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Nervous system > Parkinsons disease > Flashcards

Parkinsons disease Flashcards

1
Q

What are the two types of symptoms in parkinsons disease?

A

Motor and non motor

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2
Q

If parkinsons is affecting daily life what is the first line treatment?

A

Levadopa

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3
Q

What is the alternative treatment in parkinsons disease if it is not affecting daily life

A

Levodopa
Non ergot derived dopamine receptor antagonist
MAOB inhibitor

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4
Q

Add on treatments in Parkinsons

A

Non ergot derived dopamine receptor antagonist
MAOB inhibitor
COMT inhibitor

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5
Q

When can Apomorphine SC be used

A

During “off periods” with levodopa/ cannot swallow wtc

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6
Q

What antiemetic cannot be used in Parkinsons and why

A

Metaclopramide cannot be used because it crosses BBB and causes parkinsonism symptoms

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7
Q

Domperidone and Apomorphine used together

A

Risk of QT prolongation when the two are given together so monitor ECG for signs of arrhythmias

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8
Q

How does Levodopa work

A

By replenishing dopamine in the brain

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9
Q

What are levodopa side effects?

A

End dose deterioration/ off periods
Impulse control disorders
Sudden sleep onset
Motor complications during off periods

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10
Q

Dopamine receptor antagonists- What are the non ergot derived?

A

Pramipexole
Ropinerole
Ritogitine

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11
Q

WHat are some other DRA

A

Apomorphine and Amantadine

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12
Q

WHat are the side effects of ergot derived DRA

A

FIbrotic reactions

Retroperitoneal-
Pericardial
Pulmonary

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13
Q

Side effects of DRA

A 
Cardiovascular events 
Sudden sleep onset 
Impulse control disorders 
Psychosis 
Hypotensive
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14
Q

MAOB- Inhibits MAOB what are the two MAOB

A

Selegline

Rasageiline

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15
Q

Interactions of MAOB

A

Hypertensive crisis- Adrenaline, noradrenaline, corticosteroids, pseudoephedrine, phenyl-ephedrine

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16
Q

COM-T inhibitors what are they?

A

Entacapone

Tolcapone

17
Q

What is the use for COMT inhibitors?

A

Never used alone, always with levodopa as they inhbit the enzyme catechol-o- methyltransfarase to stop the breakdown of levodopa so it can enter BBB

18
Q

Entacapone colours urine what colour

A

red/brown

19
Q

What is the patient counselling for COMT-I

A

Hepatotoxicity look our for signs of jaundice, N&V, abdo pain

20
Q

Interactions of COMT-I

A

increased cardiovascular effects

21
Q

Daytime sleepiness/ sudden onset of sleep treatment

A

have Parkinson’s meds adjusted/

Modafanil

22
Q

Postural hypo in Parkinsons 1st line treatment

A

Midodrine

23
Q

Psychotic symptoms do you always treat?

A

No. do not need treatment if well controlled.

If severe then treat
If no cognitive impairment give quetiapine

clozapine if ineffective

24
Q

rapid eye movement treatment

A

Clonazepam

25
Q

Drooling

A

Botulinum or glycopyronium

Nervous system (8 decks)

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