Parkinson Disease

Question 1

S&Sx of parkinson

Answer 1

bradykinesia-slow movement
arm/leg/trunk rigidity
tremors
postural instability

Question 2

What is the main cause of parkinson disease

Answer 2

low dopamine levels

Question 3

Which drug is preferred for psychosis

Answer 3

quetiapine

-low risk of movement disorders

Question 4

which drugs are preferred for initial treatment in the elderly

Answer 4

levodopa/carbidopa

Question 5

which drugs are preferred for initial treatment in younger patients

Answer 5

dopamine agonists

Question 6

Amantadine is useful for treating what symptom

Answer 6

dyskinesia

Question 7

Apomorphine is useful for treating what symptom

Answer 7

severe freezing episodes

Question 8

Levodopa MOA

Answer 8

precursor of dopamine

Question 9

Carbidopa MOA

Answer 9

inhibits dopa decarboxylase enzyme preventing peripheral metabolism of levodopa

Question 10

how much carbidopa is required to inhibit dopa decarboxylase

Answer 10

70-100 mg/day

Question 11

CI to carbidopa/levodopa

Answer 11

use of non-selective MOA-I within 14 days

narrow angle glaucoma

Question 12

SE of carbidopa/levodopa

Answer 12

nausea
dizzy
orthostasis
dyskinesia
brown or black urine
priaprism

Question 13

Brand name for carbidopa/levodopa

Answer 13

sinemet

Question 14

COMT inhibitor MOA

Answer 14

increase the duration of action of levodopa by inhibiting the enzyme catechol-o-methyltransfersase (COMT) to prevent peripheral conversion of levodopa

Question 15

List COMT inhibitor

Answer 15

entacapone

Question 16

COMT inhibitor should always be used with what

Answer 16

levodopa

Question 17

Entacapone brand name

Answer 17

Comtan

Question 18

Dopamine agonist MOA

Answer 18

act similar to dopamine at the dopamine receptor

Question 19

List dopamine agonists

Answer 19

pramipexole
ropinirole
rotigotine
apomorphine

Question 20

SE of DA agonists

Answer 20

somnolence
orthostasis
hallucinations
dyskinesias

Question 21

Apomorphine CI

Answer 21

use with 5HT3 antagonists = hypotension, LOC

Question 22

Amantadine MOA

Answer 22

blocks dopamine reuptake into presynaptic neurons and increases dopamine release from presynaptic fibers. primarily used to treat dyskinesias associated with peak-dose of sinemet

Question 23

SE of amantadine

Answer 23

somnolence
psychosis
dizzy
orthostatic hypotension
livedo reticularis (reddish skin mottling)

Question 24

Selective MOA-B inhibitors MOA

Answer 24

block the breakdown of dopamine which increases dopaminergic activity. primarily used as adjunctive treatment to sinemet

Question 25

list MOA-B inhibitors

Answer 25

selegiline
rasaglinine
safinamide

Question 26

Counseling point for selegiline

Answer 26

activating do not take dose at bedtime

Question 27

Purpose of centrally acting anticholinergics

Answer 27

tremor

Question 28

list centrally-acting anticholinergics

Answer 28

benztropine

Question 29

counseling point for MOA-B inhibitors

Answer 29

avoid foods high in tyramine d/t serotonin syndrome