Parkinson's Disease Flashcards
Define Parkinsons disease
Degenerative brain disorder affecting movement
Loss if muscle control
Not fatal but progressive and incurable
Pathophysiology
Loss of DA neurons in substantia nigra of brain.
Most common PD
Idiopathic parkinson’s
What is parkinsonism?
Umbrella term that describes many conditions that share the symptoms of PARKINSONS DISEASE
Types of PARKINSONISM
- Vascular Parkinsonism
- Dementia with Lewy Bodies
- Drug induced parkinsonism
(A secondary parkinsonism)
Clinical symptoms of PD
- Tremor
- Rigidity
- Akinesia, bradykinesia (initiating movement)
- Postural instability
Goal of pharmacotherapy
Symptomatic relief
Doesn’t slow Progression of disease
Medications = MOA
Increase DA
Or
Inhibit Ach in brain
What if TREMOR is the only symptom?
Consider other contions:
Hyperthyroidism
Essential tremor
Medications to manage motor symptoms
- Levadopa = replaces DA
- Dopamine agonists = mimic DA
- Mo oamine oxidise type B Inhibitors = conserve DA by blocking MOA enzyme
- Anticholinergics
Initial treatment choice for OVER 70
Levodopa
Treatment choice for YOUNG PATIENTS
Dopamine agonist
Why is LEVODOPA given with
dopa-decarboxylase inhbitior
To decrease peripheral metabolism of Levodopq to dopamine
Dopamine agonists:
Pramipexole, rotigotine ans ropinirole
Have less or more
Dyskinesia and motor fluctuations when compared to LEVODOPA
Less than Levodopa
Side effects of PRAMIPEXOLE, ROTIGOTINE, ROPINIROLE
Higher incidence OF AE
Including
Impulse control disorder
Hypersexuality
Neuropsychiatric affects
Name
MONOAMINE OXIDASE TYPE B INHBITIORS
Moa
Rasagiline and Selegiline
Reduce breakdown of DA
MOAi and levodopa
Side effects of combo use?
Increase dopaminergic side effects
ANTICHOLINERGICS
drug names
Moa
Benzhexol, Benztropine and Biperiden
Reduce excess cholinergic activity that accompanies DA deficiency
Medications to AVOID in ppl with dementia
- Anti nausea =
Metoclopramide, prochlorperazine - Antiopsychotics =
Haloperidol, risperidone
If an antipsychotic is needed for a person with parkinsons, which one should they use?
Clozapine or quetiapine