PD

Question 1

Parkinson sx

Answer 1

T tremor at rest
R rigidity
A akinesia or bradykinesia
P postural instability

Also
depression, psychosis, dementia
Drooling
Staggering gait
Autonomic disturbances

Question 2

Levodopa

Answer 2

Given with carbidopa or carbidopa/entacapone
Oral
Food delays absorption
High protein foods reduce therapeutic Fx
Full response takes months
Sx well controlled for 2 years
Return to pretreatment state at end of 5 years
Enhanced activity by vitamin B6

Question 3

How to minimize wearing off effect of levodopa

Answer 3

1. Shorten intervals between doses
2. Give with drug (entacapone) that prolongs plasma life of levodopa
3. Giving a direct-acting dopamine agonist