Pharm Movement Disorders, Kinder I

Question 1

What dopamine agonists are used for movement disorders

Answer 1

bromocriptine

pramipexole

Question 2

what kind of drug is rasagiline

Answer 2

Monoamine oxidase inhibitor MAOI

Question 3

what type of drug is entacapone

Answer 3

catechol o methyltransferase inhibitor

Question 4

benztropine

Answer 4

antimuscarinic agent

Question 5

resting tremor

Answer 5

parkinsons

Question 6

intention tremot

Answer 6

essential

tremor during purposeful movement

Question 7

chorea

Answer 7

irregular unpredictable involuntary muscle jerks

Question 8

athetosis

Answer 8

abnormal movements which are slow and writhing

Question 9

dystonia

Answer 9

sustained athetosis

regarded as abnormal postures

Question 10

Tics

Answer 10

sudden involuntary coordinated abnormal movements

tend to be repetitive about face and head

Question 11

gilles de la tourettes

Answer 11

chronic multiple tics

Question 12

parkinsons

Answer 12

combination of rigidity, bradykinesia tremor and postural instability
other non-motor Sx

Question 13

pathophys parkinsons

Answer 13

loss dopaminergic neurons in substantia nigra causing disinhibition GABAergic neurons

Question 14

why is dopamine ineffective when given to parkinson patient

Answer 14

dopamine does not cross bbb

give Levodopa

Question 15

how does levodopa enter brain

Answer 15

L amino acid transporter LAT

Question 16

MOA levodopa

Answer 16

stimulates D2 R

Question 17

PK levodopa

Answer 17

infestion of food delays absorption so take 30-60 min before a meal

Question 18

what is carbidopa

Answer 18

dopa decarboxylase inhibitor

reduces peripheral metabolism of levodopa

Question 19

use of levodopa/carbidopa

Answer 19

lower mortality and early initiation of parkinsons
some become less responsive to levodopa
1/3 people respond very well

Question 20

GI effects levodopa

Answer 20

anorexia nausea comiting

Question 21

prevent GI side effects levodopa

Answer 21

give with carbidopa

Question 22

CV effects levodopa

Answer 22

postural hypotension
tachy, ventricular extrasystoles
HTN with large doses or with combination of MAOIs

Question 23

behavioral effects levodopa

Answer 23

depression, anxiety, agitation, insomnia, somnolence, confusion delusions, hallucinations, nightmares, euphoria

Question 24

80% patients on levodopa for 10 years have what side effect

Answer 24

dyskinesia

Question 25

dyskinesia caused by levodopa

Answer 25

choreathetosis of face and distal extremitites

Question 26

on-off phenomenon when on levodopa

Answer 26

off periods- akinesia | on periods- improved mobility with dyskinesia

Question 27

levodopa with pyridoxine B6

Answer 27

increase extracerebral metabolism | goes away if add carbidopa

Question 28

levodopa and MAOIs

Answer 28

HTN | do not give within 2 weeks of administration

Question 29

CI levodopa

Answer 29

angle closure glaucoma, psychosis, active peptic ulcer disease, malignant melanoma

Question 30

levodopa is a precursor to what

Answer 30

melanin

Question 31

MOA dopamine agonists

Answer 31

act on postsynaptic Dopamine R

Question 32

1st line therapy for parkinsons

Answer 32

dopamine agonist

Question 33

what are the DA used for movement disorders

Answer 33

bromocriptine and pramipexole

Question 34

Dopamine R bromocriptine likes

Answer 34

D2 agonist | it is an ergot alkaloid derivative

Question 35

therapeutic use bromocriptine

Answer 35

hyperprolactinemia, prolactin secreting adenomas, acromegaly | parkinsons

Question 36

dopamine R pramipexole likes

Answer 36

D3

Question 37

dose adjustment in what patients with pramipexole

Answer 37

renal insufficiency

Question 38

therapeutic use pramipexole

Answer 38

parkinsons | mod-severe, primary and restless leg syndrome

Question 39

GI effects dopamine agonists

Answer 39

anorexia, nausea vomiting constipation dyspepsia reflux

Question 40

CV effects dopamine agonists

Answer 40

postural hypotension | painless digital vasospasm

Question 41

movement effects dopamine agonists

Answer 41

dyskinesias

Question 42

mental disturbances from dopamine agonists

Answer 42

confusion, hallucinations, delusions | disorders of impulse control

Question 43

side effects seen with bromocriptine

Answer 43

HA nasal congestion, increased arousal, pulmonary infiltrates, pleural and retroperitoneal fibrosis

Question 44

weird side effect with pramipexole

Answer 44

uncontrollable tendency to fall asleep at inappropriate times

Question 45

CI dopamine agonists

Answer 45

history of psychotic ilnesss, recent MI, active peptic ulcer disease best avoided in peripheral vascular disease