Parkinsons Disease

Question 0

What is going on chemically with Parkinson’s

Answer 0

Too much acetylcholine and not enough dopamine

Question 1

What type of a disease is Parkinson’s

Answer 1

Degenerative

Question 2

What two drug types are used for Parkinson’s

Answer 2

Dopaminergics and anticholinergic

Question 3

Dopamine is considered a _____ neurotransmitter

Answer 3

Inhibitory

Question 4

Acetylcholine is considered a _____ neurotransmitter

Answer 4

Excitatory

Question 5

Dopaminergics

Answer 5

Increase amount of dopamine available

Question 6

What do you have to have to produce dopamine

Answer 6

Levodopa

Question 7

Larodopa (levodopa) (L-dopa)

Answer 7

Precursor of dopamine synthesis

Can cross the blood brain barrier (dopamine can’t)

Question 8

What can we do to get more levodopa to the brain

Answer 8

Add carbidopa to levodopa

Question 9

Sinemet (carbidopa-levodopa)

Answer 9

Combination between carbidopa and levodopa to get more levodopa to the brain so more dopamine can be made

Question 10

Side effects of sinemet

Answer 10

Eps symptoms (uncontrolled movements of face, tongue, arms, upper body)

Question 11

What is bad about the side effects of sinemet

Answer 11

They are the same side effects that people with Parkinson’s want to get rid of

Question 12

You should use sinemet with caution for what type if patients

Answer 12

Emphysema, history of mi, asthma, severe organ disease

Most Parkinson’s patients have one of these

Question 13

There aRe many interactions with Parkinson’s drugs

Answer 13

True

Mostly with other CNS depressants

Question 14

Dopamine agonists

Answer 14

Directly activate dopamine receptors

Make brain think there are more

Question 15

Side effects of dopamine agonists

Answer 15

Can be severe

Nausea, constipation, headache, orthostatic hypotension, hallucinations

Question 16

Why are dopamine agonist side effects better than dopaminergic drugs if dopamine agonists are more severe

Answer 16

Patients respond better because their Parkinson’s symptoms are gone

Question 17

Mirapex (pramipexole)

Answer 17

Dopamine agonist

Most common

Question 18

Requip (ropinirole)

Answer 18

Dopamine agonist

Question 19

You should use caution when giving dopamine agonist agents to what patients

Answer 19

History of orthostatic hypotension (side effect)
Hallucinations
Renal impairment

Question 20

Antiviral medication (and dopaminergic)

Answer 20

Increase release of dopamine from nerve terminals

Blocks reuptake of dopamine

Question 21

Symmetrel (amantadine)

Answer 21

Antiviral medication and dopaminergic

Question 22

What kind of cautions should you take when giving antiviral medications

Answer 22

Orthostatic hypotension and seizures

Question 23

Enzyme inhibitors

Answer 23

Inhibits enzymes that destroy levodopa and dopamine

Question 24

What are the two kinds of enzyme inhibitors we use

Answer 24

MAOI | COMT inhibitor

Question 25

Side effects of enzyme inhibitors

Answer 25

``` Dyskinesia N/V/D Headache Mental confusion Hallucinations ```

Question 26

Anticholinergics for Parkinson's

Answer 26

Inhibit over activity of acetylcholine Generally act by relieving severe symptoms

Question 27

What do we know about the usage of anticholinergics for Parkinson's

Answer 27

Never used by themselves. Only in adjunct with mirapex or other drugs

Question 28

Cogentin (benztropine mesylate)

Answer 28

Anticholinergics for Parkinson's disease

Question 29

Cogentin is used in conjunction with anti-psychotics. Why?

Answer 29

To treat eps symptoms