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Pharmocology > Parkinsons Alzheimers.pptx > Flashcards

Parkinsons Alzheimers.pptx Flashcards

1
Q

Which are PARKINSONS drugs

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

a. levodopa
c. carbidopa
d. entacapone
f. pramiprexole/ ropinirole
g. benztropine
i. bromocriptine/apomorphine

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2
Q

Which are ALZHEIMERS drugs

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

b. rivastigmine
e. donepezil
h. memantine

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3
Q

Is there a cure for PARKINSONS?

Yes or no

A

No

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4
Q 
PARKINSONS
Symptoms
T
R
A
P
B
A 
Tremor
Rigidity 
Akinesia
Posterier Instability
Bradykinesia
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5
Q

Parkinson’s Pathophysiology

  1. ? of dopamine neurons
    a. Gain
    b. Loss
A

b. Loss

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6
Q 
Parkinson’s Pathophysiology
Where are these dopamine neurons destroyed?  In Order
a. Basal Ganglia
b.Substantia Nigra
c. Extra Pyramidal System (EPS)
A

b. Substantia Nigra
a. Basal Ganglia
c. Extra Pyramidal System (EPS)

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7
Q

Which has Acetylcholine◦Dopamine?

a. Basal Ganglia
b. Substantia Nigra
c. Extra Pyramidal System (EPS)

A

a. Basal Ganglia

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8
Q

Which causes Parkinson’s

a. High Acetylcholine + High Dopamine
b. Low Acetylcholine + High Dopamine
c. High Acetylcholine + Low Dopamine

A

c. High Acetylcholine + Low Dopamine

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9
Q

PARKINSONS
Symptoms do not typically appear until ? neurons destroyed?
a. 80
b. 90

A

a. 80

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10
Q

Precursor of Dopamine= ?

a. K-Dopa
b. L-Dopa

A

b. L-Dopa

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11
Q 
Treats:
Parkinson's
Restless Legs Syndrome (off label)
a. levodopa +carbidopa (L-Dopa + carbidopa)
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

a. levodopa +carbidopa

L-Dopa

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12
Q

Which INHIBITS the peripheral breakdown (before it crosses the Blood Brain Barrier) of levodopa to allow more L-Dopa to get into the brain?

a. levodopa +carbidopa (L-Dopa + carbidopa)
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

c. carbidopa

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13
Q

Why we do not use L- Dopa as a monotreatment?

a. We can
b. 91-93 % goes to the brain
c. 1-3% goes to the brain

A

c. 1-3% goes to the brain

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14
Q

Which will a Parkinson’s patient experience While on Dopamine Medications?

a. TROUGH/ Wearing Off Phenomenon
b. Honeymoon period
c. On/OffPhenomenon
d. All

A

d. All

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15
Q

Al dopamine Med cause ?

a. Nausea and vomiting
b. Psychosis/Agitation/Hallucinations
c. Drowsiness
d. Melanoma
e. Impulse Control Issues
f. Postural/orthostatic hypotension
g. Hyper sexuality, gambling behavior
h. Tachycardia/Palpitations

A

a. Nausea and vomiting
f. Postural/orthostatic hypotension
h. Tachycardia/Palpitations

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16
Q

In Dopamine Precursor/Replacements- ADVERSE EFFECTS◦Peripheral ( (Central- inside the BBB))

a. Nausea and vomiting
b. Psychosis/Agitation/Hallucinations
c. Drowsiness
d. Melanoma
e. Impulse Control Issues
f. Postural/orthostatic hypotension
g. Hyper sexuality, gambling behavior
h. Tachycardia/Palpitations

A

a. Nausea and vomiting
b. Psychosis/Agitation/Hallucinations
c. Drowsiness
d. Melanoma
e. Impulse Control Issues
g. Hyper sexuality, gambling behavior

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17
Q

What is true about DYSKINESIAS

a. If you give not enough L-Dopa, it can PEAK inside the brain
b. If you give too much L-Dopa, it can PEAK inside the brain
c. Not enough causes more affinity for D2 receptors in substantia nigra
d. Too much- loses affinity for D2 receptors in substantia nigra
e. Will not bind to other receptors in the EPS
f. May bind to other receptors in the EPS

A

b. If you give too much L-Dopa, it can PEAK inside the brain
d. Too much- loses affinity for D2 receptors in substantia nigra
f. May bind to other receptors in the EPS

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18
Q

Which is important to tell a patient?- L-Dopa + Carbidopa

a. Educate patients- GI effects are common
b. Educate patients- GI effects are not common
c. Take with food to induce (yes protein)
d. Take with food to reduce (no protein)
e. L-Dopa can cause dyskinesias
f. Reduce dose or add medications to treat dyskinesias
g. discoloration of urine/sweat/bodily fluids
h. unusual sleepiness
i. Report any skin lesions as L-Dopa has been linked with j. activation of melanomas

A

a. Educate patients- GI effects are common
d. Take with food to reduce (no protein)
e. L-Dopa can cause dyskinesias
f. Reduce dose or add medications to treat dyskinesias
g. discoloration of urine/sweat/bodily fluids
h. unusual sleepiness
i. Report any skin lesions as L-Dopa has been linked with j. activation of melanomas

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19
Q

Patients should notice improvements over several weeks with - L-Dopa + Carbidopa what true?

a. Improved sense of well-being
b. Decreased concentration
c. Increased appetite
d. Decreased appetite
e. Improved ability to think and concentrate
f. Induced TRAP symptoms
g. Reduced TRAP symptoms

A

a. Improved sense of well-being
c. Increased appetite
e. Improved ability to think and concentrate
g. Reduced TRAP symptoms

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20
Q

Is it true that Parkinson‘s patient should stay hydrated because of the medication. T/F

A

No because of the disease

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21
Q

Which drugs are dopamine agonist drugs?

