Parkinsons Disease Drugs

Question 1

What is Parkinson’s disease

Answer 1

Progressive disabling neurodegenerative disorder of movement

Question 2

Main reason of Parkinson’s disease

Answer 2

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

Question 3

Clinical features of Parkinson’s diseases

Answer 3

Tremor
rigidity
bradykinesia

Question 4

Two forms of Parkinson’s disease

Answer 4

Idiopathic Parkinson disease with unknown cause

Iatrogenic Parkinson disease drug induced

Question 5

What type of drugs can cause Parkinson’s disease

Answer 5

Antipsychotic drugs like butyrophenone and phenothiazines

Question 6

Genes involved in Parkinson’s disease

Answer 6

Alpha synuclein
Parkin 
Glucocerebrosidase
PINK1
LRRK2
DJ1

Question 7

Is there a cure for parkinsonism

Answer 7

No

Question 8

Drugs type that good provides relief in Parkinson’s disease

Answer 8

Levodopa
Dopamine agonists
Mono amine oxidase inhibitors
Anticholinergic agents

Question 9

Most reliable and effective drug in Parkinson’s disease

Answer 9

Levodopa

Question 10

Mechanism of action of levodopa

Answer 10

Precursor of dopamine which innovate dopamine level

Question 11

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

Answer 11

Because cannot cross the blood brain barrier contrary to level

Question 12

Metabolism of levodopa

Answer 12

Amino acid decarboxylase in the liver kidney and GHT

Question 13

How do we prevent metabolism of levodopa

Answer 13

By coadministering carbidopa or benserazide

Question 14

Can food delay the appearance of levodopa in the plasma

Answer 14

Yes

Question 15

When do you think the best results of levodopa treatment

Answer 15

In the first three or four years of therapy

Question 16

Adverse effects of levodopa

Answer 16

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

Question 17

What are some miscellaneous adverse effects of levodopa

Answer 17

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

Question 18

Can you give levodopa to Patience taking MAO

Answer 18

No

Question 19

Can you give levodopa to psychotic patients

Answer 19

No

Question 20

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

Answer 20

No

Question 21

Can you give levodopa to patient with active peptic ulcer

Answer 21

Yes but precaution

Question 22

What is the advantage of dopamin agonist compared to levodopa

Answer 22

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

Question 23

Examples of dopamine agonist

Answer 23

Bromocriptine
Pergolide
Pramipexole
 Ropinirole
Rotigotine
Apomorphine

Question 24

Drug used to treat Parkinson’s disease and hyperprolactinemia

Answer 24

Bromocripti

Question 25

Receptor stimulated by bromocriptine

Answer 25

D2

Question 26

Receptor stimulated by pergolide

Answer 26

D1 D2

Question 27

In which way is percolate more effective than bromocriptine

Answer 27

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

Question 28

Pramipexole act on which receptor

Answer 28

D3

Question 29

When is pramipexole effective

Answer 29

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

Question 30

Ropinirole Acton which receptor

Answer 30

D2

Question 31

When do you use ropinirole

Answer 31

Does Moov in response to levodopa in More advanced disease

Question 32

How do you administer rotigotine

Answer 32

Transdermal patch

Question 33

How do you administer Apomorphine

Answer 33

IV injection

Question 34

Dopamine agonist adverse effects

Answer 34

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

Question 35

Miscellaneous effect of dopamine agonist

Answer 35

``` Headache nasal congestion increased arousal pulmonary infiltrates Pleural and retroperitoneal fibrosis erythromelalgia Narcolepsy ```

Question 36

Contra indications of dopamine agonist

Answer 36

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

Question 37

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

Answer 37

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

Question 38

When should you give selegiline

Answer 38

When declined fluctuating response to levodopa

Question 39

Should not give these drugs with selegeline

Answer 39

Pethidine TCAs serotonin reuptake inhibitors

Question 40

Which is more potent , selegiline or rasagiline

Answer 40

Rasagiline

Question 41

Can you give both MAO and levodopa

Answer 41

No risk of hypertensive crisis

Question 42

How do drugs part of the catechol o methyltransferase inhibitors help

Answer 42

Prevent competition 3OMD with levodopa for active carrier mechanism

Question 43

Selective COMT USED

Answer 43

Tolcapone | Entacapone

Question 44

When can you give COMT inhibitors

Answer 44

Response fluctuations with levodopa

Question 45

Viral agent used for Parkinson disease

Answer 45

Amantadine

Question 46

Acetylcholine blocking drugs examples

Answer 46

``` Benztropine mesylate Biperiden Orphenadrine Procyclidine Trihexyphenidyl ```

Question 47

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

Answer 47

Yes