Parkinsons Disease Flashcards
What causes Parkinson’s disease?
Degeneration of dopaminergic neurons, causing reduced dopamine in the nigrostrial tract & increased GABA activity
What are the symptoms of Parkinson’s disease?
Tremor
Muscle rigidity
Stiffness
Uncontrolled muscle movements
Urinary problems
Constipation
Depression
Dementia
Dyskinesia
What is the mechanism of action of levodopa?
It is a dopamine precursor which replenishes dopamine by transporting across the BBB
What is given alongside levodopa to prevent levodopa peripheral breakdown?
Dopa-decarboxylase inhibitors, e.g. benseraside
It also aids in minimising side effects like N+V
Which antiemetic is used to treat N+V in Parkinson’s disease?
Domperidone
What are some examples of levodopa + dopa de-carboxylate inhibitor combination drugs?
Madopar
Carbidopa
What can MR levodopa help with?
End of dose deterioration
What are some examples of ergot-derived dopamine agonists?
Bromocriptine
Cabergoline
What are some examples of non-ergot derived dopamine agonists?
Ropinirole
Pramipexole
Out of the 2 types of dopamine receptor agonists, which one is most preferred?
Non-ergot derived
What should patients on ergot-derived dopamine agonists monitor for?
Cough
Fever
Chest pain
Cardiac failure
- Because they can cause fibrotic reactions
What are some examples of monoamine-oxidase B inhibitors?
Selegline
Rasagline
Safinamide
When are monoamine oxidase B inhibitors used?
Used with levodopa to reduce ‘end of dose’ deterioration and allows levodopa dose reductions
What are some examples of COMT inhibitors?
Entacapone
Talcapone
How do COMT inhibitors work?
They prevent the peripheral breakdown of levodopa by inhibiting COMT enzymes. so more levodopa reaches the brain
