levodopa for parkinson's/seizure stuff -

Question 1

What is the most effective drug for Parkinson’s disease (PD)?

Answer 1

Levodopa/Carbidopa

Question 2

What is the “wearing-off” effect in PD treatment?

Answer 2

A gradual loss of medication effectiveness before the next dose is due.

Question 3

What should be questioned if a patient receives dopamine but shows no response?

Answer 3

Whether the patient truly has Parkinson’s disease.

Question 4

What are the adverse effects of Levodopa/Carbidopa?

Answer 4

Nausea, vomiting, drowsiness (dose-dependent).

Question 5

How does Pyridoxine (Vitamin B6) affect Levodopa?

Answer 5

It converts levodopa to dopamine.

Question 6

Should patients change their Vitamin B6 intake while taking Levodopa?

Answer 6

No, they should maintain a consistent intake.

Question 7

Why should protein intake be spaced out with Levodopa?

Answer 7

Protein can block the absorption of Carbidopa.

Question 8

What is Carbidopa’s role in Levodopa therapy?

Answer 8

It prevents the breakdown of dopamine so it remains in the system longer.

Question 9

What are signs of dyskinesias caused by Levodopa?

Answer 9

Head bobbing, tics, grimacing, tremors.

Question 10

What cardiovascular effects can Levodopa cause?

Answer 10

Beta-1 stimulation leading to tachycardia, palpitations, and irregular heart rate.

Question 11

What psychiatric effects can Levodopa cause?

Answer 11

Visual hallucinations, nightmares, paranoid ideation (psychosis).

Question 12

What is a unique discoloration side effect of Levodopa?

Answer 12

Darkening of sweat and urine.

Question 13

What skin condition must be assessed before prescribing Levodopa?

Answer 13

Malignant melanoma history.

Question 14

What impulse control issues can Levodopa cause?

Answer 14

Gambling, binge eating, hypersexuality, alcohol abuse.

Question 15

How can nausea/vomiting from Levodopa be managed?

Answer 15

Take with a small, non-protein snack.

Question 16

Why should Levodopa not be discontinued abruptly?

Answer 16

Risk of severe withdrawal effects and worsening symptoms.

Question 17

What serious sleep-related adverse effect can dopamine agonists cause?

Answer 17

Sudden sleep attacks.

Question 18

What are other adverse effects of dopamine agonists?

Answer 18

Daytime drowsiness, orthostatic hypotension, psychosis, impulse control issues, dyskinesias, nausea.

Question 19

What adverse effect is unique to Selegiline?

Answer 19

Insomnia.

Question 20

What foods should be avoided with MAO-B inhibitors?

Answer 20

Tyramine-rich foods: avocados, soybeans, figs, smoked meats, dried/cured fish, cheese, yeast products, beer, red wine, chocolate, caffeine.

Question 21

What are anticholinergic (atropine-like) effects?

Answer 21

Blurred vision, mydriasis, urinary retention, dry mouth, constipation.

Question 22

What antihistamine effects do anticholinergics have?

Answer 22

Sedation, drowsiness.

Question 23

What skin discoloration is caused by Amantadine?

Answer 23

Livedo reticularis (mottled skin discoloration, cosmetic only).

Question 24

What GI effects do COMT inhibitors cause?

Answer 24

Vomiting, diarrhea, constipation.

Question 25

What is a notable discoloration side effect of COMT inhibitors?

Answer 25

Yellow-orange urine.

Question 26

What serious adverse effect can COMT inhibitors cause?

Answer 26

Rhabdomyolysis (muscle pain, tendon weakness) and liver failure.

Question 27

What is Alzheimer’s disease?

Answer 27

A chronic, progressive neurodegenerative disorder characterized by irreversible cerebral impairment.

Question 28

What is the life expectancy of Alzheimer’s disease?

Answer 28

4-8 years (can last up to 10 years).

Question 29

What neurotransmitter is decreased in Alzheimer’s?

Answer 29

Acetylcholine (ACh).

Question 30

What are the hallmark features of Alzheimer’s pathology?

Answer 30

Neurofibrillary tangles, senile plaques, neuronal loss, brain atrophy.

Question 31

How effective are cholinesterase inhibitors?

Answer 31

Marginally effective (similar to losing only ½ pound on a weight loss pill in 6 months).

Question 32

What are adverse effects of cholinesterase inhibitors?

Answer 32

Increased GI motility & secretions, diaphoresis, bradycardia, urinary urgency (cholinergic effects).

Question 33

What is a cholinergic crisis?

Answer 33

DUMBBBELS: Diarrhea/Diaphoresis, Urination, Miosis, Bradycardia, Bronchospasm, Bronchorrhea, Emesis, Lacrimation, Salivation.

Question 34

How is a cholinergic crisis managed?

Answer 34

Mechanical ventilation, oxygen, atropine.

Question 35

What are contraindications for cholinesterase inhibitors?

Answer 35

Neuromuscular blockers (i.e. succinylcholine), renal/GI obstruction, seizures, PUD, asthma, bradycardia, hypotension.

Question 36

What are the adverse effects of Memantine?

Answer 36

Dizziness, headache, confusion, constipation (better tolerated than cholinesterase inhibitors).

Question 37

What is epilepsy?

Answer 37

A neurological disorder involving repeated seizures due to abnormal neuronal discharges.

Question 38

Why should antiepileptics never be stopped abruptly?

Answer 38

Can cause withdrawal seizures.

Question 39

What are the primary treatment goals for epilepsy?

Answer 39

Suppress neuron discharges and prevent abnormal focus from forming or spreading.

Question 40

What therapeutic considerations are important for epilepsy?

Answer 40

Monitor drug levels, promote adherence, manage withdrawal, assess suicide risk.

Question 41

What are other treatments for epilepsy besides medication?

Answer 41

Neurosurgery, vagal nerve stimulation, deep brain stimulation.