Movement Disorders

Question 1

L-Dopa (levodopa)

Answer 1

Dopamine replacement therapy

Often combined with carbidopa + entacapone

Question 2

Dental effect of L-Dopa and entacapone

Answer 2

Interaction with epi - tachycardia, arrhythmia, hypertension

Question 3

Most common medication for Parkinson’s

Answer 3

Ropinirole

Question 4

Ropinirole

Answer 4

Dopamine receptor agonist by mimicking dopamine

Question 5

Selegiline

Answer 5

MAOB
Interactions with epi and narcotics (meperidine)
–> hypertension, tachycardia

Question 6

Rasigiline

Answer 6

MAOB

Interaction with narcotics like meperidine –> hypertension and tachycardia

Question 7

Amantadine

Answer 7

Enhanced release of dopamine
Usually with younger patients
Short effective period (~6 months) then switch

Question 8

Classes of movement disorder repair

Answer 8

1. replace dopamine
2. dopamine receptor agonists
3. block dopamine breakdown: MAOB
4. enhance dopamine release
5. muscarinic antagonists

Question 9

Benztropine

Trihexyphenidyl

Answer 9

Anti-cholinergic aka muscarinic antagonists

Question 10

3 dental tx considerations

Answer 10

1. orthostatic hypotension
2. early am appt ~90 minuses after L-DOPA
3. cognitive decline