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Pcol Finals > Mock Test for Parkinson's diseases > Flashcards

Mock Test for Parkinson's diseases Flashcards

1
Q

a slowly progressive degenerative neurological disorder, characterized by tremors, muscular rigidity, bradykinesia, and postural and gait abnormalities

A

Parkinson’s Disease
Idiopathic Parkinsonism
Primary parkinsonism
Paralysis Agitans

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2
Q

the cause is unknown while the treatment may be palliative the disease incurable.

most patient suffer from this type of parkinsonism

hypothesis of neuronal loss might be cause by toxins and exposure to free radicals

aka: Classic Parkinson’s Disease of Paralysis Agitans

A

Primary Parkinson’s Disease (Idiopathic)

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3
Q

may cause by the drugs, including Dopamine antagonist such as Phenothiazines, Butyrophenones and Reserpine

Caused by poisoning from chemicals or toxins such as CO heavy metals and MPTP

May be cause by the atherosclerosis, degenerative diseases of the CNS and Metabolic disorder

from a known cause

A

Secondary Parkinson’s Disease

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4
Q

many other motor symptoms may occur.

Non- motor symptoms:
cognitive changes
depression, anxiety, apathy, irritability
hallucination and delusions
sleeping problems
swallowing, chewins, speaking difficulty
unrinary or constipation problems

A

Parkinson’s Disease (PD)

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5
Q

IPD means

A

idiopathic Parkinson’s disease

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6
Q

other symptoms occurs, not generally present in PD, and vary based on the specific form of the Parkinson’s plus syndrome.

6 common forms are:
Multiple system atrophy (MSA)
Progressive supranuclear palsy (PSP)
Cortibasal syndrome (CBS)
Dementias w/ Lewy bodies (DLB)
drug- induced parkinsonism
vascular parkinsonism (VP)

also referred to as “atypical parkinonism or parkinson’s plus syndrome”

A

Parkinsonism

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7
Q

deplete biogenic monoamines from their storage sites

theses drugs may therefore produce a parkinsonian syndrome usually 3 within 3 months after introduction

Drug- induced parkinsonism

A

Reserpine / Tetrabenzine

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8
Q

______ and the ____ block dopamine receptors

A

Haloperidol and phenothiazine

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9
Q

sign and symptoms of PD “TRAP: means

A

Tremor
Rigidity
Akinesia
Postural difficulties

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10
Q

Inc. of Ach, most evident at rest and w/ low frequency movement
aka Pill- Rolling _____

A

Tremor

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11
Q

detected when arm responds w/ rachet-like movement when the limb moved passively

A

Limb Rigidity

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12
Q

difficulty in initiating movements: Slowness in performing common voluntary movements

A

Akinesia/ Bradykinesia

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13
Q

patient walk w/ a stopped, flexed posture

A

Gait and Postural difficulties

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14
Q

depression 50%, dementia 25% and psychosis

A

changes in mental status

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15
Q

stages of pd: no clinical signs evident

A

stages 0

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16
Q

stages of pd: unilateral movements

A

stage 1

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17
Q

stages of pd: bilateral involvement but no postural abnormalities

A

stage 2

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18
Q

stages of pd: Mild to moderate bilateral disease

A

stage 3

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19
Q

stages of pd: bilateral involvement w/ postural instability

A

stage 4

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20
Q

stages of pd: severe diseases

A

stage 5

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21
Q

precursor of dopamine agonists

A

Levodopa and carbidopa

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22
Q

Direct acting Dopamine agonist :Ergot derivative

A

Bromocriptine, pergolide

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23
Q

Direct acting Dopamine agonist: Non-Ergot derivative

A

Pramipexole / ropinirole

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24
Q

COMT inhibitors

A

Tolcapone and Entacapone

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25
Q

COMT means

A

catechol- o- methyltransferase

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26
Q

indirect- acting Dopamine agonists: Dopamine releaser

A

Amantadine

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27
Q

indirect- acting Dopamine agonists: monoamine oxidase inhibitors

A

Selegiline

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28
Q

Anticholinergics/ antimuscarinics

A

Benztropine, biperiden, trihexyphenidyl, orphenadine and procyclidine

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29
Q

Moa: L-dopa is converted to Dopamine by dopa decarboxylase thereby inc the CNS levels of DA in the brain carbidopa inh metabolism of L-dopa thereby inc level of DA in the CNS

A

Carbidopa Levodopa (sinemet)

30
Q

Carbidopa Levodopa (sinemet) ADR:

A

Gi: Anorexia , N/V, adominal pain
CV: postural hypotension and tachycardia
musculoskeletal: dyskinesia/ Choreiform movement
CNS: depression , fluctuation in response
Hematologicals: Anemia
others: Mydriasis, glaucoma, hot flushes, gout, agranulocytosis, wearing off reaction

31
Q

drug interaction: may inc efficacy of levodopa

A

Amantadine, benztropine, procyclidine, trihexyphenidyl

32
Q

drug interaction: inc peripheral breakdown of L-dopa

A

Pyridoxine

33
Q

drug interaction: Hypertension crisis

A

L-dopa + Phenelzine

34
Q

drug interaction: block dopamine receptor /parkinsonian receptor

A

antipsychotic drugs

35
Q

used in hyperprolactinemia
moa: partial D2 agonist and adjunct to L-dopa

A

Bromocriptine (Parlodel)

36
Q

Bromocriptine (Parlodel) ADR:

