Parkinson Drugs

Question 1

What is Parkinson’s disease

Answer 1

Progressive degenerative disorder of the CNS caused by a lack of dopamine

Question 2

Signs and symptoms of Parkinson’s

Answer 2

Bradykinesia
Intention tremor 
Rigidity
Muscle weakness
Shuffling gait or pitched gait
Stalling and freezing
Mask facial features 
Dysphasia 
Depression 
Anxiety
Hallucinations

Question 3

Dopamine agonists

Answer 3

Restore dopamine balance in the brain

Reduce tremor and rigidity

Question 4

Carbidopa/levodopa

Sinemet

Answer 4

Reduces “wearing off” effect
Replaces Dopamine in the brain
Prolongs half life
Changes balance of dopamine and acetylcholine in the brain
Adverse effects: dyskinesia, dysrrhythmias, delusions, delirium, hallucinations, GI symptoms, insomnia, confusion, headaches, hypotension

Question 5

Amatadine

Answer 5

Enhance release of dopamine

Used for PD and extrapyramidal effects

Question 6

Bromocriptine

Answer 6

Makes dopamine receptors more receptive

Question 7

COMT inhibitors

Answer 7

Reduce symptoms by inhibiting enzyme that breaks down Dopamine
Works with natural and synthetic Dopamine
Restores balance of Dopamine and acetylcholine
Used as an add on drug

Question 8

entacopone (Comtan)

tolcapone

Answer 8

Interact with MAO inhibitors
Turns urine orange or brown, causes GI upset, hypotension and hallucinations
Don’t use with liver disease
May cause dyskinesia and psychosis

Question 9

MAO B inhibitors

Answer 9

Inhibits reuptake of dopamine in the brain allowing Dopamine to remain active
Used as mono therapy in early disease

Question 10

Selegeline
Salfinamide
Rasagaline

Answer 10

Side effects/adverse effects: dry mouth, constipation, confusion, hallucinations, lightheadedness, severe hypotension
Tyramine rich foods can cause hypertensive crisis
Interactions: pain meds, SSRIs, tricyclic antidepressants, meperidine, tramadol, methadone, gingseng, ephedra, and St. John’s wart