Parkinson's/RLS Flashcards
Gold standard for Parkinson’s is ___ (aka Sinemet).
carbidopa/levodopa
Long-term use of carbidopa/levodopa can l/t ___.
dyskinesia
Meds used to tx PD:
levodopa/carbidopa, dopamine agonists, COMT inhibitors, MAO selective inhibitors, amantadine, anticholinergics
Dopamine agonists have potential for ___ behaviors.
compulsive
MAO inhibitor includes: ___. Metabolites are amphetamine, so can cause ___ if taken later in day. Wait ___ wks before starting on another med.
Selegiline, insomnia, 2
COMT inhibitors include:
tolcapone, entacapone
Tolcapone has risk of ___, so monitor ___. Take ___ before or after meals at same time each day.
hepatotoxicity, LFT, 2
Entacapone has a ___ onset and ___ duration.
quick, short
___ is used as adjunctive therapy w/COMT, MAO inhibitors, carbidopa/levodopa if pt’s continue to have ___.
Amantadine, tremors
___ can also be used as adjunctive therapy for PD tx and is useful for ___. Avoid in ___ d/t urinary retention and confusion. May be difficult to ___ once started.
Anticholinergics, tremors, elderly, withdraw
From lowest to strongest potency:
MAO inhibitors, dopamine agonists, carbidopa/levodopa
Peripheral dopaminergic s/e include:
n/v/d, orthostatic hypotension
Central dopaminergic s/e include:
insomnia, somnolence, sleep attacks, hallucinations, psychosis, nightmares
Levodopa/carbidopa may interact w/___.
iron/ferrous sulfate
Avoid ___ w/dystonia.
CR
D-I-D represents ___ of disease.
progression
Nonmotor symptoms may include:
erectile dysfunction, orthostatic hypotension, urinary incont, constipation, excessive daytime sleepiness, insomnia, periodic limb movements of sleep, fatigue, REM sleep behavior disorder, anxiety
For cognitive-related PD, tx dementia w/___.
rivastigmine
Atypical antipsych’s to use in PD include:
quietiapine, clozapine, ariprazole
___ and ___ are shown to be effective in tx’ing essential tremors.
Propranolol, primidine
Tx for RLS is similar to that of ___.
PD
Nonpharmacologic tx for RLS includes: ___ activities, stopping ___/___/___, supplementing w/___ if deficient.
alerting, caffeine, nicotine, alcohol, iron
Most common cause of RLS is ___ deficiency.
iron
70% of pts who use carbidopa/levodopa experience ___ of RLS symptoms, which is known as ___. Tx is to ___ the dose and change meds.
worsening, augmentation, decrease
Both ___ and ___ stimulation alleviate the symptoms of RLS.
physical, mental
Any pt w/a plasma ferritin concentration < 50mcg and have RLS symptoms should be started on an ___ ___.
iron replacement
___/___ is a good choice for pt’s w/intermittent symptoms b/c it can be taken on a ___ basis.
carbidopa/levodopa, PRN
___ is effective in tx’ing tremors.
propranolol
