Parkinsons Disease Flashcards
What is going on chemically with Parkinson’s
Too much acetylcholine and not enough dopamine
What type of a disease is Parkinson’s
Degenerative
What two drug types are used for Parkinson’s
Dopaminergics and anticholinergic
Dopamine is considered a _____ neurotransmitter
Inhibitory
Acetylcholine is considered a _____ neurotransmitter
Excitatory
Dopaminergics
Increase amount of dopamine available
What do you have to have to produce dopamine
Levodopa
Larodopa (levodopa) (L-dopa)
Precursor of dopamine synthesis
Can cross the blood brain barrier (dopamine can’t)
What can we do to get more levodopa to the brain
Add carbidopa to levodopa
Sinemet (carbidopa-levodopa)
Combination between carbidopa and levodopa to get more levodopa to the brain so more dopamine can be made
Side effects of sinemet
Eps symptoms (uncontrolled movements of face, tongue, arms, upper body)
What is bad about the side effects of sinemet
They are the same side effects that people with Parkinson’s want to get rid of
You should use sinemet with caution for what type if patients
Emphysema, history of mi, asthma, severe organ disease
Most Parkinson’s patients have one of these
There aRe many interactions with Parkinson’s drugs
True
Mostly with other CNS depressants
Dopamine agonists
Directly activate dopamine receptors
Make brain think there are more
Side effects of dopamine agonists
Can be severe
Nausea, constipation, headache, orthostatic hypotension, hallucinations
Why are dopamine agonist side effects better than dopaminergic drugs if dopamine agonists are more severe
Patients respond better because their Parkinson’s symptoms are gone
Mirapex (pramipexole)
Dopamine agonist
Most common
Requip (ropinirole)
Dopamine agonist
You should use caution when giving dopamine agonist agents to what patients
History of orthostatic hypotension (side effect)
Hallucinations
Renal impairment
Antiviral medication (and dopaminergic)
Increase release of dopamine from nerve terminals
Blocks reuptake of dopamine
Symmetrel (amantadine)
Antiviral medication and dopaminergic
What kind of cautions should you take when giving antiviral medications
Orthostatic hypotension and seizures
Enzyme inhibitors
Inhibits enzymes that destroy levodopa and dopamine
What are the two kinds of enzyme inhibitors we use
MAOI
COMT inhibitor
Side effects of enzyme inhibitors
Dyskinesia N/V/D Headache Mental confusion Hallucinations
Anticholinergics for Parkinson’s
Inhibit over activity of acetylcholine
Generally act by relieving severe symptoms
What do we know about the usage of anticholinergics for Parkinson’s
Never used by themselves. Only in adjunct with mirapex or other drugs
Cogentin (benztropine mesylate)
Anticholinergics for Parkinson’s disease
Cogentin is used in conjunction with anti-psychotics. Why?
To treat eps symptoms
