Parkinson's

Question 1

First line treatment of Parkinson’s

Answer 1

Levodopa and carbidopa

Question 2

Dopa decarboxylase inhibitors

Answer 2

• Carbidopa
• Benserazide

Question 3

COMT inhibitors

Answer 3

• Entacapone
• Tolcapone

Question 4

Which COMT inhibitor Is used rarely and why

Answer 4

• Talcapone
• due to hepatotoxicity

Question 5

Monoamine oxidase-B inhibitors

Answer 5

• Rasagiline
• Selegiline

Question 6

Which Monoamine inhibitor has amphetamine-like metabolites

Answer 6

Selegiline
May cause anxiety and insomnia

Question 7

MOA of cheese reaction

Answer 7

• Less tyramine metabolised in GIT by MAO, thus nervous system availability increases
• Tyramine transported into nerve terminal NET
• Synaptic NA increases causing clinically-relevant adrenergic activation
• NA cannot be metabolised

Question 8

Dopamine agonists

Answer 8

• Bromocriptine
• Pramipexole
• Ropinirole

Question 9

Which dopamine agonist is not used in SA and why

Answer 9

• Bromocriptine
• Ergot-derivative that may cause ergotism and severe side effects

Question 10

Anticholinergics

Answer 10

Orphenadrine

Question 11

Amatadine

Answer 11

Recommissioned ant-influenza drug used for less sever Parkinson’s disease to help reduce tremors, rigidity and bradykinesis

Question 12

Drugs that may be used to treat cheese reaction

Answer 12

• Prazosin
• Phentolamine