Parkinsons disease and ALS

Question 1

main neurotransmitter that is affected in parkinsons

Answer 1

dopamine

Question 2

extrapyramidal tracts

Answer 2

part of the brain controls semiautomatic functions and coordinated movmt

Question 3

level of dopamine in parkinsons

Answer 3

down to 80%

Question 4

resting tremors

Answer 4

tremors disappear with movement and sleeping

Question 5

rigidity

Answer 5

resistance to passive limb movement

Question 6

passive movement of the extremity

Answer 6

causes limb to move in jerky in increments called cogwheel rigidity

Question 7

shuffling gait (postural instability)

Answer 7

pt tries to walk faster trying to move feet forward under center of gravity - steps are shorter in stride and drag their feet and reduce arm movement

Question 8

freezing gait (postural instability)

Answer 8

difficultly in initiating walking – feet are glued to the floor

Question 9

psychiatric changes in parkinsons patients

Answer 9

depression, anxiety, dementia, delirium, hallucination

Question 10

hypokinesia

Answer 10

decresed range of bodily mvmt/slow

Question 11

dysphonia

Answer 11

voice impairment– voice is hoarse/nasal

Question 12

levodopa “on-off syndrome”

Answer 12

sudden periods of immobility (seems like drug is not working/then working again)

Question 13

dyskinesia

Answer 13

involuntary repetitive of facial and oral muscles

Question 14

Anticholingeric drug info

Answer 14

-Trihexyphenidyl hydrochloride- control tremors
-Benztropine mesylate- counteract the action of the acetylcholine
SE: constipation, urinary retention, blurred vision; CI: patient with narrow angle glaucoma

Question 15

amantidine hydrochloride

antiviral

Answer 15

reduces rigidity and tremor, bradykinesia in early parkinsons
se: hallucination; depression

Question 16

Bromocriptine mesylate
(dopamine agonist)

Answer 16

secondary drug used after levodopa losses its effectiveness

SE hypotension, lightheadedness

Question 17

Ropinirole hydrochloride

Nonergot derivative

Answer 17

SE: dizziness, drowsiness

Question 18

what to do if patient has SE like insomnia, hallucination etc. ?

Answer 18

stop drug see if it subsides, if it doesn’t then it’s the disease not the drug

Question 19

pudding-thick

Answer 19

spoon-thick, holds own shape, requires a spoon (advanced parkinsons - those who can not swallow)

Question 20

risk factors for amyoptripic later sclerosis/ Lou Gehrig disease

Answer 20

smoking; viral infections; autoimmune disease; environmental exposure to toxins

Question 21

when/how does Lou Gehrig disease occur

Answer 21

Commonly occurs between 40-60 years of age; affects all social and racial background; men affected slightly more than women;
About 5-10% of cases are familial from an autosomal dominant trait

Question 22

diagnosis for Lou Gehrig disease

Answer 22

based ONLY on s/s - no labs specific

Question 23

Riluzole (Rilutek)- glutamate antagonist

Answer 23

– can prolong the survival ; Neuroprotective effect especially in early stage