parkinson ttt

Question 1

Drug list mnemonic

Answer 1

Levocarp Apes seem Amazed peripexol Bring Benzo, Entacapone!Levo/carpidopa, apomorphine, Amantadine, peripexol, Bromocriptine, Bezotropine, Entacapone

Question 2

why we reserve L-dopa Till Symptoms become Trouble Some, although it’s the most effective drug in parkinson?

Answer 2

It’s The most effective as it improves all Signs and Symptoms brady kinesia but after Few years benefits decrease due to gradual neural degradation.

Question 3

Mention adverse effects of L-dopa.

Answer 3

1- Nausea , Vomiting 2- Hypotension arrythmia 3- Flauctuation in.Response ..on/off effect ..wearing off / End close Akinesia4- DysKinesia choreathetosis.5- pshycosis

Question 4

Drug used to Solve on/off effect of L-dopa… Mechanism?

Answer 4

(1) Entacapone COMT inhibitor(2) Apo Morphine (Sc) D₂ Agonist

Question 5

Drug used to solve End of doseAkinesia…. mechanism

Answer 5

(1) SelegilineMAOB inhibitor(2) Apomorphine resueD2 Agonist

Question 6

Don’t Take Vit B6 with L-dopa!why?

Answer 6

↑ periphral advese effect (vommiting, diarrhea, Nausea Hypotension, arrythmia)asIncrease peripheral metabolism of L-dopa to dopamine

Question 7

How To decrease periphral adverse effects of L-dopa.

Answer 7

useDompeidone (Dz Agonist) → block CTZ →↓ vomiting, Nausea* doesn’t interfere with Central L dopa Can’t Cross BBB2 Don’t use Vit B6 with L-dopa

Question 8

Advantage of (L-dopa / carbidopa)

Answer 8

1- Decrease daily dose of Ldopa by75%2- decrease periphral side effect3- Improve signs and symptoms Rapidly.

Question 9

Adverse effect of Apo Morphine

Answer 9

Severe Vomiting →require pre, post antiemetic

Question 10

Selegiline1- Mechanism of action2- indications.

Answer 10

1- Selegiline is MAO B inhibitor.2- decrease Breakdown of dopamine End of dose Akinesia

Question 11

Selegiline Adverse effects

Answer 11

HallucinationDyskinesia InsomniaLow risk cheese reaction

Question 12

Amantadine Mechanism and indications.

Answer 12

1- Block NAMDA receptors ↑ Dp Release2- as parkinson drug therapy

Question 13

Amantadin Adverse effect.

Answer 13

1- Ankle edema2- Livido Reticularis3- Hallucination4- dyskinesiaEasy Tolerated /Fast

Question 14

Pramipexole Mechanism And Adverse effects

Answer 14

1- Non ergort D2 Agonist.Adverse1-Day time sleepiness2- impulse control disorder3- Hallucination, Hypotension

Question 15

BromocriptineAdverse effect Mechanism

Answer 15

D2 Agonist ergotAdverse1- Fibrosis Cardia Lung2- Vasospasm3- Hallucination, Hypotension

Question 16

what Bezotropine best at?why?

Answer 16

best at (Tremors) than rigidity bradykinesiaAs it’s Anticholenergic Central blockerRestore Ach/ Dp balance

Question 17

How bezotropine interfere with L-dopa ?

Answer 17

delaying its GI absorption.May delay gastric emptying

Question 18

Benzo tropine Adverse effects

Answer 18

same as Atropine Confusion, constipation, dry mouthelder1- Hallucination, Demensia2- Urine Retention (BPH)

Question 19

Drugs used to Treat Dementia induced by parkinson

Answer 19

RivastigmineMemantine (NAMD Blocker)

Question 20

Drug choice as antiphysotic as a complication of Parkinson.

Answer 20

1- clozapine2-Antidepressant

Question 21

Entacapone.Mechansim shows that it can’t given alone.

Answer 21

It’s COMT inhibitorL-dopa periphral metabolism To dopamineon/off effect (best).✓ wearking off

Question 22

Adverse effects of Entacapone

Answer 22

dizziness.diarrhea.Nausea.movements you cannot control.drowsiness.