Parkinson's: Anticholinergics

Question 0

do all the anticholinergics tx tremor and problematic drooling in parkinson’s?

Answer 0

yes. only used if drooling is a major prob bc they have bad mental side effects.

Question 1

5 anticholinergics that can be used for PD?

Answer 1

1. Benztropine
2. biperiden
3. trihexyphenidyl
4. procyclidine
5. ethopropazine

Question 2

do all the anticholinergics cause confusion, impaired memory, and hallucinations, in addition to the typical anticholinergic effects (dry mouth, etc)? (and what are they again?)

Answer 2

yes: benztropine, biperiden, trihexyphenidyl, procyclidine, ethopropazine

Question 3

what are the CI to use anticholinergics?

Answer 3

demented Parkinson’s, abrupt discontinuation exacerbates Sxs.

Question 4

antiviral drug that’s 2nd line for mild/early parkinson’s, or best as adjunct to levodopa/carbidopa for long term TX, movmt disorders in Huntingtons, THE ONLY ADJUVANT THAT DEC DYSKINESIAS

Answer 4

amantadine

Question 5

which drug is excreted in urine unchanged, therefore need dec dosage for renal dysfnc pts, and CI in elderly demented pts?

Answer 5

amantidine

Question 6

ADRs of amantadine?

Answer 6

DA side effects, edema, psychosis, NMS upon w/d

Question 7

surgery that hits subthalamic nucleus and is used as tx for motor fluctuations or dyskinesias refractory to other meds, helps dec off time, may dec L-DOPA dosage. only in pts that are still sensitive to levodopa therapy

Answer 7

DBS