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Pharm 3 > Parkinsons Stuff > Flashcards

Parkinsons Stuff Flashcards

1
Q

What are some theroies for PD and it’s etiology?

A

Viral infection, brain injuries, genetic component

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2
Q

What is PD characterized by?

A

Loss of DA neurons in the substantia niagra

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3
Q

What causes pseudoparkinsoism?

A

DA receptor antagonists like antipsychotics and antiemetics

Toxins like MPTP

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4
Q

What does MPTP break down into because of MAO-B?

A

MPP+

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5
Q

What is PD triad symptoms?

A

Bradykinesia/akinesia- Difficulty initiating movements
Resting tremor
Skeletal muscle rigidity or hypertonicity

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6
Q

Given the pathophys of PD, what two broad therapies are indicated?

A

Replacement therapy for DA

Decreasing cholinergic transmission

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7
Q

What are the main muscarinic anticholinergic drugs for PD?

A

Trihexyphenidyl and BENZTROPINE

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8
Q

What are the side effects of anticholinergics?

A

Drowsiness, mental slowness, tachycardia, dry mouth, constipation

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9
Q

What are contraindications to anticholinergics?

A

Prostate hyperplasia, obstructive GI disease, angle-closure glaucoma

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10
Q

What is the rate limiting step in the production of dopamine?

A

Tyrosine to dopa by the enzyme tyrosine hydroxylate

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11
Q

Which crosses the BBB? L-Dopa or dopamine?

A

L-dopa

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12
Q

Whats the pathway to create dopamine?

A

Tyrosine, to Dopa, to dopamine

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13
Q

What does dopamine stimulate once in the brain?

A

Basal ganglia

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14
Q

What are the problems with L-dopa?

A

Diminished effectiveness after 4-6 years (Wearing off effect, and on-off phenomenon)
Does not stop progression of PD

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15
Q

What are the side effects to L-dopa?

A

GI disturbances (Avoid dopaminergic antiemetics like prochlorperazine)
Tachycardia, orthostatic hypotension
Dyskinesia- up to 80% patients
Behavioral issues-agitation,delerium, etc
Hormonal-inhibition of the HPA axis and prolactin

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16
Q

What are the drug interactions with L dopa?

A

Pyridone(Vit B6)
MAOI inhibitors
Antipsychotics- strictly prohibited
High protein diet needed for absorption and transport

17
Q

Why is carbidopa added with L dopa?

A

Reduces daily requirement of levodopa by 75% through reduced metabolism in the GI tract

18
Q

What are the dopamine receptor agonists for PD?

A

Bromocriptine, ropinirole. pramipexole, and roigotine

19
Q

What receptor affinity does bromocriptine and ropinirole have?

A

D2 agonist

20
Q

What receptor affinity does pramipexole have?

A

D3 agonist

21
Q

What is the administration of rotigotine?

A

Patch

22
Q

What is the contraindications for DA in PD?

A

Psychotic illness history, recent MI, or GI ulcers

23
Q

What is the age DA agonist are no longer recommended?

A

60

24
Q

What are side effects of DA agonists?

A

GI issues
CV problems- orthostatic hypotension, arrhythmias
Dyskinesia
Mental disturbances

25
Q

What is Amantadine?

A

AN antiviral compound that potentiates dopaminergic function

26
Q

What class of drugs is selegiline and rasagiline?

A

MAO-B, decreases L-Dopa’s wearing off effect and dyskinesia

27
Q

What class is Entacapone, tolcapone, and stalevo?

A

COMT inhibitors

28
Q

What are the surgical options for PD?

A

Deep brain stimulator, tissue transplantation, stem cell, gene therapy

29
Q

What are the two common symptoms exhibited in PD before this diagnosis is ever made?

A

Constipation and REM sleep behavioral disorder (RBD)

30
Q

What is the newly approved medicaiton for PD? Class?

A

Istradefylline

Adenosine A2A receptor antagonist

31
Q

What is Levodopa inhalation powder used for?

A

Off episodes in adults treated with regular carbidopa/levodopa medicine

32
Q

What is the definition of neurogenetive disease?

A

Progressive and irrevesible loss of neurons

33
Q

What are the three medications listed for treatment of AD?

A

Doneprezil, rivastigmine, memantine

34
Q

What are the three medications listed for ALS?

A

Riluzole, baclofen, and tizanidine

35
Q

What are the three medications for Huntingtons?

A

Reserpine, tetrabenazine, haldol

Pharm 3 (6 decks)

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