parkinson

Question 1

what is definition of parkinson?

Answer 1

progressive brain disorder that cause unintended or uncontrollable movements

Question 2

what is pathophysiology of parkinson ?

Answer 2

low level of dopamine and increased acetylcholine

Question 3

where is the part of brain that cause parkinson

Answer 3

substantia nigra

Question 4

what is non motor symptoms in parkinson ?

Answer 4

• loss of sense of smell
• drooling
• restless leg problem
• constipation
• mask like facial expression

Question 5

what is motor symptoms in parkinson ?

Answer 5

• rigidity
• postural instability
• tremor
• bradykinesia

Question 6

what is the risk factor of parkinson disease?

Answer 6

• genetics
• exposure to pesticides such as farming
• being male
• increased age

Question 7

how to diagnose parkinson disease?

Answer 7

• diagnose by neurologist based on medical history , view of signs and symptoms, neurological and physical examination.
• develop between 55 and 65 years old

Question 8

what is the complication that may occur ?

Answer 8

• aspiration pneumonia
• bed sores
• falls
• bowel and bladder disorders
• depression

Question 9

what is non pharmacological treatment for parkinson ?

Answer 9

• meditation
• relaxation technique
• physiotherapy
• speech therapy
• surgical treatment

Question 10

what is common drug use in parkinson ?

Answer 10

• levodopa ( dopamine precursor )

Question 11

what is drug that usually combine with levodopa ?

Answer 11

• carbidopa and benserazide
  ( decarboxylase inhibitors)

Question 12

explain what is decarboxylase inhibitors and its function ?

Answer 12

• dopamine cannot cross BBB
• levodopa can cross but is susceptible to conversion into dopamine by decarboxylase enzymes outside the brain
• so decarboxylase inhibitors is used to prevent the conversion
• their function :
  ( increases availability of levodopa in brain so more effective to manage PD )
  ( reduce nausea and vomiting cause by presence of dopamine outside the brain )

Question 13

what is MAOB i drugs and it’s moa ?

Answer 13

• selegiline and rasagiline
• this drug inhibit MAOB enzymes inside the brain that degrade dopamine. so more dopamine available ( may used for early PD or adjuct to levodopa )

Question 14

what is COMT i and it’s moa ?

Answer 14

• entacapone and tolcapone
• this drug inhibit COMT enzymes outside the brain that degrade levodopa . so more levodopa available in brain .

Question 15

what is the side effect of dopamine precursor?

Answer 15

• dizziness
• hypotension
• dry mouth
• sudden sleep

Question 16

what is drug of dopamine agonists?

Answer 16

• bromocriptine
• piribedil
• amantadine

Question 17

what is the side effect of dopamine agonists?

Answer 17

• sudden sleep
• impulse control disorder

Question 18

what is the aim of antiparkinsonian drugs ?

Answer 18

• slow down its progression and improve quality life

Question 19

what if the patient is young patient or early PD ?

Answer 19

• used dopamine agonist or MAOB inhibitor , so can delay need of levodopa treatment. since levodopa is reserved for older patients and severe parkinson disease

Question 20

what is meaning of dyskinesia ?

Answer 20

• unknown mechanism or involuntary muscle movement
• high chance to occur if one have used levodopa for years ( so better to delay the levodopa )

Question 21

is the parkinson drug is safe for pregnancy?

Answer 21

• yes during pregnancy and breastfeeding