Case 4- Parkinsons And Dementia

Question 1

Why should metoclopromide be avoided in Parkinson’s disease?

Answer 1

Metoclopramide worsens symptoms of Parkinson’s disease

They block D2 receptors

Question 2

Why is metoclopramide sometimes used in nausea and vomiting induced by levodopa ?

Answer 2

Prevents symptoms of nausea and vomiting

Question 3

How could we help remind a patient to take time specific Parkinson’s disease medication ?

Answer 3

Set alarms/reminders
Put medicines in a place that they will remember
Make sure times are out on drug chart and prescription if possible

Question 4

What are the 4 drugs that can be used to treat symptoms of oarksinons disease ?

Answer 4

Entacapone
Co-carbedopa
Co-beneldopa
Rispinerole

Question 5

What is the mechanism of action of roapinerol?

Answer 5

D2 receptor agonist
Mimics dopamine and Binds to D2 receptors
Increasing neuronal activity

Question 6

What is the mechanism of action of co-careldopa or co-beneldopa?

Answer 6

Contain both levodopa and carbodopa

Levodopa is a precursor of dopamine

As it is able to cross the BBB

Carbodopa is an decarboxylase inhibitor which makes suree that levodopa is not broken down/ metabolised before it reaches the brain

Levodopa gets to the brain and is converted to dopamine

Question 7

What is the mechanism of action of entacapone?

Answer 7

It is a COMT inhibitor (catecol-o-methyltrasfersse inhibitor)

It would by preventing the breakdown of peripheral levodopa before it gets to the brain

Increasing the availability of levodopa in the brain

Should be administered with levodopa