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MD4001 Drugs > Parkinson's > Flashcards

Parkinson's Flashcards

1
Q

what are the symptoms of parkinson’s

A 
tremour at rest
cogwheel rigidity 
bradykinesia
assymetry 
loss righting reflex
cognitive decline 
hypomimia
glabellar tap
quiet speech 
micrographia
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2
Q

describe the gait of someone with parkinson’s

A 
rigidity and trembling of the head 
forward tilt of trunk
reduced arm swinging with arm in slight flexion 
rigidity and trembling of extremities
shuffling gait with short steps
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3
Q

what drugs are used to treat parkinsons

A 
levodopa 
carbidopa/ benserazide
dopamine antagonist
monoamine oxidase inhibitors 
amantadine release dopamine 
muscarinic antagonists
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4
Q

what are carbidopa/ benserazide

A

dopa decarboxylase inhibitor

reduces dose needed and reduces peripheral system effects

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5
Q

what are the side effects of levodopa

A

involuntary writhing movements (dyskenesia)

fluctuations in clinical state-
hypokinesia and rigidity comes and goes rapidly

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6
Q

what is bromocriptine, cabergoline and pergolide

A

orally active D1 and 2 receptor agonists

can have severe side effects

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7
Q

what is pramipexole and ropinole

A

D2/ 3 selective receptor agonists with fewer side effects

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8
Q

what is rotigotine

A

transdermal dopamine patch

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9
Q

what is apomorphine

A

injection of to control effects of levodopa

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10
Q

what are features of dopamine dysregulation syndrome

A

narcolepsy
impulse control disorders
hypotension
neuroleptic malignant syndrome if stopped abruptly

a dysfunction of the reward system observed in some individuals taking dopaminergic medications for an extended period

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11
Q

what is selegiline/ rasagiline

A

selective MAO-B
protects dopamine from extraneuronal degradation
combined with levodopa is effective

rasagiline may retard disease progression
used in combination with levodopa

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12
Q

what is amantadine

A

antiviral drug found to be beneficial in PD
increased dopamine release
less effective than levodopa

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13
Q

what is the moa of acetylcholine antagonists

A

inhibitory effect on dopaminergic nerves which compensates for a lack of dopamine

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14
Q

what are benshexol, orphenadrine and procycline

A

acetylcholine antagonists

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15
Q

what is the extrapyramidal system

A

involved in unconscious movement

chiefly found in the reticular formation of the pons and medulla, and target neurons in the spinal cord involved in reflexes, locomotion, complex movements, and postural control

rubrospinal tract
pontine reticulospinal tract
medullary reticulospinal tract
lateral vestibulospinal tract
tectospinal tract
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16
Q

what are extrapyramidal symptoms

A

drug induced movement disorders

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17
Q

what are Akinetic-rigid syndromes

A

paucity and slowness of movement accompanied by muscle stiffness and resistance to passive movement.

typical of parkinsons

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18
Q

what is Parkinson’s plus syndrome

A

features of regular parkinsons disease but with extra features

19
Q

what is multiple syndrome atrophy

A

a degenerative[1] neurological disorder that depicts a group of disorders characterised by the neuronal degeneration mainly in the substantia nigra, striatum, autonomic nervous system and cerebellum.

20
Q

what is Progressive Supranuclear Palsy

A

rare and progressive condition that can cause problems with balance, movement, vision, speech and swallowing.

caused by a build up of tau proteins

21
Q

what is cortical lewy body disease aka dementia with lewy bodies

A

dementia with symptoms of parkinsons

22
Q

what is Drug-induced Parkinsonism

A

caused by drugs that interfere with dopamine

23
Q

what is Corticobasal degeneration

A

symptoms of parkinsons and dementia due to a build up of tau proteins

24
Q

what is hypomimia

A

lack of facial expression

25
Q

what is a glabella tap

A

the forehead is tapped repeatedly

the patient should only blink for the first few taps, if blinking persists this may indicate parkinsons

26
Q

what is the name for progressively smaller handwriting

A

micrographia

27
Q

what percentage cognitive decline is typical of parkinsons

A

30%

28
Q

what is the righting reflex

A

body’s automatic response to retain balance and equilibrium

29
Q

describe parkinson posture

A

rigidity and trembling of the head

forward trunk tilt

reduced arm swinging
shuffling

trembling and rigidity of extremities

30
Q

what is the function of the indirect pathway

A

decreases excitatory thalamic input to the cortex

this turns down motor activity

31
Q

what is the function of the direct pathway

A

increases excitatory thalamic input to the cortex

turns up motor activity

32
Q

what is the function of the substantia nigra dopaminergic neurons

A

turns up the direct pathway and turns down the indirect pathway which increases motor activity

33
Q

what is the striatal interneurones function (cholinergic)

A

turns down the direct pathway
turns up the indirect pathway
causes less motor activity

34
Q

what factors can contribute to neurodegeneration

A 
toxins
immune attack
activation of cell death pathways 
mitochondrial dysfunction 
ionic dysequilibrium 
excito toxicity 
oxidative stress
lack of growth factors
protein handling disorders
35
Q

what is the purpose of acetylcholine inhibitors as a drug treatment

A

blocks action of acetylcholine in the striatum

36
Q

what is dyskinesia

A

involuntary writhing movements

occurs at peak therapeutic effect

37
Q

what drugs cause rapid fluctuations in clinical state as a side effect

A

levodopa

due to fluctuating receptor dynamics

38
Q

what are some alternative treatments for parkinsons

A

transplants

stem cell technology is a possible future treatment

electrical stimulation of the subthalamic or GPI nuclei by inserted electrodes can be used

39
Q

dopa decarboxylase inhibitor

A

carbidopa

40
Q

COMT inhibitor (catechol-O-methyl transferase)

A

entacapone

41
Q

dopamine agonist

A

pramipexole, ropinirol, rotigotine, bromocriptine

42
Q

MAO-B (monoamine oxidase B) blocks breakdown of dopamine

A

selegine, rasagiline

43
Q

dopamine release enhancer

A

amantadine

44
Q

muscarinic antagonists

A

benzhexol

MD4001 Drugs (10 decks)

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