parkinsons, alzheimers, hypo/hyperthyroidism

Question 1

what neurotransmitter is linked to Parkinson’s Disease?

Answer 1

Dopamine

Question 2

Can someone be given straight dopamine?

Answer 2

yes, through IV only.

Question 3

Why do we not use Dopamine as a treatment for Parkinson’s?

Answer 3

It can not cross the blood brain barrier so it wont work

Question 4

What Drug is the cornerstone for Parkinsons?

Answer 4

Levodopa

Question 5

What drug is Levodopa always given with?

Answer 5

Carbidopa

Question 6

Why is Levodopa always given with Carbidopa?

Answer 6

Carbidopa protects levodopa from being converted to dopamine outside of the brain.

Question 7

What is foods affect on levodopa?

Answer 7

it can delay absorption

Question 8

What kind of diet will compete levodopa for amino acids?

Answer 8

Protein

Question 9

What is a big adverse effect with levodopa?

Answer 9

Dyskinesia

Question 10

Dyskinesia

Answer 10

involuntary muscle movements

Question 11

Dopamine agonists

Answer 11

Pramipexole & Ropinirole

Question 12

What disorder can Dopamine agonists cause?

Answer 12

Impulse control disorder

Question 13

Anticholinergic agents

Answer 13

benztropine

Question 14

When are anticholinergic agents most useful?

Answer 14

in combination with levodopa

Question 15

Adverse effects of anticholinergic agents?

Answer 15

drowsiness, trouble focusing, confusion, delusions and MEMORY PROBLEMS

Question 16

Alzheimers Disease

Answer 16

leading cause of dementia
low acetycholine in the brain

Question 17

Cholinesterase inhibitor

Answer 17

Donepezil

Question 18

Why do you avoid abrupt discontinuation of Donepezil?

Answer 18

It causes acute impairment in cognition and behavioral problems

Question 19

What is the purpose of Alzheimer meds?

Answer 19

they will slow the progression of dementia but will not reverse it

Question 20

Memantine

Answer 20

blocks glutamate
can be used with donepezil

Question 21

What can too much glutamate cause?

Answer 21

neurotoxicity

Question 22

Hypothyroidism

Answer 22

low thyroid hormones

Question 23

What are the 3 thyroid hormones

Answer 23

TSH, T3 and T4

Question 24

Is T3 or T4 more active?

Answer 24

T3

Question 25

Symptoms of hypothyroidism

Answer 25

lethargy, cold, dry skin, hair loss and high cholesterol

Question 26

What are T3 and T4 for?

Answer 26

energy use, cardiac activity, growth and development

Question 27

Levothyroxine

Answer 27

can be oral and injectable; used for hypothyroidism

Question 28

What are the rules with taking levothyroxine with food?

Answer 28

take on an empty stomach; 30-60 minutes before breakfast, evening : 3-4 hours after last meal

Question 29

Why is generic substitution controversial with levothyroxine?

Answer 29

The generics only have to be with in 80% (or higher) with the amount that will be in the blood stream as the brand name. This dose is so specific they want it to be consistent but with all the different manufacturers it is hard

Question 30

What do Brand name drugs have to prove?

Answer 30

relatively safe and effective

Question 31

What do generic drugs have to prove?

Answer 31

that 10mg of this generic is equivalent to 10mg of the brand drug dissolving. (with in 80% or higher)

Question 32

Armour Thyroid

Answer 32

mix of T3 and T4 like how the body would create it; treats hypothyroidism

Question 33

What is armour thyroid made of?

Answer 33

dried animal thyroid glands

Question 34

Hyperhtyroidism

Question 35

Methimazole

Answer 35

treats hyperthyroidism, blocks T3 and T4

Question 36

how long can you give methimazole?

Answer 36

12-18 months

Question 37

How many people relapse after methimazole?

Answer 37

30-70

Question 38

Adverse effects of methimazole

Answer 38

Agranulocytosis- medical emergency
hepatitis, hepatic failure

Question 39

When should you not take methimazole?

Answer 39

The 1st trimester of pregnancy