Parkinson's

Question 1

Gold standard treatment

Answer 1

Levodopa & Carbidopa

Question 2

Levodopa MoA

Answer 2

DA precursor; converted to DA by DOPA decarboxylase

Question 3

Levodopa side effects

Answer 3

hallucinations (early side effect)
risk taking behaviour (gambling)
postural hyotension
dyskinesia (involuntray movements) later on

Question 4

Carbidopa MoA

Answer 4

Inhibits DOPA decarboxylase but cannot cross BBB.

Always given with Levodopa to inhibit DA production in the periphery - as this can cause cardiotoxicity & increases drug availability in the brain.

Question 5

MAO inhibitors MoA

Answer 5

Inhibit MAO so DA isn’t broken down to DOPAL and stays in synaptic cleft longer
Usually MAOb inhibitors

Question 6

COMT inhibitors MoA

Answer 6

Inhibits COMT so DA not broken down to 3-methoxytyramine and stays in cleft longer

Question 7

Dopamine agonists MoA

Answer 7

Trigger EPSP in D2 receptors

Question 8

Treatment usually used first and why

Answer 8

Dopamine agonists to delay use of levodopa as once it is used it’s efficacy is on a timer

Question 9

Dopamine agonist side effects

Answer 9

Postural hypotension
hallucinations
pathological gambling
nausea, vomiting, dizziness

Question 10

Example of a dopamine agonist

Answer 10

Rupinirole

Question 11

Example of a MAO inhibitor

Answer 11

Selegiline