Parkinson's Drugs

Question 1

Parkinson’s Dse is also known as

Answer 1

paralysis agitans

Question 2

PD is caused by

Answer 2

degeneration of dopaminergic neurons in substantia nigra

Question 3

PD Triad

Answer 3

Bradykinesia, Resting Tremors, Dystonia

Question 4

Manifestations of PD

Answer 4

It’s a TRAP.

Tremor
Rigidity
Akinesia
Postural Instability

Question 5

Pathological Hallmark of PD

Answer 5

loss if pigmented, dopaminergic neurons of the substantia nigra pars compacta

with the appearance of intracellular inclusions known as LEWY BODIES

Question 6

Principal component of Lewy Bodies

Answer 6

aggregated alpha-synuclein

Question 7

Drug Induced Parkisonism

Answer 7

Typical antipsychotics (Dopamine antagonists)
Reserpine (depletes catecholamine stores)
MPTP (protoxin damaging dopaminergic neurons)

Question 8

alternating periods of improved mobility and akinesia during treatment that is UNRELATED to timing of doses

Answer 8

ON-OFF PHENOMENA

Question 9

alternating periods of improved mobility and akinesia during treatment that is RELATED to timing of doses

Answer 9

WEARING-OFF PHENOMENA

Question 10

Drugs causing Livedo Reticularis

Answer 10

A man reads FHM and GQ

Amantadine
Hydroxyurea
Minocycline
Gemcitabine
Quinidine

Question 11

Drugs for Huntington Disease

Answer 11

TETRABENAZINE, RESERPINE

depletes amine transmitters (Dopamine) from nerve endings by reversibly inhibiting human vesicular monoamine transporter type 2 (VMAT2) resulting to decrease uptake of monoamines

Question 12

Drugs for Tourette’s Syndrome

Answer 12

Haloperidol, Pimozide

Blocks central D2 receptora, reduce vocal and motor tic frequency and severity

Question 13

dopamine precursor

Answer 13

Levodopa-Carbidopa

Question 14

DOC for PD

Answer 14

Levodopa-Carbidopa

Question 15

should not be given to patients taking L-dopa

Answer 15

Phenothiazine

Question 16

AE of L-dopa + Carbidopa

Answer 16

On-Off phenomena, Wearing-off phenomena

Question 17

ERGOT DOPAMINE AGONIS

Answer 17

Bromicriptine
Pergolide
Cabergoline
Piribedil

Question 18

MOA: DOPAMINE AGONIST ERGOT

Answer 18

partial agonist at D2 receptors in brain

Piribedil - acts as a D3 agonist and A2 antagonist

Question 19

USE: DOPAMIN AGONIST ERGOT

Answer 19

PD, LEVODOPA INTOLERANCE, HYPERPROLACTINEMIA

Question 20

AE OF BROMOCRIPTINE

Answer 20

erythromelalgia and pulmonary infiltrate

Question 21

DOPAMINE AGONIST NON ERGOT

Answer 21

PRAMIPEXOLE, ROPINIROLE

Question 22

MOA: DOPAMINE AGONIST NON ERGOT

Answer 22

Partial agonist at D2 (pramipexole) and D3 (ropinirole)

Question 23

USE: NON ERGOT

Answer 23

PD, RESTLESS LEGS SYNDROME, ON-OFF PHENOMENON

Question 24

OPIOID DOPAMINE AGONIS

Answer 24

APOMORPHINE

Question 25

MOA: APOMORPHINE

Answer 25

agonist at D2 | antagonist at 5HT and alpha adrenoceptors

Question 26

USE: APOMORPHINE

Answer 26

rescue tx for off-periods of PD, Alcoholism, opiate addiction, erectile dysfunction, alzheimer's

Question 27

Premedicate with ______ before taking Apomorphine

Answer 27

TRIMETHOBENZAMIDE

Question 28

SELECTIVE MAO B inhibitors

Answer 28

SELEGILINE RASAGILINE no cheese effect

Question 29

COMT INHIBITORS

Answer 29

ENTACAPONE, TOLCAPONE

Question 30

ANTICHOLINERICS FOR PD

Answer 30

BENZTROPINE BIPERIDEN TRIHEXYPHENIDYL PROCYCLIDINE

Question 31

COMT inhibitor in the brain

Answer 31

Tolcapone

Question 32

COMT inhibitor at periphery

Answer 32

Entecapone, Tolcapone

Question 33

Notable side effect of COMTi

Answer 33

Orange urine Hepatotoxicity - Tolcapone only

Question 34

Drug that potentiates dopaminergic function by influencing the synthesis, release or reuptake of dopamine and is also used for influenza.

Answer 34

AMANTADINE

Question 35

Drug class that decreseas the excitatory actions of cholinergic neurons on cells in the striatum by blocking muscarinic receptors.

Answer 35

ANTICHOLINERGICS

Question 36

AE: Anticholinergics

Answer 36

Atropine-like effects (urinary retention, constipation, dry mouth)

Question 37

Acute Dystonia

Answer 37

Diphenhydramine

Question 38

Parkinsonism and Rabbit Syndrome

Answer 38

Benztropine

Question 39

Akathisia

Answer 39

Diphenhydramine