Drugs used in Parkinsonism

Question 1

Neurodegenerative disease caused by degeneration of dopaminergic neurons in the substantia nigra

Answer 1

Parkinson disease

Question 2

Primary signs of Parkinson disease

Answer 2

PD is a TRAP!
Tremor
Rigidity
Akinesia
Postural instability

Question 3

Occurence of reversible Parkinsonian symptoms in patients w/ ff. drugs: typical antipsychotics, Reserpine, MPTP (methylphenyltetrahydropyridine)

Answer 3

Drug-induced Parkinsonism

Si Sandara PARK ay may dalang DRUGS sa MRT
MPTP
Reserpine
Typical antipsychotics

Question 4

Antiparkinsonism drug/dopamine precursor used in PD which may cause WEARING-OFF PHENOMENA and is contraindicated in pxs with history of SCHIZOPHRENIA or psychosis

AE: DYSKINESIA (choreoathetosis), behavioral changes, postural hypotension, emesis

Answer 4

Levodopa

may result to HYPERTENSIVE CRISIS if used with MAO inhibitors

Question 5

Parkinsonian phenomena

Answer 5

On-off phenomena - alternating periods of imroved mobility and akinesia

Wearing-off phenomena - deterioration of drug effect in between medication doses, d/t progressive destruction of nigrostriatal neurons

Question 6

Antiparkinsonism drug/dopamine agonist used in PD, LEVODOPA INTOLERANCE and HYPERPROLACTINOMA

AE: ERYTHROMELALGIA, PULMO FIBROSIS, dyskinesia (choreoathetosis), behavioral changes, postural hypotension, emesis

Answer 6

Bromocriptine

SimD: Pergolide

BRomocriptine: BReast milk production -> hyperPROLACTINoma

Question 7

Antiparkinsonism drug/dopamine agonist used in PD, RESTLESS LEGS SYNDROME

AE: HYPERSEXUALITY, COMPULSIVE GAMBLING, OVEREATING, SLEEPINESS, dyskinesia (choreoathetosis), behavioral changes, postural hypotension, emesis

Answer 7

Pramipirole

SimD: Ropinirole

PRIAmipirole: Pramipirole -> Priapism -> hypersexuality

Question 8

Antiparkinsonism drug/dopamine agonist used in OFF-PERIODS OF PD, ALCOHOLISM, OPIATE ADDICTION, ED, AD

AE: SEVERE NAUSEA, dyskinesia (choreoathetosis), hypotension

Answer 8

Apomorphine

premedicate with Trimethobenzamide to prevent severe nausea

Question 9

Antiparkinsonism drug/MAO Type B inhibitor used in PD which may cause SEROTONIN SYNDROME if used w/ SSRI and causes agitation, delirium and death (FATAL REACTION) if used with Meperidine

Answer 9

Selegiline

SimD: Rasagline

SELEgline loves to SELEbrate -> SErotonin syndrome

Question 10

Antiparkinsonism drug/COMT inhibitor used in PD (WEARING-OFF PHENOMENA) which may cause ORANGE URINE, HEPATOTOXICITY and NEUROMALIGNANT SYNDROME, also Rhabdomyolysis

Answer 10

Entacapone