Parkinsons disease

Question 1

Parkinson’s syndrome is the lack of what? and the over stimulation of what?

Answer 1

lack of dopamine and over stimulation of GABA

Question 2

how is levodopa absorbed?

Answer 2

small intestine

Question 3

If levodopa is absorbed in the small intestine then how does food effect it?

Answer 3

it delays absorption

Question 4

Is levodopa given alone?

Answer 4

no in combo with another drug

Question 5

which drug is given in combo with levodopa?

Answer 5

carbidopa

Question 6

how long before you see results of levodopa?

Answer 6

several months

Question 7

how long does levodopa effects last until pretreatment state returns?

Answer 7

5 years, wearing off symptoms occur

Question 8

how can you minimize wearing off symptoms of levodopa

Answer 8

shorten dosing interval, give a drug that prolongs levodopa plasma half-life, give a direct-acting dopamine agonist

Question 9

Adverse effects of levodopa and what helps with this?

Answer 9

n/v, -carbidopa helps with this
cardiovascular 
postural hypotension
paranoid ideation
visual hallucinations

Question 10

Dyskinesias

Answer 10

movement disorders

Question 11

which anticholinergic agent is given for parkinson

Answer 11

cogentin

Question 12

How can movement disorders be managed?

Answer 12

decrease levodpa

amantadine

surgery

Question 13

Amantadine

Answer 13

given to help with dyskinesias

Question 14

why is it important to do a thorough skin assessment on a patient before prescribing levodopa?

Answer 14

because the drug can activate malignant melanoma

Question 15

Levodopa drug interactions

Answer 15

MAOI inhibitors, First generation antipsychotics, anticholinergic drugs, Pyridoxine (vit B6)

Question 16

Requip, Mirapex are which kind of drugs?

Answer 16

dopamine agonists

Question 17

How long does it take for dopamine agonists to work?

Answer 17

several weeks

Question 18

are dopamine agonists less likely or more likely to cause movement disorders than levodopa?

Answer 18

less likely

Question 19

Entacapone is which kind of drug

Answer 19

COMT inhibitor

Question 20

Rasagiline and selegiling are which kind of drug

Answer 20

MAO-B inhibitors

Question 21

first line drug for parkinson?

Answer 21

dopamine inhibitors (Requip)

Question 22

Dopamine inhibitors (Requip) adverse effects

Answer 22

hallucinations, daytime sleepiness, postural hypotension

Question 23

Carbidopa function vs levodopa

Answer 23

carbidopa blocks levodopa destruction

Levodopa increases dopamine synthesis

Question 24

why are MAO-B inhibitors used?

Answer 24

to reduce the wearing off effect of levodopa

Question 25

why are COMT inhibitors used?

Answer 25

to inhibit metabolism of levodopa in the periphery

Question 26

Why should we avoid using anticholinergic drugs (Cogentin) in the elderly?

Answer 26

because they cause sedation, confusion and delusions

Question 27

why are dopamine agonists (Requip) used?

Answer 27

to help activate dopamine receptors in the striatum