Parkinson's disease

Question 1

what are the side effects of L-DOPA and Carbidopa (Sinemet)

Answer 1

nausea,
hypotension,
depression,
psychosis (up to 15%)

Question 2

name the 4 dopamine receptor agonists

Answer 2

Ropinirole (Requip) – Dose 0.5-10 mg/day
Pramipexole (Mirapex)- Dose 1-5 mg/day
Pergolide (Permax) – pulled from market 2007
for causing heart valve defects
--Apomorphine

Question 3

what is Amantadine (symmetryl)

Answer 3

A Drug which facilitates the release of endogenous dopamine.
(May also work as a glutamate receptor
antagonist)

Question 4

what sx’s are seen in Dopamine Receptor Agonists toxicity

Answer 4

Nausea,
hallucinations
Sudden onset of sleep (car accidents)
cardiac valve thickening (Pergolide, FDA withdrew drug)

Question 5

Carbidopa – blocks _______ in intestine,

liver, and other peripheral tissues, delivers 90% to brain

Answer 5

DOPA decarboxylase

Question 6

what are Rasagiline, and Selegiline

Answer 6

MAO inhibitor – blocks the breakdown of dopamine

Question 7

what are Tolcapone, and Entacapone

Answer 7

Catechol-o-methyl transferase inhibitors (COMT inhibitors) – block metabolism of L-DOPA and
dopamine

Question 8

what are Trihexyphenidyl,

• -Benztropine &
• -Diphenhydramine

Answer 8

Anticholinergics - Have some limited value in treating some patients with
tremor

Question 9

what are Thalamotomy and Pallidotomy

Answer 9

Surgical treatments for Parkinson’s
Thalamotomy—relieves tremor
Pallidotomy—relieves drug-induced dyskinesias

Question 10

what environmental factors have shown to increase risk of Parkinsons

Answer 10

well water,
pesticides,
copper
iron

Question 11

what environmental factors have shown to decrease risk of Parkinson,s

Answer 11

tea, coffee, smoking

Question 12

L-DOPA can be absorbed _______ ; it crosses the blood brain barrier and is converted in the brain to dopamine by aromatic L-amino acid decarboxylase which is found in surviving _______ nerve terminals

Answer 12

orally

dopaminergic

Question 13

what are the side effects of anti cholinergic drugs?

Answer 13

Side effects reflect block of peripheral parasympathetic activity including dry mouth, constipation, and urinary retention

Question 14

what are the side effects of maoi’s?

Answer 14

worsening of postural hypotension