A

1st dose phenomenon
dizziness
drowsiness
fainting
cardiac arrhythmias
postural hypotension
tachycardia

37
Q

moa: stimulate d1 & d2 receptors
more effective than bromocriptine (1000x)
inh secretion of prolactine, inc serum conc of GH, dec. the serum conc of LH
used as adjunct treatment to L-dopa and C-dopa

A

Pergolide(Permax)

38
Q

Pergolide(Permax) ADR:

A

Hypersensitivity

39
Q

moa: d3 receptor agonist
used as monotherapy for mild parkinsonism
helpful in patient w/ adverse disease permitting dec. of dose of L-dopa
Has ability to scanvenge H2O2 and inc neuropathic activity in mesencephalic dopamine cell

A

Pramipexole (mirapex)

40
Q

Pramipexole (mirapex) ADR:

A

Symptomatic hypotension & constipation

41
Q

Moa: d2 agonist
monotherapy in patient w/ mild disease and as a means od smoothing the response to L- dopa

A

Ropinirole (requip)

42
Q

Ropinirole (requip) ADR:

A

Syncope
bradycardia
dizziness
somnolence
symptomatic hypotension
hallucinations
Headache
Fatigue

43
Q

Moa: Da agonist
temporary relief of “off-periods” of akinesia

A

Apomorphine (apokyn)

44
Q

Apomorphine (apokyn) ADR:

A

severe nausea
dyskinesia
hypotension
drowsiness
sweating

45
Q

moa: selective , reversible inh
used as adjunct to l-dopa /c-dopa therapy
inh comt peripherally and centrally
prolong action of l-dopa
improve response and prolonging “on time”
result in doubling of the elimination t 1/2 of l-dopa and inc oral BA of L-dopa (40-50%)

A

Tolcapone (tasmar)

46
Q

Tolcapone (tasmar) ADR:

A

Liver failure, hyperpyrexia and confusion

47
Q

moa: slective and reversible inh of comt only in peripherally
improves duration of “on time” and dec” off time”

A

Entacapone (Comtan)

48
Q

Entacapone (Comtan) ADR

A

rapid with drawal; causes hyperpyrexia and confusion

49
Q

moa: mao B inh (DA)
mao a inh (high doses) (ne, 5-ht, DA)
more potent than selegiline in preventing MPTP- induced parkinsonism
neuroprotective agent

A

Rasagiline (azlect)

50
Q

Rasagiline (azlect) ADR:

A

Flu syndrome, arthralgia, depression & dyspepsia

51
Q

moa: selective inh of Mao B b
retards breakdown of DA
enhance & prolong fix of L-dopa
MAO-a INH (high dose)
Used as adjunctive therapy for patient w/ declining response to L-dopa/C-dopa
reduce” end of dose” or “ on- off” fluctuation in response

A

Selegiline (selegos)

52
Q

Selegiline (selegos) ADR:

A

HTN crisis & inc l-dopa side effect

53
Q

inc Da level at the postsynaptic receptor sites by dec reuptake & enhance Da synthesis & releases
anti viral agent
anticholinergic effect
decreases TRAP Symptoms
given in combi w/ l-dopa

A

amantidine

54
Q

amantidine ADR:

A

livedo reticularis (netlike rashes)

55
Q

contraindication of amantidine

A

seizures and heart failure

56
Q

blocks the excitatory neurotransmitter cholinergic influence in the basal ganglia
more effective for tremor/rigidity
used for mild symptoms tremors
less effective for bradykinesia & less effective for postural imbalance

A

anticholinergics

57
Q

may be alleviated by b- blocker including ___ but caution w/ CHF, asthma, diabetes & hypoglycemia

A

Propranolol

58
Q

__ has been used w/patientt w/ concomitant pulmonary diseases

A

Metoprolol

59
Q

types of tremor: normal phenomenon, enhanced amplitude by anxiety, fatigue, thyrotoxicosis and iv epi

A

Physiologic postural tremor

60
Q

types of tremor: A postural tremor. sometimes familial

A

essential tremor

61
Q

types of tremor: present during movement

A

intention tremor

62
Q

types of tremor: due to parkinsonism

A

Rest tremor

63
Q

an inherited disorder characterized by progressive chorea and dementia that begins at adulthood
related to imbalance of DA, ACH, GABA & perhaps other neurotransmitter in the basal ganglia

A

Huntington’s Disease

64
Q

a continuous stream of slow, sinuous writhing movements, typically of the hands and feet

it is said to caused damage by corpus striatum of brain

movements typical to ___ isa called athetoid movements

64
Q

unpleasant creeping discomfort in the limbs that occurs particularly when the patient is at rest

more common in pregnant women, uremic & diabetic patients

opioid analgesics & BZD are also used for treatment

A

Restless legs syndrome

65
Q

Dopaminergic therapy is the preferred treatment & ___, a long-acting drug for restless legs syndrome

A

ropinirole

66
Q

inherited disorder of copper metabolism results in deposition of copper salts in the liver and other tissues

A

Wilson’s Diseases

67
Q

Violent movements of the limbs , as in chorea, sometimes affecting only one side of the body

68
Q

unknown cause that frequently responds to haloperidol and other dopamine D2 receptor blockers pimozide.

A

Tourette’s syndrome

69
Q

treatment for Hutington’s disease

A

haloperidol, tetrabenazine

70
Q

treatment for wilson’s disease

A

chelating agent , D penicillamine, trientine

Pcol Finals (5 decks)

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