IC17

Question 1

What is levodopa usually combined with

Answer 1

inhibitor of DOPA decarboxylase;
benserazide/ carbidopa

Question 2

Does dopamine cross BBB?

Answer 2

No

Question 3

Does levodopa cross BBB?

Answer 3

No

Question 4

Purpose of DCI

Answer 4

Prevent peripheral conversion of levodopa to dopamine, thereby reducing side effects

Question 5

How long does dyskinesia develop aft starting levodopa tx?

Answer 5

3-5 yrs later

Question 6

Examples of non-ergot dopamine agonist

Answer 6

Ropinirole & Pramipexole

Question 7

Which MAO-B inhibitor is hepatically metabolised into amphetamines?

Answer 7

Selegiline

Question 8

Examples of MAO-B inhibitors

Answer 8

Selegiline, rasagiline

Question 9

COMT stands for

Answer 9

Catechol-O-Methyl Transferase

Question 10

One of the chemicals a/w neurotoxicity is____

Answer 10

glutamate

Question 11

How does glutamate act on NMDA receptor

Answer 11

glutamate binds & activate NMDA receptor, activating processes that encourage cell death

Question 12

Anti-emetic of choice in PD

Answer 12

Domperidone

Question 13

Example of anticholinergic

Answer 13

trihexyphenidyl

Question 14

Dose of levodopa needed to saturate DOPA-carboxylase

Answer 14

75-100mg daily

Question 15

Levodopa: adverse effects

Answer 15

• N/V, orthostatic hypotension
• drowsiness, sudden onset of sleepiness
• hallucination, psychosis
• dyskinesia

Question 16

Levodopa: DDI

Answer 16

• pyridoxine
• iron
• protein
• dopamine antagonist e.g. metoclopramide, typical antipsychotics, risperidone

Question 17

Example of non-ergot dopamine agonist

Answer 17

ropinirole, pramipexole

Question 18

Ropinirole: metabolism

Answer 18

mainly metabolised by liver, to inactive metabolite

Question 19

Pramipexole: metabolism

Answer 19

excreted largely unchanged in urine

Question 20

Adverse effects for non-ergot dopamine agonist

Answer 20

Peripheral
- N/V, orthostatic hypotension
- leg edema

Central
- hallucination
- drowsiness, daytime sleepiness
- compulsive behaviour

Question 21

Adverse effects for ergot dopamine agonist

Answer 21

• valvular heart disease
• fibrosis

Question 22

Medications that need 2nd dose in afternoon

Answer 22

1. MAO-B inhibitor (selegiline)
2. Amantadine

Question 23

Amantadine: adverse effects

Answer 23

• hallucination, insomnia
• confusion
• nausea
• light-headedness
• livedo reticularis