Theory - Parkinsons Supplement 01

Question 1

How do you treat peak dose dyskinesias (choreiform, myoclonic, dystonic movements that occur at peak levels)?

Answer 1

• Decrease levodopa dose by 25 mg
• increase dose of dopamine agonist
• switch to controlled-release

Question 2

How do you treat diphasic dyskinesias (dyskinesias which occur at the beginning and end of dosing intervals)?

Answer 2

Use dopamine agonist as primary treatment and levodopa as ancillary treatment

Question 3

How do you treat off dystonias (cramping, dystonic movements, especially of lower limbs)?

Answer 3

• Use dopamine agonist as primary treatment and levodopa as ancillary treatment
• Baclofen, anticholinergics, botulinum toxin

Question 4

Why can a dopamine agonist be neuroprotective?

Answer 4

Because of their levodopa sparing effect