Exam 2; Parkinson's Flashcards
What causes Parkinsons
dopamine deficiency in the CNS
What are five major symptoms of Parkinson’s
tremor in the hand and facial muscles muscle rigidity bradykinesia akinesia loss of cognitive function
What will result in the death of someone with Parkinson’s
lack of swallowing; aspiration pneumonia
pulmonary embolism due to loss of movement
DOPA (dihydroxyphenylalanine) is converted to DA is via what enzyme
DOPA decarboxylase
The enzyme that converts DA to NE is what
dopamine hydroxylase
What are DOPA and DA metabolized by
MAO
COMT
These are selective inhibitors of MAO; found only in the CNS; slowing the progression of the symptoms of Parkinson’s
selegiline
rasagiline
What is selegiline metabolized to in the body
methamphetamine
rasagiline is not metabolized to this
This is a pro-drug precursor to dopamine that is used because dopamine itself cannot penetrate the blood-brain barrier and enter the CNS
L-DOPA (levoDOPA)
Why is DOPA not just given as a drug to treat Parkinson’s
DOPA is metabolized in the gut by DOPA decarboxylase to DA, therefore DOPA is not getting into the CNS
DOPA is given along with what other thing and why
DOPA decarboxylase
this allows the DOPA to survive long enough to get into the CNS, allowing DOPA to be converted to dopamine and inducing the effect
DOPA plus DOPA decarboxylase is known as what drug
carbi-DOPA
What are the six side effects of carbi-DOPA
nausea postural hypotension hallucinations confusion dyskinesias (uncontrolled movements) worsens closed angle glaucoma
For how long is carbi-DOPA effective for
5 years; due to the loss of endogenous DA
What will the sudden discontinuation of L-DOPA plus carbidopa result in
neuroeptic malignant syndrome
muscle rigidity and high fever
What are two COMT inhibitors
tolcapone
entacapone
True or False
COMT inhibitors are more significant than MAO
False; they are not, they do enhance the duration of action of DA
What are COMT inhibitors used with
L-DOPA
These act directly on the DA receptors, but are not as effective as L-DOPA
dopamine agonisits
This stimulated dopamine-2 receptors
bromocryptine
What are three side effects of bromocryptine
nausea
hallucinations
hypotension
These two drugs are DA agonsits that have been used to treat RLS
pramipexole
ropinirole
This is a DA agonist in patch form
rotgotine
This DA agonist is given by injection and causes severe nausea
apomorphine
What are the four symptoms of DA agonists
nausea
hypotension
confusion
sudden sleep syndrome
DA agonists can have this symptom similar to someone with bi-polar disorder
lack of impulse control; may uncharacteristically go out and buy stuff, compulsive gambling, hypersexuality
These decrease the imbalance between DA and ACh that occurs during Parkinson’s
anticholinergics
Parkinson’s = deficiency in dopamine = activated cholinergic receptors
What are the three anticholinergics used to treat Parkinson’s
trihexyphenidyl
benztropine
amantadine
This anticholinergic is a muscarinic blocker
benzotropine
What are four symptoms of benzotropine
anti-muscarinic effects; (mad as a hatter, etc.) dry mouth urinary retention blurred vision memory loss and hallucinations
This anticholinergic is also used as an anti-viral; it increases the release of stored dopamine from nerve endings
amantadine
What are two side effects of amantadine
insomnia
restlessness
What are three alternate treatments for Parkinson’s
surgery
deep brain stimulation
tissue/stem cell transplantation
