Parkinson's Disease

Question 1

Define Parkinsons disease

Answer 1

Degenerative brain disorder affecting movement
Loss if muscle control

Not fatal but progressive and incurable

Question 2

Pathophysiology

Answer 2

Loss of DA neurons in substantia nigra of brain.

Question 3

Most common PD

Answer 3

Idiopathic parkinson’s

Question 4

What is parkinsonism?

Answer 4

Umbrella term that describes many conditions that share the symptoms of PARKINSONS DISEASE

Question 5

Types of PARKINSONISM

Answer 5

1. Vascular Parkinsonism
2. Dementia with Lewy Bodies
3. Drug induced parkinsonism
   (A secondary parkinsonism)

Question 6

Clinical symptoms of PD

Answer 6

1. Tremor
2. Rigidity
3. Akinesia, bradykinesia (initiating movement)
4. Postural instability

Question 7

Goal of pharmacotherapy

Answer 7

Symptomatic relief

Doesn’t slow Progression of disease

Question 8

Medications = MOA

Answer 8

Increase DA

Or

Inhibit Ach in brain

Question 9

What if TREMOR is the only symptom?

Answer 9

Consider other contions:

Hyperthyroidism
Essential tremor

Question 10

Medications to manage motor symptoms

Answer 10

1. Levadopa = replaces DA
2. Dopamine agonists = mimic DA
3. Mo oamine oxidise type B Inhibitors = conserve DA by blocking MOA enzyme
4. Anticholinergics

Question 11

Initial treatment choice for OVER 70

Answer 11

Levodopa

Question 12

Treatment choice for YOUNG PATIENTS

Answer 12

Dopamine agonist

Question 13

Why is LEVODOPA given with

dopa-decarboxylase inhbitior

Answer 13

To decrease peripheral metabolism of Levodopq to dopamine

Question 14

Dopamine agonists:
Pramipexole, rotigotine ans ropinirole

Have less or more

Dyskinesia and motor fluctuations when compared to LEVODOPA

Answer 14

Less than Levodopa

Question 15

Side effects of PRAMIPEXOLE, ROTIGOTINE, ROPINIROLE

Answer 15

Higher incidence OF AE
Including
Impulse control disorder
Hypersexuality
Neuropsychiatric affects

Question 16

Name
MONOAMINE OXIDASE TYPE B INHBITIORS

Moa

Answer 16

Rasagiline and Selegiline

Reduce breakdown of DA

Question 17

MOAi and levodopa

Side effects of combo use?

Answer 17

Increase dopaminergic side effects

Question 18

ANTICHOLINERGICS

drug names

Moa

Answer 18

Benzhexol, Benztropine and Biperiden

Reduce excess cholinergic activity that accompanies DA deficiency

Question 19

Medications to AVOID in ppl with dementia

Answer 19

1. Anti nausea =
   Metoclopramide, prochlorperazine
2. Antiopsychotics =
   Haloperidol, risperidone

Question 20

If an antipsychotic is needed for a person with parkinsons, which one should they use?

Answer 20

Clozapine or quetiapine