Parkinson's Disease

Question 1

PD:

what, etiology, sx (4.4)

Answer 1

• neurodegenerative
• eti: no dopamine in substantia nigra

signs/sx
- stooped posture, rigid back, masked face, forward trunk tilt
- dec arm swing, shuffling gait, FLEX elbow wrist hips knees, tremor in hands & legs

Question 2

PD: Pharmacological Mx

levodopa - what, 1=1=1, route (3), sx (5), withdrawal (3)

baliw

Answer 2

• precursor for dopamine
• stable enough to pass BBB = decarboxylated to dopamine = effect

side effects
- confused, hallucination, delusion, psychosis, agitation

sudden withdrawal = neuroleptic malignant syndrome
- high fever, involuntary fever, muscle rigidity

Question 3

PD: Pharmacological Mx

carbidopa - purpose, sx (3.5)

baliw, gutom

Answer 3

• levodopa might transform into dopamine in periphery
• inhibit dopa decarboxylase (enzyme)

side effects
- confused, agitation, anxiety
- blurred vision, constipation, dec appetite, darkened urine & sweat, allergy

Question 4

PD: Pharmacological Mx

MAO-B inhibitor - purpose, example, sx (4)

baliw, hilo

Answer 4

monoamine oxidase B inhibitors
- inhibits dopamine metabolize into DOPAC in brain
- ex: gline

side effects
- nausea, light headed, constipation, dec appetite

Question 5

PD: Pharmacological Mx

COMT inhibitor - purpose, example, sx (5)

hilo, baliw

Answer 5

catechol-o-methyl-transferase inhibitor
- inhibits dopamine metabolize into 3-methoxytramine
- ex: pone

side effects
- nausea, OH, vomit, hallucination, sleep disorder

Question 6

PD: Pharmacological Mx

dopamine agonist - purpose (2), sx (6)

hilo

Answer 6

• inc binding of dopamine in cellular level (synaptic cleft)
• mimic dopamine

side effects
- nausea, OH, vomit, headache, dizzy, cardiac arrythmia

Question 7

PD: Pharmacological Mx

amantadine - purpose (1=1), sx (9)

Answer 7

• blocks dopamine reuptake in presynaptic neuron = reach synapse

side effects
- OH, dizzy, syncope, falls, delusion, hallucination
- constipation, xerostomia, peripheral edema

Question 8

PD:

effects - psych cognitive sleep mood autonomic sensory (2.2.3.3.3.3)

Answer 8

PSYCH
- impulse, hallucination

COGNITIVE
- judgement, identity

SLEEP
- REM, apnea, restless leg syndrome

MOOD
- depression anxiety apathy

AUTONOMIC
- GIT, OH, sex

SENSORY
- pain & paresthesia, anosmia, ageusia