Treatment of movement disorders

Question 1

Dopamine precursor

Answer 1

L dopa - sinemat, parcopa, madopar, stalevo

active transport across BBB

treat with decarboxylase inhibtior eg. carbidopa, benserazide

side effects : dyskinesias - on/off effect

Question 2

Dopamine agonists

Answer 2

pramiprexole, rotigotine, ropinirole

side effects: n+v, dizziness, postural hypertension, headaches, confusion, hallucination, paranoia, pleural probs, Raynauds

Question 3

MAO inhibitors

Answer 3

selegiline, rasagiline

irreversible patch
interaction with TCAs
low tyramine diet

side effects: insomnia, hallucination, nausea

Question 4

COMT inhibitors

Answer 4

entacapone, tolcapone

Question 5

Anticholinergic

Answer 5

trihexyphenidyl, benzotropine, ethopropazine

side effects: dry mouth, sedation, constipation, urinary retention, confusion and delirium

Question 6

NMDA blockade

Answer 6

amantidine (antiviral), memantine

Question 7

gene therapy

Answer 7

neurotrophins - BDNF