Parkinson

Question 1

Drug list mnemonic

Answer 1

Levocarp Apes seem Amazed peripexol Bring Benzo, Entacapone!

Levo/carpidopa, apomorphine, Amantadine, peripexol, Bromocriptine, Bezotropine, Entacapone

Question 2

why we reserve L-dopa Till Symptoms become Trouble Some, although it’s the most effective drug in parkinson?

Answer 2

It’s The most effective as it improves all Signs and Symptoms brady kinesia but after Few years benefits decrease due to gradual neural degradation.

Question 3

Mention adverse effects of L-dopa.

Answer 3

1- Nausea , Vomiting
2- Hypotension arrythmia
3- Flauctuation in.Response
..on/off effect
..wearing off / End close Akinesia
4- DysKinesia choreathetosis.
5- pshycosis

Question 4

Drug used to Solve on/off effect of L-dopa… Mechanism?

Answer 4

(1) Entacapone COMT inhibitor

(2) Apo Morphine (Sc) D₂ Agonist

Question 5

Drug used to solve End of dose
Akinesia…. mechanism

Answer 5

(1) Selegiline

MAOB inhibitor

(2) Apomorphine resue

D2 Agonist

Question 6

Don’t Take Vit B6 with L-dopa!

why?

Answer 6

↑ periphral advese effect (vommiting, diarrhea, Nausea Hypotension, arrythmia)
as
Increase peripheral metabolism of L-dopa to dopamine

Question 7

How To decrease periphral adverse effects of L-dopa.

Answer 7

use

Dompeidone (Dz Agonist) → block CTZ →↓ vomiting, Nausea

• doesn’t interfere with Central L dopa Can’t Cross BBB

2 Don’t use Vit B6 with L-dopa

Question 8

Advantage of (L-dopa / carbidopa)

Answer 8

1- Decrease daily dose of Ldopa by75%

2- decrease periphral side effect

3- Improve signs and symptoms Rapidly.

Question 9

Adverse effect of Apo Morphine

Answer 9

Severe Vomiting →

require pre, post antiemetic

Question 10

Selegiline

1- Mechanism of action

2- indications.

Answer 10

1- Selegiline is MAO B inhibitor.

2- decrease Breakdown of dopamine
End of dose Akinesia

Question 11

Selegiline Adverse effects

Answer 11

Hallucination
Dyskinesia
Insomnia
Low risk cheese reaction

Question 12

Amantadine Mechanism and indications.

Answer 12

1- Block NAMDA receptors ↑ Dp Release

2- as parkinson drug therapy

Question 13

Amantadin Adverse effect.

Answer 13

1- Ankle edema
2- Livido Reticularis
3- Hallucination
4- dyskinesia

Easy Tolerated /Fast

Question 14

Pramipexole
Mechanism And Adverse effects

Answer 14

1- Non ergort D2 Agonist.

Adverse
1-Day time sleepiness
2- impulse control disorder
3- Hallucination, Hypotension

Question 15

Bromocriptine

Adverse effect
Mechanism

Answer 15

D2 Agonist ergot

Adverse

1- Fibrosis Cardia Lung

2- Vasospasm

3- Hallucination, Hypotension

Question 16

what Bezotropine best at?

why?

Answer 16

best at (Tremors) than rigidity bradykinesia
As it’s Anticholenergic Central blocker
Restore Ach/ Dp balance

Question 17

How bezotropine interfere with L-dopa ?

Answer 17

delaying its GI absorption.May delay gastric emptying

Question 18

Benzo tropine Adverse effects

Answer 18

same as Atropine Confusion, constipation, dry mouth

elder

1- Hallucination, Demensia

2- Urine Retention (BPH)

Question 19

Drugs used to Treat Dementia induced by parkinson

Answer 19

Rivastigmine

Memantine (NAMD Blocker)

Question 20

Drug choice as antiphysotic as a complication of Parkinson

.

Answer 20

1- clozapine
2-Antidepressant

Question 21

Anti emetic drug choice with Apo morphine

Question 22

Entacapone.
Mechansim shows that it can’t given alone.

Answer 22

It’s COMT inhibitor

L-dopa periphral metabolism To dopamine

on/off effect (best).

✓ wearking off

Question 23

Adverse effects of Entacapone

Answer 23

dizziness.
diarrhea.
Nausea.
movements you cannot control.

drowsiness.