Lecture: Parkinson's Disease Flashcards
Parkinson’s disease has ___.
No cure
The drugs used for Parkinson disease help to alleviate symptoms but do not cure the disease
In Parkinsons, the dopamine is low and the acetylcholine is ___.
the same. But w/o inhibition it stays excited.
Therefore drug therapy is geared at raising dopamine or inhibiting acytlcholine.
___ is the most used dopaminergic agent.
Levodopa
It is the most effective drug, but has a wearing-off effect.
Failure of symptom relief with___ in a new diagnosis of Parkinson’s would lead to questioning diagnosis
Levodopa
Adverse Effects of Levodopa
(1) N/V - Food blocks absorption so try to avoid meals, and start with a low dose and increase
(2) Dyskinesias - Treat w/amantadine
(3) CV - orthostatic hypotension
(4) Psychosis
(5) CNS - Anxiety, agitation, insomnia
(6) Lack of impulse control (promiscuity, binge eating, gambling, etc)
(7) Can darken urine
(8) Can activate melanoma
What is the most effective THERAPY for Parkinson’s?
Levodopa/Carbidopa
___ works by enhancing the effects of levodopa. So the dose of Levodopa is able to be lower. However, dyskinesias and psychiatric disturbances are sooner and greater.
Carbidopa
Other dopamine agonists that are less effective than levodopa, but still used as first line drugs are:
pramipexole (gives sleep attacks)
bromocriptine (combined w/levodopa)
COMT inhibitors such as ___ inhibit levodopa metabolism in the periphery which helps it last longer.
entacapone
tolcapone
MAO-B Inhibitors such as ____ are first line therapy.
selegiline and rasagiline
These cause a hypertensive crisis with tyramine foods So no wine, cheese, preserved meats, or chocolate.
___ is used to help manage levodopa dyskinesias.
amantadine
it can cause a netlike pattern of reddish-blue skin discoloration
____ are the most appropriate therapy for younger patients with mild symptoms. They reduce tremor and possibly rigidity (but not bradykinesia)
Centrally acting anticholinergics (Benztropine)
