Parkinsons disease Flashcards
Parkinson’s syndrome is the lack of what? and the over stimulation of what?
lack of dopamine and over stimulation of GABA
how is levodopa absorbed?
small intestine
If levodopa is absorbed in the small intestine then how does food effect it?
it delays absorption
Is levodopa given alone?
no in combo with another drug
which drug is given in combo with levodopa?
carbidopa
how long before you see results of levodopa?
several months
how long does levodopa effects last until pretreatment state returns?
5 years, wearing off symptoms occur
how can you minimize wearing off symptoms of levodopa
shorten dosing interval, give a drug that prolongs levodopa plasma half-life, give a direct-acting dopamine agonist
Adverse effects of levodopa and what helps with this?
n/v, -carbidopa helps with this cardiovascular postural hypotension paranoid ideation visual hallucinations
Dyskinesias
movement disorders
which anticholinergic agent is given for parkinson
cogentin
How can movement disorders be managed?
decrease levodpa
amantadine
surgery
Amantadine
given to help with dyskinesias
why is it important to do a thorough skin assessment on a patient before prescribing levodopa?
because the drug can activate malignant melanoma
Levodopa drug interactions
MAOI inhibitors, First generation antipsychotics, anticholinergic drugs, Pyridoxine (vit B6)
Requip, Mirapex are which kind of drugs?
dopamine agonists
How long does it take for dopamine agonists to work?
several weeks
are dopamine agonists less likely or more likely to cause movement disorders than levodopa?
less likely
Entacapone is which kind of drug
COMT inhibitor
Rasagiline and selegiling are which kind of drug
MAO-B inhibitors
first line drug for parkinson?
dopamine inhibitors (Requip)
Dopamine inhibitors (Requip) adverse effects
hallucinations, daytime sleepiness, postural hypotension
Carbidopa function vs levodopa
carbidopa blocks levodopa destruction
Levodopa increases dopamine synthesis
why are MAO-B inhibitors used?
to reduce the wearing off effect of levodopa
why are COMT inhibitors used?
to inhibit metabolism of levodopa in the periphery
Why should we avoid using anticholinergic drugs (Cogentin) in the elderly?
because they cause sedation, confusion and delusions
why are dopamine agonists (Requip) used?
to help activate dopamine receptors in the striatum
