Parkinson’s disease

Question 1

What are four signs of Parkinson’s disease?

Answer 1

• Tremor, rigidity, akinesia/bradykinesia and postural instability. Non motor skills include mental and behavioural issues, sense of smell, sweating and melanoma, GI issues and pain

Question 2

What is the rationale for drug use of Parkinson’s disease?

Answer 2

• Provide symptomatic relief

Question 3

What is levodopa given with?

Answer 3

• dopa decarboxylase inhibitors

Question 4

What is the MOA of levodopa with dopa decarboxylase inhibitors?

Answer 4

• Levodopa is converted to dopamine in the brain and peripheral tissues, and replenishes depleted dopamine.

Question 5

What are 3 adverse effects of levodopa with dopa decarboxylase inhibitors?

Answer 5

• anorexia, n and v, orthostatic hypotension, dyskinesia

Question 6

What are two patient education points to levodopa with dopa decarboxylase inhibitors?

Answer 6

• protein in food reduces levodopa absorption, do not stop abruptly,

Question 7

What is the MOA of dopamine agonists?

Answer 7

• Stimulate dopamine receptors

Question 8

What is the drug class of Cabergoline, bromocriptine and pergolide and what are their AEs?

Answer 8

• Dopamine agonists. AEs are similar to levodopa and cardiac vulvular disease and pleuro pulmonary retroperitoneal fibrosis

Question 9

What is the drug class of Pramipexole, rotigotine and ropinirole and what are their AEs?

Answer 9

• similar to levodopa plus peripheral oedema

Question 10

What are 2 patient education points for people having Cabergoline, bromocriptine and pergolide

Answer 10

• Monitoring is essential if unable to switch from ergot preparations.
• do not drive or operate machinery if feeling dizzy or drowsy, inform doctor if you notice any change of habits, take tablets with food

Question 11

What is the MOA of monoamine oxidase type B inhibitors?

Answer 11

• Reduces breakdown or dopamine and block dopamine reuptake

Question 12

What are 2 AEs of monoamine oxidase type B inhibitors?

Answer 12

• orthostatic hypotension, dyskinesia, headache, insomnia, nausea, vomiting, accidental injury, rash

Question 13

What is an education point for someone taking monoamine oxidase type B inhibitors?

Answer 13

• Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly

Question 14

What is the MOA of anticholinergics?

Answer 14

• Reduce excess cholinergic activity accompanying dopamine deficiency

Question 15

Name an anticholinergic

Answer 15

• Benzhexol, Benztropine and Biperiden

Question 16

What are 2 AEs of anticholinergic?

Answer 16

• confusion, hallucinations, memory disturbance, dry mouth, constipation, urinary retention, glaucoma

Question 17

What is an education point for anticholinergics?

Answer 17

• avoid stopping treatment abruptly in Parkinson’s disease to prevent an acute exacerbation. Can lead to cholinergic crisis.