PARKINSON'S

Question 1

Parkinson’s DOC - elderly

Answer 1

Carbidopa/Levodopa (Sinemet)

Question 2

Pramipexole (Mirapex), Ropinirole (Requip) and Rotigotine (Neupro) - class?

Answer 2

Dopamine agonist

Question 3

Parkinson’s - first line younger patient

Answer 3

Dopamine agonist (controls for 2-3 yrs, save L-Dopa)

Question 4

Which dopamine agonist has the most DDI?

Answer 4

Requip

1A2 major substrate (Cipro, Cimetidine, Amniodarone can increase levels)

Question 5

Which dopamine agonist is available in patch form?

Answer 5

Rotigotine (Neupro)
good if impaired swallowing
not for RLS

Question 6

What drug is the Catechol-o-methyltransferase inhibitor (COMT inhibitor)?

Answer 6

Entacapone (Comtan)

Question 7

Entacapone DDI

Answer 7

Avoid with MAO

Question 8

Selegiline (Eldepryll) and Rasagiline (Azilect) - class?

Answer 8

MAO Inhibitors

Question 9

Which MAO inhibitor can also be used for depression?

Answer 9

Selegiline - available as Emsam patch (depression only not PD)

Question 10

MAO inhibitor DDI

Answer 10

Avoid with:
tramadol
meperidine
TCAs
tyramine containing products

Question 11

MAO inhibitors and surgery

Answer 11

must stop 10-14 days prior - counsel patients

b/c blood loss may require vasoconstrictors and don’t want exaggerated response

Question 12

PD add on for tremor management

Answer 12

Anticholinergics - Trihexyphenidyl (Artane) and Benztropine (Cogentin)

Question 13

Anticholinergics - ADE

Answer 13

dry mouth
blurred vision
constipation
urinary retention