Parkinson's and Alzheimer's

Question 1

What is a progressive neurological disorder of muscle movement, characterized by tremors, muscular rigidity, bradykinesia (slowness in initiating and carrying out voluntary movements), and postural and gait abnormalities?

Answer 1

Parkinson’s disease

Question 2

What neurotransmitter is reduced in Parkinson’s disease?

Answer 2

Dopamine

Question 3

What neurotransmitter is overproduced in Parkinson’s disease?

Answer 3

Acetylcholine

Question 4

What is the most effective drug for the symptomatic treatment of PD?

Answer 4

Levodopa

Question 5

What may be employed either as monotherapy in early PD or in combination with other antiparkinsonian drugs for treatment of more advanced disease?

Answer 5

Dopamine agonists

Question 6

Are Dopamine agonists effective or ineffective in patients who show no response to levodopa?

Answer 6

Ineffective

Question 7

What are most useful as monotherapy in patients under 70 years of age with disturbing tremor who do not have significant bradykinesia or gait disturbance?

Answer 7

Anticholinergic drugs

Question 8

What is a relatively weak antiparkinsonian drug with low toxicity that is most useful in treating younger patients with early or mild PD and perhaps later when dyskinesia becomes problematic?

Answer 8

Amantadine

Question 9

What symptom of Parkinson’s is Levodopa most effective at managing?

Answer 9

Bradykinesia

Question 10

What does Carbidopa do when combined with Levodopa

Answer 10

Inhibits the decarboxylation of peripheral Levodopa allowing for more Levodopa to cross the BBB

Question 11

What anticholinergic drug is a centrally acting anticholinergic/antihistamine and antagonizes acetylcholine, decreasing the imbalance between acetylcholine and dopamine?

Answer 11

Benztropine

Question 12

What reduces the peripheral (entacapone) and central (tolcapone) methylation of levodopa and dopamine, which in turn increases the plasma half-life of levodopa, produces more stable plasma levodopa concentrations, and prolongs the therapeutic effect of each dose?

Answer 12

COMT Inhibitors

Question 13

When are COMT Inhibitors mainly used?

Answer 13

motor fluctuations who are experiencing end-of-dose wearing “off” periods.

Question 14

What drug’s most common side effect is due to increased dopaminergic stimulation and include dyskinesia, hallucinations, confusion, nausea, and orthostatic hypotension?

Answer 14

Tolcapone

Question 15

What drugs block the breakdown of dopamine therefore increasing its activity?

Answer 15

MOA-B Inhibitors

Question 16

What MOA-B inhibitors is modestly effective as symptomatic treatment for PD and may have neuroprotective properties and often causes confusion in older adults, thereby limiting its use in patients with late-onset disease?

Answer 16

Selegiline

Question 17

What increases cholinergic transmission by inhibiting cholinesterase at the synaptic cleft and provide modest symptomatic benefit in some patients with dementia (Alzheimer’s)?

Answer 17

Acetylcholinesterase Inhibitors

Question 18

What AChE Inhibitor is the only agent approved for the management of dementia associated with Parkinson’s disease and also the only AChE inhibitor available as a transdermal formulation?

Answer 18

Rivastigmine

Question 19

What inhibit the prolonged influx of calcium ions, particularly from extrasynaptic receptors, which forms the basis of neuronal excitotoxicity and is proposed to be neuroprotective?

Answer 19

Memantine