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Neurology > Parkinsons Disease Drugs > Flashcards

Parkinsons Disease Drugs Flashcards

1
Q

What is Parkinson’s disease

A

Progressive disabling neurodegenerative disorder of movement

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2
Q

Main reason of Parkinson’s disease

A

Gradual loss of neurons in the substantia nigra of the brain. So loss of dopamine which coordinate movements

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3
Q

Clinical features of Parkinson’s diseases

A

Tremor
rigidity
bradykinesia

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4
Q

Two forms of Parkinson’s disease

A

Idiopathic Parkinson disease with unknown cause

Iatrogenic Parkinson disease drug induced

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5
Q

What type of drugs can cause Parkinson’s disease

A

Antipsychotic drugs like butyrophenone and phenothiazines

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6
Q

Genes involved in Parkinson’s disease

A 
Alpha synuclein
Parkin 
Glucocerebrosidase
PINK1
LRRK2
DJ1
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7
Q

Is there a cure for parkinsonism

A

No

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8
Q

Drugs type that good provides relief in Parkinson’s disease

A

Levodopa
Dopamine agonists
Mono amine oxidase inhibitors
Anticholinergic agents

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9
Q

Most reliable and effective drug in Parkinson’s disease

A

Levodopa

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10
Q

Mechanism of action of levodopa

A

Precursor of dopamine which innovate dopamine level

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11
Q

Why is dopamine not administered directly but rather through levodopa’s

A

Because cannot cross the blood brain barrier contrary to level

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12
Q

Metabolism of levodopa

A

Amino acid decarboxylase in the liver kidney and GHT

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13
Q

How do we prevent metabolism of levodopa

A

By coadministering carbidopa or benserazide

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14
Q

Can food delay the appearance of levodopa in the plasma

A

Yes

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15
Q

When do you think the best results of levodopa treatment

A

In the first three or four years of therapy

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16
Q

Adverse effects of levodopa

A

Anorexia nausea vomiting so should divide doses and take antacids and anti-emetics

Cardiac arrhythmias tachycardia ventricular extrasystole’s

Dyskinesias

Depression anxiety agitation insomnia somnolence confusion delusions hallucinations nightmares euphoria

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17
Q

What are some miscellaneous adverse effects of levodopa

A 
Mydriasis
Various blood dyscrasias
Hot flashes positive comes test 
precipitation of gout 
smell or taste abnormalities 
Priaprism 
blood urea nitrogen elevated
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18
Q

Can you give levodopa to Patience taking MAO

A

No

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19
Q

Can you give levodopa to psychotic patients

A

No

20
Q

Can you give liver to fly to patient with angle closure glaucoma

A

No

21
Q

Can you give levodopa to patient with active peptic ulcer

A

Yes but precaution

22
Q

What is the advantage of dopamin agonist compared to levodopa

A

Limited adverse effects
no potential toxic metabolites
no competition at the blood brain barrier no response fluctuations and dyskinesia

23
Q

Examples of dopamine agonist

A 
Bromocriptine
Pergolide
Pramipexole
 Ropinirole
Rotigotine
Apomorphine
24
Q

Drug used to treat Parkinson’s disease and hyperprolactinemia

A

Bromocripti

25
Q

Receptor stimulated by bromocriptine

A

D2

26
Q

Receptor stimulated by pergolide

A

D1 D2

27
Q

In which way is percolate more effective than bromocriptine

A

Relieving symptoms and signs of Parkinson’s disease
increasing on-time response from response fluctuators
permitting levodopa dose s to be reduced

28
Q

Pramipexole act on which receptor

A

D3

29
Q

When is pramipexole effective

A

When used as a single agent for mild Parkinson. So used in advanced disease to reduce levodopa

30
Q

Ropinirole Acton which receptor

A

D2

31
Q

When do you use ropinirole

A

Does Moov in response to levodopa in More advanced disease

32
Q

How do you administer rotigotine

A

Transdermal patch

33
Q

How do you administer Apomorphine

A

IV injection

34
Q

Dopamine agonist adverse effects

A 
Anorexia 
nausea 
vomiting 
constipation 
dyspepsia 
reflux oesophagitis 
s bleeding from peptic ulcer confusion 
hallucination 
delusions 
postural hypotension 
painless digital vasospasm 
cardiac arrhythmias 
peripheral edema
35
Q

Miscellaneous effect of dopamine agonist

A 
Headache 
nasal congestion 
increased arousal
 pulmonary infiltrates 
Pleural and retroperitoneal fibrosis 
erythromelalgia
Narcolepsy
36
Q

Contra indications of dopamine agonist

A

Psychotic illness
recent myocardial infarction
active peptic ulcer ration
ergot derived agonist avoided in peripheral vascular disease

37
Q

Which monoamine oxidase inhibitors are used in Parkinson’s disease treatment

A

The one that ACT on MAO B Which is the one concerned with metabolism of dopamine
Selegiline
Rasagiline

38
Q

When should you give selegiline

A

When declined fluctuating response to levodopa

39
Q

Should not give these drugs with selegeline

A

Pethidine
TCAs
serotonin reuptake inhibitors

40
Q

Which is more potent , selegiline or rasagiline

A

Rasagiline

41
Q

Can you give both MAO and levodopa

A

No risk of hypertensive crisis

42
Q

How do drugs part of the catechol o methyltransferase inhibitors help

A

Prevent competition 3OMD with levodopa for active carrier mechanism

43
Q

Selective COMT USED

A

Tolcapone

Entacapone

44
Q

When can you give COMT inhibitors

A

Response fluctuations with levodopa

45
Q

Viral agent used for Parkinson disease

A

Amantadine

46
Q

Acetylcholine blocking drugs examples

A 
Benztropine mesylate
Biperiden 
Orphenadrine
Procyclidine
Trihexyphenidyl
47
Q

Can you use antihistamine diphenhydramine as anticholinergic agent for mild Parkinson patient who can’t tolerate anything else

A

Yes

Neurology (31 decks)

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