Parkinsons Alzheimers.pptx Flashcards
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. levodopa
c. carbidopa
d. entacapone
f. pramiprexole/ ropinirole
g. benztropine
i. bromocriptine/apomorphine
Which are ALZHEIMERS drugs
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine
b. rivastigmine
e. donepezil
h. memantine
Is there a cure for PARKINSONS?
Yes or no
No
PARKINSONS Symptoms T R A P B
Tremor Rigidity Akinesia Posterier Instability Bradykinesia
Parkinson’s Pathophysiology
- ? of dopamine neurons
a. Gain
b. Loss
b. Loss
Parkinson’s Pathophysiology Where are these dopamine neurons destroyed? In Order a. Basal Ganglia b.Substantia Nigra c. Extra Pyramidal System (EPS)
b. Substantia Nigra
a. Basal Ganglia
c. Extra Pyramidal System (EPS)
Which has Acetylcholine◦Dopamine?
a. Basal Ganglia
b. Substantia Nigra
c. Extra Pyramidal System (EPS)
a. Basal Ganglia
Which causes Parkinson’s
a. High Acetylcholine + High Dopamine
b. Low Acetylcholine + High Dopamine
c. High Acetylcholine + Low Dopamine
c. High Acetylcholine + Low Dopamine
PARKINSONS
Symptoms do not typically appear until ? neurons destroyed?
a. 80
b. 90
a. 80
Precursor of Dopamine= ?
a. K-Dopa
b. L-Dopa
b. L-Dopa
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. levodopa +carbidopa
L-Dopa
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
c. carbidopa
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
c. 1-3% goes to the brain
Which will a Parkinson’s patient experience While on Dopamine Medications?
a. TROUGH/ Wearing Off Phenomenon
b. Honeymoon period
c. On/OffPhenomenon
d. All
d. All
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. Nausea and vomiting
f. Postural/orthostatic hypotension
h. Tachycardia/Palpitations
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. Nausea and vomiting
b. Psychosis/Agitation/Hallucinations
c. Drowsiness
d. Melanoma
e. Impulse Control Issues
g. Hyper sexuality, gambling behavior
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
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
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. 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
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. Improved sense of well-being
c. Increased appetite
e. Improved ability to think and concentrate
g. Reduced TRAP symptoms
Is it true that Parkinson‘s patient should stay hydrated because of the medication. T/F
No because of the disease
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
f. pramiprexole/ ropinirole
i. bromocriptine/apomorphine
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
d. entacapone
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
d. entacapone
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
d. entacapone
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
d. entacapone
k. tolcapone *****
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
d. entacapone
k. tolcapone *****
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
d. entacapone
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
f. pramiprexole/ ropinirole
i. bromocriptine/apomorphine
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
f. pramiprexole/ ropinirole
i. bromocriptine/apomorphine
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
f. pramiprexole/ ropinirole
i. bromocriptine/apomorphine
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
f. pramiprexole/ ropinirole
i. bromocriptine/apomorphine
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
f. pramiprexole/ ropinirole
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
b. They are because they are stimulating the dopamine receptor directly
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. impulse control issues
b. sleep attacks
c. psychosis
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
g. benztropine
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
g. benztropine
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
g. benztropine
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
g. benztropine
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
g. benztropine
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
g. benztropine
Since benztropine has anticholinergic effects such dry mouth/ eyes, constipation, and urine retention, What can a patient do?
a. Nothing
b. Drink water
b. Drink water
Alzheimer’s Disease develops when Acetylcholine levels ?% below normal.
a. 80
b. 90
b. 90
Is there a cure for Alzheimer’s Disease?
Y/N
No
Which are Cholinesterase Inhibitors’
a. levodopa
b. rivastigmine
c. carbidopa
d. entacapone
e. donepezil
f. pramiprexole/ ropinirole
g. benztropine
h. memantine
i. bromocriptine/apomorphine
b. rivastigmine
e. donepezil
Remember that the ? and other parts of the brain require appropriate levels of Acetylcholine.
a. cancer
b. hippocampus
b. hippocampus
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
g. benztropine
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
b. rivastigmine
e. donepezil
rivastigmine & donepezil
Only work in ? in 12 patients shown to benefit
1
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
b. rivastigmine
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
e. donepezil
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
b. rivastigmine
e. donepezil
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
b. rivastigmine
e. donepezil
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
e. donepezil
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
b. rivastigmine
e. donepezil
