Movement Disorders

Question 1

Dopamine replacement short term SE

Answer 1

N&V at start constipation orthostatic hypo

Question 2

Dop replacement long term

Answer 2

wearing off phenomenon durg induced dyskinesia

Question 3

Dopamine agonists - 2 ergot deriavatives and SE

Answer 3

cabergoline bromicriptine SE: CVS, valve damage, fibrosis

Question 4

Dopamine agonists 2- non-ergot derivatives

Answer 4

pramipexole, rotigotine patch

Question 5

Dop agonist SE

Answer 5

Pathological gambling, shopping, eating, sexual activities

Question 6

1 MAO-B inh + 2 SE

Answer 6

Selegilline insomnia, neuropsych

Question 7

1 COMT inh + 1 SE

Answer 7

entacapone Diarrhoea

Question 8

rx for tremor alone

Answer 8

amantadine (anticholinergic)

Question 9

5 strategies for wearing off

and their mechanism

Answer 9

1. smaller but more frequent dosage, more constant level
2. CR levodopa, more constant levels
3. Combine levodopa with dopamine agonist, increase effect
4. catechol-o-methly-transferase inhibitor (entacapone), reduced breakdown in peripheries
5. MAO-B inhibitor selegiline, reduced breakdown in CNS