Parkinson's Disease Flashcards
Define Parkinson’s disease.
The progressive degeneration of neurones in the substantia nigra, leading to a deficiency of the neurotransmitter dopamine.
Describe the aim of drug therapy for the treatment of Parkinson’s disease.
Drug therapy does not prevent disease progression, it improves most patient’s quality of life.
Give examples of dopaminergic drugs used in the treatment of Parkinson’s disease.
Levodopa, ropinirole, rotigotine, bromocriptine, cabergoline, pergolide, pramipexole.
With which class of anti-Parkinson’s drugs is there a risk of the patient developing impulse control disorders?
Dopaminergic drugs (levodopa, ropinirole, rotigotine).
How does levodopa work in the treatment of Parkinson’s disease symptoms?
It crosses the BBB and is converted into dopamine by DOPE decarboxylase, replacing the dopamine deficit which leads to the symptoms of Parkinson’s disease.
Further classify the dopaminergic drugs ropinirole and rotigotine.
Dopamine receptor agonist, triggering the dopamine receptors to reduce the symptoms of Parkinson’s disease.
What course of action should be taken if a patient with Parkinson’s disease, being treated with a dopaminergic drug experiences impulse control disorders?
The drug should be withdrawn or the dose reduced until the symptoms resolve.
What symptoms of dopaminergic drugs, used in the treatment of Parkinson’s disease, may cause issues when a patient is driving or operating machinery?
Excessive daytime sleepiness, sudden onset of sleep, hypotension.
With regards to the excessive daytime sleepiness and sudden onset of sleep associated with the use of dopaminergic drugs used in Parkinson’s disease, what counselling can be given to patients?
Improving sleep behaviour.
When is the hypotension associated with dopaminergic drugs most likely to occur?
In the first few days of treatment.
Use of which dopaminergic drugs is associated with pulmonary, retroperitoneal, and pericardial fibrotic reactions?
Bromocriptine, cabergoline, pergolide (ergot derivatives).
Before commencing treatment with ergot derivative dopaminergic drugs (bromocriptine, cabergoline, pergolide), what monitoring is required?
ECG, erythrocyte sedimentation rate, serum creatinine, chest x-ray.
During the use of ergot derivative dopaminergic drugs (bromocriptine, cabergoline, pergolide), what monitoring for what symptoms is required?
Dyspnoea, persistent cough, chest pain, cardiac failure, abdominal pain or tenderness.
What is the salt equivalent of 88mcg of pramipexole base?
125mcg salt.
What is the salt equivalent of 180mcg of pramipexole base?
250mcg salt.
