Parkinsons Flashcards
What are some motor symptoms in parkinsons
Hypokinesia
Bradykinesia
Rigidity
Rest
Tremor
Postural instability
What are some non motor symptoms of Parkinson’s
Dementia
Depression
Sleep disturbances
Bladder and bowel dysfunction
Speech and language changes
Swallowing issues
Weight loss
What is the drug management of motor symptoms in Parkinsons
First line treatment if motor symptoms are decreasing quality of life - Levodopa (combined with carbidopa to make co-careldopa or benserazide to make co-beneldopa)
Managing non- motor symptoms: Daytime sleepiness
Modafinil
Don’t drive, inform DVLA
Managing non- motor symptoms: Nocturnal akinesia
First line: Levodopa or oral dopamine-receptor agonists
Second Line: Rotigotine
Managing non- motor symptoms: Postural hypotension
Midodrine
Fludrocortisone: second line
Managing non- motor symptoms: Psychotic symptoms
Quetiapine
Clozapine as alternative
Managing non- motor symptoms: Rapid eye movement
Clonazepam/ melatonin
Managing non- motor symptoms: Drooling of saliva
First line: Glycopyrronium bromide
Second line: Botulinum toxin Type A
What is given in advanced Parkinson’s disease
Apomorphine
(give domperidone to control nausea and vomiting associated with apomorphine)
Impulse control disorders are possible when patients are given what?
Dopaminergic therapy (levodopa, ropinorole, rotigotine)
What are some com-t inhibitors
Opicapone
Tolcapone
Entacapone - changes colour to reddish-brown
What colour can entacapone colour the urine
Red/brown
Caution with bromocriptine
Pulmonary retropentoneal reactions
Caution with prampexole
Postural hypotension - give midodrine
