Parkinson's Disease Flashcards
What is Parkinson’s disease?
A condition characterized by a progressive reduction in dopamine in the basal ganglia, leading to movement disorders.
What is the typical age and gender of a Parkinson’s disease patient?
An older man, around 70 years old.
What are the main functions of the basal ganglia?
Responsible for coordinating habitual movements, voluntary movement, and learning specific movement patterns.
What role does dopamine play in Parkinson’s disease?
Dopamine plays an essential role in the basal ganglia, and patients experience a slow but progressive drop in dopamine production.
What is the classic triad of clinical features in Parkinson’s disease?
Resting tremor, rigidity, bradykinesia.
Describe the characteristics of resting tremor in Parkinson’s disease.
Worse at rest, 4-6 hertz frequency, ‘pill-rolling’ movement, improves with voluntary movement.
What is rigidity in the context of Parkinson’s disease?
Resistance to passive movement of the joint, also known as ‘cogwheel’ rigidity.
What does bradykinesia refer to?
Slower and smaller movements, including micrographia, shuffling gait, festinating gait, and difficulty initiating movement.
List some other features associated with Parkinson’s disease.
- Depression
- Sleep disturbance and insomnia
- Anosmia
- Postural instability
- Cognitive impairment and memory problems.
How does Parkinson’s tremor differ from benign essential tremor?
Parkinson’s is asymmetrical, 4-6 hertz, worse at rest, improves with intentional movement, and has no change with alcohol, while benign essential tremor is symmetrical, 6-12 hertz, improves at rest, worsens with intentional movement, and improves with alcohol.
What is multiple system atrophy?
A rare condition where neurons in the brain degenerate, leading to parkinsonian presentation and autonomic dysfunction.
What are the symptoms associated with dementia with Lewy bodies?
- Progressive cognitive decline
- Visual hallucinations
- Delusions
- REM sleep disorder
- Fluctuating consciousness.
What do patients with Parkinson’s disease mean by ‘on’ and ‘off’ regarding medications?
‘On’ when medications are acting, ‘off’ when medications wear off, experiencing symptoms when the next dose is due.
What is levodopa, and how is it used in Parkinson’s disease treatment?
Synthetic dopamine taken orally, often combined with peripheral decarboxylase inhibitors to prevent metabolism before reaching the brain.
What are some side effects of levodopa?
- Dyskinesia
- Excessive motor activity (including dystonia, chorea, athetosis).
What are COMT inhibitors and provide an example?
Inhibit catechol-O-methyltransferase, slowing levodopa breakdown; an example is entacapone.
What do dopamine agonists do in the treatment of Parkinson’s disease?
Mimic the action of dopamine by stimulating dopamine receptors; less effective than levodopa.
What is a notable side effect of dopamine agonists?
Pulmonary fibrosis.
What are monoamine oxidase-B inhibitors used for?
Block MOA-B enzymes to increase circulating dopamine levels and delay the use of levodopa.
Provide examples of monoamine oxidase-B inhibitors.
- Selegiline
- Rasagiline.
Bromocriptine, pergolide, cabergoline…
Dopamine agonists used to manage symptoms in Parkinson’s disease.
Notable SE includes pulmonary fibrosis
Entacapone
COMT inhibitor.
Used to manage symptoms in Parkinosns by preventing breakdown of levodopa in brian.
Extends duration of action of levodopa.
Amantadine
Glutamate antagonist
Used to manage dyskinetic side effects produced by levodopa treatment in Parkinson’s patients
Carbidopa, benserazide
Peripheral decarboxylase inhibitors.
Combined with levodopa to reduced metabolism of levodopa prior to crossing BBB.