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

f. pramiprexole/ ropinirole

i. bromocriptine/apomorphine

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22
Q

Which drug only just treats Parkinson’s ?

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

d. entacapone

23
Q

Which drugs decreases L- Dopa peripheral breakdown?

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

d. entacapone

24
Q 
Which drug causes (With L-DOPA)
Orange-yellow discoloration of urine
Diarrhea- #1 cause for discontinuation
Hepatocellular injury and liver failure 
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

d. entacapone

25
Q 
Which cause Hepatocellular injury and liver failure 
with L-Dopa?
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
k. tolcapone
A

d. entacapone

k. tolcapone *****

26
Q

Which drug with L-Dopa should Liver function should be measured periodically.

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine
k. tolcapone

A

d. entacapone

k. tolcapone *****

27
Q

Which drug with L- Dopa causes orange/yellow urine/sweat- notify patients this is harmless

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

d. entacapone

28
Q 
Which drugs treat 
Parkinson's
Restless Leg syndrome 
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

f. pramiprexole/ ropinirole

i. bromocriptine/apomorphine

29
Q

Which drugs have the biggest side effects of Parkinson’s Medications is Nausea

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

f. pramiprexole/ ropinirole

i. bromocriptine/apomorphine

30
Q

I’m Prabably going to throw up. Which drugs?

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

f. pramiprexole/ ropinirole

i. bromocriptine/apomorphine

31
Q

Which drugs Stimulate Dopamine Receptors (Dopamine receptor agonists)

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

f. pramiprexole/ ropinirole

i. bromocriptine/apomorphine

32
Q

Which drugs causes Sedation- “sleep attacks”

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

f. pramiprexole/ ropinirole

33
Q

pramiprexole/ ropinirole / bromocriptine/apomorphine have the same following adverse side effect as L-Dopa drugs. But why are they more severe?
Nausea occurs >50% patients
Postural hypotension◦Confusion
Impulse Control Issues (Gambling/hyper sexuality)
Hallucinations

a. They are not more severe
b. They are because they are stimulating the dopamine receptor directly

A

b. They are because they are stimulating the dopamine receptor directly

34
Q

Which of the following you should educated you patient about when they are taking pramiprexole/ ropinirole / bromocriptine/apomorphine ( Dopamine agonist)

a. impulse control issues
b. sleep attacks
c. psychosis
d. hypertension

A

a. impulse control issues
b. sleep attacks
c. psychosis

35
Q

Which is an Anticholinergics drug with Parkinson

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

g. benztropine

36
Q

Which drug treat tremors (rigidity) with Parkinson

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

g. benztropine

37
Q

Which treats Pseudoparkinsons/Extrapyramidal Symptoms (EPS) caused by antipsychotics

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

g. benztropine

38
Q

Which is Muscarinic receptor antagonist – partially blocks cholinergic activity in basal ganglia.

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

g. benztropine

39
Q 
Which drug has this Adverse Side effect?
Peripheral- opposite of SLUDGE
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

g. benztropine

40
Q 
Which drug has this Adverse Side effect?
Central-sedation/confusion/hallucination
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

g. benztropine

41
Q

Since benztropine has anticholinergic effects such dry mouth/ eyes, constipation, and urine retention, What can a patient do?

a. Nothing
b. Drink water

A

b. Drink water

42
Q

Alzheimer’s Disease develops when Acetylcholine levels ?% below normal.

a. 80
b. 90

A

b. 90

43
Q

Is there a cure for Alzheimer’s Disease?

Y/N

A

No

44
Q

Which are Cholinesterase Inhibitors’

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

b. rivastigmine

e. donepezil

45
Q

Remember that the ? and other parts of the brain require appropriate levels of Acetylcholine.

a. cancer
b. hippocampus

A

b. hippocampus

46
Q

Which drug would you give to young adult and Geriatics because of fall risk?

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

g. benztropine

47
Q

Which drug treats Alzheimer’s Disease

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

b. rivastigmine

e. donepezil

48
Q

rivastigmine & donepezil

Only work in ? in 12 patients shown to benefit

A

1

49
Q 
Acetylcholinesterase Inhibitors:
which is a patch?
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

b. rivastigmine

50
Q 
Acetylcholinesterase Inhibitors:
Which is a pill?
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

e. donepezil

51
Q

Which block the enzyme acetylcholinesterase which normally breaks down acetylcholine/

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

b. rivastigmine

e. donepezil

52
Q 
Which of the following drugs have this Adverse effect
Bronchospasm
bronchorrhea
bradycardia
SLUDGE
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole 
g. benztropine
h. memantine
i. bromocriptine/apomorphine
A

b. rivastigmine

e. donepezil

53
Q

Which drug should be taken at night?

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

e. donepezil

54
Q

Which solely has adverse side effects with the Lungs GI, and Heart

a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine

A

b. rivastigmine

e. donepezil

Pharmocology (36 decks)

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