Treatment of parkinson's Flashcards

1
Q

general aim

A

increase dopamine
agonists
increase secretion
decrease enzyme activity, lengthening time in the synaptic cleft

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2
Q

levadopa

A

most effective and improves motor symptoms significantly
converted by body into dopamine

some SE:
nausea and vomitting
confusion
postural hypotension
somnolence
long term:
dyskinesia

end of dose fluctuations where the drug starts to wear off
freezing
confusion and hallucinations

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3
Q

management of motor complications

A

fractionate dose
adjuvant treatment
cont.

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4
Q

dopamine agonist

A

act directly on post synaptic dopamine receptors
oral, sub cut or transdermal
similar side effects to l-dopa and also impulse control disorders - eg gambling, hypersexuality, compulsive buying, binge eating

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5
Q

mono-amine oxidase inhibitors

A

decrease breakdown of dopamine so increase the levels in the cleft
possible neuroprotective effect
same side effects as l-dopa
potential interaction with antidepressants such as SSRI’s leading to serotonin syndrome

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6
Q

catechol-O-methyltransferase inhibitors

A

inhibit COMT inhibitors to increase the amount of l-dopa available to cross the BBB to produce prolonged effect

SE
as l-dopa
also can cause diarrhoea, discolouration of body fluids

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7
Q

amantadine

A

not commonly used, sometimes used in the later stages

increases dopamine release at the synaptic cleft

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8
Q

anticholinergics

A

occasionally in younger patients with early symptoms

decrease the relative central ACh excess that occurs due to dopamine insufficiency

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