Parkinson's Disease Medications

Question 1

What are the 2 main types of drug options for Parkinson’s disease?

Answer 1

1. drugs that increase dopamine activity
2. drugs that decreased acetylcholine

Question 2

Do Parkinson’s medications actually stop the progression of Parkinson’s disease?

Answer 2

NO

Question 3

What are the specific medication options for Parkinson’s disease? (hint: Dogs Sniff Ass)

Answer 3

1. Dopamine Agonists (activators)
2. Selegiline (se-LE-ji-leen)
3. Anticholinergics

Question 4

What are the 3 dopamine agonists that you should know? (hint: CPR)

Answer 4

1. Carbidopa/levodopa
2. Pramipexole
3. Ropinirole

Question 5

What are the common uses of Dopamine Agonists?

Answer 5

-help treat Parkinson’s disease
-help with restless leg syndrome (only taken at night)

Question 6

Carbidopa/Levidopa mechanism of action

Answer 6

-levodopa gets converted to dopamine before it crosses the blood-brain barrier
-Carbidopa prevents that conversion from occurring while not crossing the blood-brain barrier itself

Question 7

Pramipexole & Ropinirole Mechanism of Action

Answer 7

-stimulates dopamine receptors in brain

Question 8

What foods should be avoided when taking Carbidopa & Levodopa?

Answer 8

-Protein
-Vitamin B6 (pyridoxine; e.g. green vegetables, bananas, legumes)
-iron supplements

Question 9

How do Dopamine Agonists cause Orthostatic Hypotension?

Answer 9

-altering dopamine levels affects blood pressure level

Question 10

How do Dopamine Agonists cause Psychiatric issues?

Answer 10

• it causes paranoia and hallucinations due to increased dopamine activity in the brain

Question 11

Patients who develop hallucinations from dopamine agonists rather than schizophrenia have what type of hallucinations?

Answer 11

visual rather than auditory

Question 12

Pramipexole and Ropinirole can cause ______ control issues

Answer 12

-impulse
-clients may become addicted to gambling, shopping, binge eating

Question 13

What are common uses of Selegiline?

Answer 13

-oral versions is for Parkinson’s
-transdermal version is for depression

Question 14

What is the Mechanism of Action for Seligiline

Answer 14

-Selegiline is a monoamine oxidase-B (MAO-B) inhibitor.
-it only prevents the breakdown of dopamine (only increases dopamine production)

Question 15

What types of food should you avoid when taking selegiline?

Answer 15

Tyramine-rich foods
(e.g., many kinds of cheese, smoked/cured meats, figs, avocados, many kinds of beer and wine, soy sauce, etc.)

Question 16

What drugs should you avoid when taking Selegiline?

Answer 16

other drugs that increase monamines (e.g., other antidepressants, meperidine, and pseudoephedrine).

Question 17

What anticholinergics should you know? (hint: Beez in the Trap)

Answer 17

1. Benztropine
2. Trihexyphenidyl

Question 18

Common uses of Anticholinergics

Answer 18

-treat Parkinson’s
-treat extrapyramidal effects caused by antipsychotic medications

Question 19

Anticholinergic mechanism of action

Answer 19

Anticholinergic medications block actylcholine receptors in the brain. This helps artificially correct the dopamine/acetylcholine imbalance in the nigrostriatal pathway.

Question 20

What are the Anticholinergic High Yield Concepts?

Answer 20

-has anticholinergic side effects including difficulty voiding, urinary retention, constipation, etc.
-Drowsiness is another common effect.