Degenerative Diseases

Question 1

What are lewy bodies

Answer 1

Inclusions inside neurons due to the abnormal accumulation of protein α-synclein bound to ubiquitin in the damaged cells.
Parkinson’s disease

Question 2

What Rx drugs are used for PD

Answer 2

L-dopa + cabidopa (precursor to dopamine)
Benztropine (anticholinergic)
Azilect; inhibits DA breakdown
Entacapone; enhances carbidopa-levodopa, inhibits COMP
Selegilline; MAO inhibitor

Question 3

What is the surgical Tx of PD

Answer 3

Thaladectomy
Pallidectomy
Deep brain stimulation into caudate; only helps tremors

Question 4

Most PD Rx will cause what oral manifestation

Answer 4

Xerostomia

Question 5

L- dopa side effects

Answer 5

Sialorrhea
Dark saliva
bruxism
trismus
glossodynia 
dysphagia

Question 6

Selegiline side effects

Answer 6

SL ulcerations
Burning: lips, mouth
Facial grimacing
supraorbital pain

Question 7

Dental Tx of PD pts

Answer 7

Determine stage
Accomplish major interventions early
Keep appointments short, 90 min after meds
Limit admin to three carpules/30 min period
Do not use epi if pt is on selegiline
Instruct pt and caregiver in good oral hygiene

Question 8

What is the Tx for Alzheimer’s

Answer 8

↑ ACh activity
AChE inhibitors
Donepezil
Antiinflammatories