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Pharmacology > Parkinson’s Disease > Flashcards

Parkinson’s Disease Flashcards

1
Q

What is Parkinsonism?

A

A neurologic syndrome exhibiting symptoms like tremor, rigidity, bradykinesia, and postural instability

Parkinsonism is not Parkinson’s disease and typically responds poorly to pharmacologic intervention.

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2
Q

What are the primary neurotransmitters affected in Parkinson’s disease?

A

Dopamine (inhibitory) and acetylcholine (excitatory)

These neurotransmitters are involved in motor control within the basal ganglia.

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3
Q

What are the characteristic symptoms of Parkinson’s disease?

A
  • Tremor
  • Rigidity
  • Bradykinesia
  • Postural instability

These symptoms can progress and worsen over time.

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4
Q

What is the average age of onset for Parkinson’s disease?

A

60 years old

The risk of developing Parkinson’s disease increases with age.

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5
Q

What is the prevalence of Parkinson’s disease among individuals aged 80 and older?

A

1–3%

This prevalence indicates an increased risk with advancing age.

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6
Q

How does dopamine loss in Parkinson’s disease compare to normal aging?

A

Dopamine loss occurs at a much greater rate in Parkinson’s disease

Normal aging involves a slow progressive loss of dopamine.

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7
Q

What is the role of caffeine in relation to Parkinson’s disease?

A

Caffeine is an adenosine A2A receptor antagonist believed to reduce the risk of developing PD

Studies have shown a correlation between coffee consumption and reduced PD risk.

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8
Q

What is the genetic predisposition for Parkinson’s disease?

A

Up to 6% of cases are linked to known genes; 15% have a family history of PD

Genetic factors contribute to the risk but are not the sole cause.

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9
Q

What are some environmental factors associated with Parkinson’s disease?

A
  • Pesticides
  • Herbicides
  • Heavy metals
  • MPTP exposure

These factors can contribute to neurodegeneration.

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10
Q

What are the two major strategies for treating Parkinsonism?

A
  • Increase brain dopaminergic activity
  • Decrease central cholinergic activity

Both strategies aim to alleviate symptoms of Parkinsonism.

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11
Q

What is Levodopa’s role in treating Parkinson’s disease?

A

Levodopa is a dopamine precursor that can cross the blood-brain barrier

It must be administered with carbidopa to reduce side effects.

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12
Q

What are the common peripheral effects of Levodopa?

A
  • Anorexia
  • Nausea
  • Vomiting
  • Tachycardia
  • Hypotension

These side effects are due to peripheral dopamine formation.

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13
Q

What is the function of carbidopa when administered with Levodopa?

A

Carbidopa inhibits the peripheral conversion of Levodopa to dopamine

This combination reduces the dose of Levodopa needed and minimizes side effects.

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14
Q

What is bradykinesia?

A

Slowed movements, a hallmark symptom of Parkinson’s disease

A diagnosis of Parkinson’s disease requires the presence of this symptom.

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15
Q

True or False: Parkinsonism can be caused by exposure to certain neuroleptic drugs.

A

True

Neuroleptic drugs can lead to symptoms similar to Parkinson’s disease.

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16
Q

What are Lewy bodies?

A

Abnormal cytoplasmic deposits within neuronal cell bodies, associated with Parkinson’s disease

These deposits are immunoreactive for the protein α-synuclein.

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17
Q

Fill in the blank: The presence of _______ is indicative of Parkinson’s disease.

A

Lewy bodies

18
Q

What are some non-motor symptoms of Parkinson’s disease?

A
  • Depression
  • GIT disturbances
  • Urinary problems
  • Skin problems

These symptoms can significantly affect the quality of life.

19
Q

What is the role of the substantia nigra in Parkinson’s disease?

A

Destruction of dopaminergic neurons in the substantia nigra leads to decreased dopamine in the corpus striatum

This results in impaired motor control.

20
Q

What is the absorption site and half-life of Levodopa?

A

Absorbed rapidly from the small intestine; half-life is 1 to 2 hours.

21
Q

What are common peripheral adverse effects of Levodopa?

A
  • Anorexia
  • Nausea
  • Vomiting
  • Tachycardia
  • Ventricular extrasystoles
  • Hypotension
22
Q

What causes mydriasis in relation to Levodopa?

A

Adrenergic action on the iris.

23
Q

What are some central nervous system (CNS) effects of Levodopa?

A
  • Visual hallucinations
  • Auditory hallucinations
  • Abnormal involuntary movements (dyskinesias)
  • Mood changes
  • Depression
  • Psychosis
  • Anxiety
24
Q

What effect does pyridoxine (B6) have on Levodopa?

A

Increases peripheral breakdown of Levodopa, diminishing its effectiveness.

25
Q

What can occur when Levodopa is administered with non-selective monoamine oxidase inhibitors (MAOIs)?

A

Hypertensive crisis due to enhanced catecholamine production.

26
Q

What is a possible consequence of abruptly withdrawing Levodopa?

A

Neuroleptic malignant syndrome.

27
Q

What enzymes metabolize dopamine?

A
  • Monoamine oxidase (MAO)
  • Catechol-o-methyl transferase (COMT)
28
Q

What are the COMT inhibitors used in Parkinson’s disease?

A
  • Tolcapone
  • Entacapone
29
Q

What is the main difference between Tolcapone and Entacapone?

A

Tolcapone inhibits COMT in both periphery and brain; Entacapone acts only in the periphery.

30
Q

What are the irreversible and selective inhibitors of MAO-B?

A
  • Selegiline
  • Rasagiline
31
Q

What is the risk associated with high doses of Selegiline and Rasagiline?

A

Hypertensive crisis with tyramine-containing foods and serotonin syndrome with tricyclic antidepressants.

32
Q

What type of drugs are bromocriptine and pergolide?

A

Ergot-derived dopamine agonists.

33
Q

What are the newer non-ergot dopamine agonists?

A
  • Pramipexole
  • Ropinirole
  • Apomorphine
34
Q

What is a significant side effect of apomorphine?

A

Used in severe and advanced stages of Parkinson’s disease.

35
Q

What are common side effects of non-ergot dopamine agonists?

A
  • Nausea
  • Hallucinations
  • Insomnia
  • Dizziness
  • Constipation
  • Orthostatic hypotension
36
Q

What is the mechanism of action of Amantadine in Parkinsonism?

A

Increases synaptic dopamine levels by increasing presynaptic release and decreasing reuptake.

37
Q

What are some adverse effects of Amantadine?

A
  • Nausea
  • Insomnia
  • Ankle edema
  • Livedo reticularis
  • Restlessness
  • Agitation
  • Confusion
  • Hallucinations
38
Q

What are the central anticholinergic drugs used for drug-induced Parkinsonism?

A
  • Trihexiphenidyl
  • Procyclidine
  • Benztropine
  • Orphenadrine
  • Biperiden
39
Q

True or False: Antimuscarinic agents are more efficacious than levodopa.

A

False.

40
Q

What can anticholinergic drugs induce as side effects?

A
  • Mood changes
  • Xerostomia
  • Constipation
  • Visual problems

Pharmacology (18 decks)

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