Parkinson's Disease Flashcards
Pathology of parkinsons disease?
Degeneration of the substantia nigra (lewy bodies form)
What symptoms HAVE to be present for diagnosis of parkinsons?
BRADYKINESIS
with one more of
- Tremor
- Rigidity
- Loss of postural reflexes
What is bradykinesis?
Slowness of movement initiation and progressing speed production
What is the typical parkinsonian tremor?
Pill rolling
What are the signs of parkinsons?
Rigidity (lead pipe)
Cogwheel pattern as tone broken up by tremor
EXPRESSIONLESS FACE
Short shuffling gate
What is the pattern of the rigidity?
Equal in both flexors and extensors
Tests?
Assess disability
Full exam
Clinical based diagnosis
What are the two classes of disease-altering drugs that can be used in parkinsons?
You basically want to increase dopamine levels
Dopaminergics
Apomorphine
- Non selective dopamine agonist
What dopaminergics should be used?
L-dopa
Can be used in conjunction with
Carbidopa
Why should dopaminergics not be started too soon?
Their effects wear off
What drugs can be used to help motor symptoms?
Anticholinergics
Antimuscarinics
What other management should be employed
REHABILLITATION
Formal exercises for posture
Respite care
Complications of parkinsons?
Dementia
- Rivastigmine
Depression
- SSRI
- Tricyclics
