Parkinson's Disease Flashcards
What is the drug(s) used in first-line therapy for Parkinson’s Disease?
Levodopa + Carbidopa (DDCi).
Why is Levodopa combined with Carbidopa (DDCi) for the treatment of Parkinson’s Disease?
Carbidopa is a DDCi which cannot cross the blood brain barrier.
This causes a decrease in the conversion of levodopa to Dopamine in the periphery.
Levodopa can cross the BBB, by administering Levodopa this increases the concentration of Levodopa into the CNS.
Therefore there is an increase of the conversion of Levodopa to dopamine in the CNS.
This lowers the risk of peripheral ADRs and increases dopamine at the site of action (basal ganglia) to reduce the CNS symptoms associated with Parkinson’s disease.
What drug is best used for tremor management in Parkinson’s?
Muscarinic antagonists (Benztropine).
Explain wearing off and on off symptoms associated with Parkinson’s.
Wearing Off: the dose of Levodopa no longer has the duration of action expected. Therefore dosing frequency is increased as a result.
On Off: Rapid cycling of where the drug is working and where it is not working. Can cause a rapid onset of movement disorders.
What is Neuroleptic Malignant Syndrome?
It is caused by the rapid discontinuation of any dopamine products.
The body creates a reflex response due to the lowered dopaminergic response.
This causes: increase BP, increased body temp, changes to neurotransmission (risk of seizures) and possibly coma.
