurons in the brain

Question 2

Symptoms of Parkinson’s are caused by

Answer 2

An imbalance of dopamine and acetylcholine

Question 3

Dopamine vs ACh in Parkinson’s

Answer 3

Dopamine: inhibitory

ACh: excitatory

Question 4

Direct vs indirect drugs affecting the dopamine system

Answer 4

Direct: dopamine receptor agonists

Indirect: levodopa-carbidopa selegiline amantidine

Question 5

Precursor to dopamine

Answer 5

Levodopa

Question 6

MAOI prevents

Answer 6

DA metabolism

Question 7

Anticholingeric agents example

Answer 7

Benztropine

Question 8

BBB does not allow

Answer 8

Exoganeously supplied dopamine to enter, but it does allow levodopa

Question 9

Levodopa is taken up by

Answer 9

Dopaminergic terminal and converted into dopamine and then released

Question 10

Levodopa therapy is aimed at

Answer 10

Increasing dopamine release form surviving DA neurones

Question 11

Levodopa therapy maintains function mobility for

Answer 11

Years
-prolongs quality of life and expectancy

Question 12

How long does it take for full therapeutic response

Answer 12

Several months

Question 13

Therapy for Parkinson’s does not

Answer 13

Cure or stop progression of disease

Question 14

As PD progresses

Answer 14

It becomes more and more difficult to control symptoms with levodopa

Question 15

Where is levodopa metabolized outside of CNS

Answer 15

GI and liver

Question 16

Combination therapy with levodopa therapy

Answer 16

Carbidopa

Question 17

Why is carbidopa given if it Cant cross the BBB?

Answer 17

Prevents levodopa breakdown in the periphery

Question 18

Levodopa can also be metabolized by COMT, how does one stop this

Answer 18

Use COMT inhibitors

Question 19

Example of COMT inhibitors

Answer 19

Entacapone

Question 20

Entacapone

Answer 20

Inhibits COMT
-more levodopa available to enter brain
-used to reduce on-off phenomenon

Question 21

Wearing off effect of levodopa therapy

Answer 21

Gradual loss
-subtherapeutic levels near end of dosing interval

Question 22

On off phenomenon

Answer 22

Abrupt loss of drug effect even at high drug levels
-lasts from minutes to hours
-unknown reason

Question 23

AE of levodopa

Answer 23

-nausea and vomiting
-dyskinesia
-CV
-psychosis

Question 24

Dyskinesia as AE of levodopa

Answer 24

Involuntary muscle movements
-oral, facial muscle, writhering and flinging movement of arms and legs

Question 25

Dopaminergic therapy

Answer 25

Prevents DA metabolism -MAO B inhibitor -inhibiting DA breakdown in neurones

Question 26

MAO-B inhibitor

Answer 26

Selegiline

Question 27

Amantadine

Answer 27

Promotes DA release from nerve endings

Question 28

selegiline

Answer 28

Irreversible MAOI that selectively inhibits MAO-B

Question 29

Selegiline is a

Answer 29

MAO-B inhibitor

Question 30

Selegiline causes an increase

Answer 30

In the levels of dopaminergic stimulation in the CNS

Question 31

Selegiline indications

Answer 31

Milder symptoms or earlier

Question 32

Selegiline has a ___ agent and it is helpful

Answer 32

Adjunctive agent, helping response to levodopa flucting on-off

Question 33

AE of Selegiline

Answer 33

Mild: nausea, abdominal pain, dry mouth, lightheaded mess, dizziness, insomnia,

Question 34

Indirect dopaminergic therapy: amantadine

Answer 34

Release of dopamine from the storage sites at the end of nerve cells that are still intact

Question 35

Indirect dopaminergic therapy: amantadine also blocks

Answer 35

The reputable of dopamine into the nerve endings

Question 36

Indirect dopaminergic therapy: amantadine does not

Answer 36

Stimulate dopamine receptors directly

Question 37

Indirect dopaminergic therapy: amantadine may help with

Answer 37

Levodopa induced dyskinesias

Question 38

Direct acting dopaminergic therapy

Answer 38

DA receptor agonists -directly stimulate dopamine receptors

Question 39

What is the first line treatment for PD in younger patients, mild/moderate symptoms, reduce wearing off effect, less effective than levodopa

Answer 39

Dopaminergic therapy

Question 40

Anticholingeric drugs do not relieve

Answer 40

Bradykinesia