Parkinsons disease Flashcards
Parkinson’s disease pneumonic
T - tremor R - rigidity A - akinesia P - postural instability P - postural hypotension S - sleep disorders
P - psychosis
D - depression / dementia
hallmark of PD
dopaminergic neuron loss in substantia nigra pars compacta
Classic tremor in PD
pill rolling tremor
tremor @ rest - vanishes with movement
is head tremor typical in PD?
no
Rigidity + rest tremor = ?
cog-wheel rigidity
PD - narrow or wide based gait?
narrow
greatest genetic RF in PD
GBA mutation
tobacco smoking, NSAIDs, CCB use, alcohol »_space; increased or decreased risk of PD?
decreased
Treatment of PD
young + fit @ onset
- Da agonists - ropinorole, pramipexole
- MOABI - rasagiline, selegiline
- L-DOPA
frail
- L-DOPA
- MOABI
PD + dementia > Rx =?
Rivastigmine
drug class good for tremor in PD
anticholinergics
1st line for psychosis in PD
clozapine
antipsychotics can worsen PD!
S/E of both dopamine agonists and levodopa
daytime somnolence and oedema
Levodopa - end of dose effect tx?
COMT inhibitor
when should dopamine agonists be avoided?
history of addiction, OCD
elderly due to hallucinations s/e