Parkinson Disease Flashcards
Main neurotransmitter involved in PD
dopamine (lack of)
When do motor symptoms of PD usually occur
~80% of dopamine-producing cells are damaged
What symptoms can present first? Motor or non-motor?
Non-motor
Motor symptoms
bradykinesia (slow movement)
Shaking and tremor
rigidity
balance trouble
Non-motor symptoms
loss of smell constipation sleep difficulties low mood orthostatis
Brain region involved in PD
substania nigra (brain stem)
Psychiatric condition common in PD
depression
Preferred treatments for depression in PD
TCA’s (secondary amines) –> desipramine, nortriptyline
SSRI (could contribute to tremor)
Drugs that can be used for psychosis in PD
Quetiapine (low risk of movement disorder among APs)
Pimavanserin (Nuplazid) - 5HT2a/2c inverse agonist
Levodopa MOA
precursor of dopamine; replaces dopamine
Carbidopa MOA
inhibits dopa decarboxylase and prevent levodopa from being metabolized
Sinemet CR tablets cannot be cut (t/f)
False, can be cut
cannot be crushed or chewed
Amount of carbidopa required to inhibit dopa decarboxylase
70-100 mg/day
Rytary
carbidopa/levodopa ER cap
Main side effects of sinimet
nausea dizziness orthostasis dyskinesias brown./dark urine
Comtan
entacapone
Comtan MOA
COMT inhibitor, prevents peripheral and central conversion of levodopa
Stalevo
Entacapone + carbidopa levodopa
Stalevo tablet strength
12.5 mg carbidopa
50 mg levodopa
200 mg entacapone
Neupro
Rotigotine patch
Main side effects of dopamine agonist
Somnolence (daytime)
Nausea
dizziness
Hallucinations
Apokyn
Apomorphine
Apokyn uses
Dopamine agonist
For severe disease as a rescue for “off” periods
IV given prn
Sinemet should not be used with this class of drugs
Non selective MAO inhibitors
