Antiparkinson Drugs

Question 1

Achalasia

Answer 1

Failure to relax, usually referring to the smooth muscle fibers of the GI tract, especially failure of the lower esophagus to relax, causing difficulty swallowing and a feeling of fullness in the sternal region

Question 2

Akathisia

Answer 2

Extreme restlessness and increased motor activity

Question 3

Blood-brain barrier

Answer 3

Ability of the nervous system to prohibit large and potentially harmful molecules from crossing the blood to the brain

Question 4

Bradykinesia

Answer 4

Slow movement

Question 5

Choreiform movements

Answer 5

Involuntary muscular twitching of the limbs or facial muscles

Question 6

Dystonic

Answer 6

Muscular spasm most often affecting the tongue, jaw, eyes, and neck

Question 7

Extrapyramidal symptoms (EPS)

Answer 7

Group of adverse reaction involving the extrapyramidal portion of the nervous system causing abnormal muscle movements, especially akathisia and dystonia

Question 8

On-off phenomenon

Answer 8

Fluctuation in levodopa therapy where inconsistent absorption causes alternating improved status and loss of therapeutic effect

Question 9

Parkinsonism

Answer 9

Referring to a cluster of symptoms associated with Parkinson disease (fine tremors, slowing of voluntary movements, muscular weakness)

Question 10

Parkinson’s disease

Answer 10

Degenerative disorder caused by an imbalance of dopamine and acetylcholine in the CNS

Question 11

Restless leg syndrome

Answer 11

Disorder with an irresistible urge to move legs, urge lessens with movement but worsens with rest

Question 12

Cardinal signs of Parkinson’s disease

Answer 12

Trembling, rigidity, difficulty walking, problems with balance, and bradykinesia

Question 13

Dopaminergic drugs ex

Answer 13

Levodopa, carbidopa, amantadine, bromocriptine, or MAOIs (selegiline, rasagiline)

Question 14

Dopaminergic Drugs MOA

Answer 14

Stimulate dopamine receptors or increase availability of dopamine

Question 15

Dopaminergic Drugs uses

Answer 15

Parkinson disease, Parkinson like symptoms, restless leg syndrome, viral infections

Question 16

Dopaminergic Drugs side effects

Answer 16

Dry mouth, diffupiculty swallowing, anorexia, nausea, vomiting, abdominal pain, constipation, increased had tremor, headache, dizziness

Question 17

Levodopa side effects

Answer 17

Choreiform movements and dystonic movements, dementia, depression, psychotic episodes, paranoia, and suicidal tendencies

Question 18

Levodopa contraindications

Answer 18

Narrow angle glaucoma, and MAOIs

Question 19

Patients taking levodopa should be screened for

Answer 19

Unusual skin lesion

Question 20

Levodopa precautions

Answer 20

Cardiovascular or pulmonary disease, peptic ulcer disease, renal or hepatic disease, and psychosis, pregnancy (cat C), and lactation

Question 21

Dopaminergic Drugs interactions

Answer 21

TCAs increase risk of hypertension and dyskinesia

Question 22

Levodopa interactions

Answer 22

Antacids increase levodopa effect, and anti-epileptics and and foods high in vitamin B6 decrease levodopa’s effect

Question 23

Dopamine receptor Agonists MOA

Answer 23

Act directly on postsynaptic dopamine receptor of nerve cells in the brain, mimicking effects of dopamine

Question 24

Dopamine receptor Agonists use

Answer 24

Treatment of the signs and symptoms of Parkinson’s disease, and RLS

Question 25

Dopamine receptor Agonists ex

Answer 25

Gabapentin encarbil, and apomorphine, ropinirole, pramipexole

Question 26

Dopamine receptor Agonists side effects

Answer 26

Nause, vomiting, dizzy, somnolence, hallucinations, confusion, visual disturbance, postural hypotension, abnormal involuntary movements, headache

Question 27

Dopamine receptor Agonists precautions

Answer 27

Dyskinesia, orthostatic hypotension, hepatic or renal impairment, cardiovascular disease, and a history of hallucinations or psychosis

Question 28

Ropinirole pregnancy cat

Answer 28

C

Question 29

Pramipexole pregnancy cat

Answer 29

C

Question 30

Dopamine receptor Agonists interactions

Answer 30

Increased risk of CNS depression, increased effects of levodopa and hallucinations, and ciprofloxacin, cimetidine, ranitidine, verapmil, and quinidine and estrogen increase dopamine agonist effectiveness, and phenothiazines decrease dopamine agonist effectiveness

Question 31

COMT inhibitors ex

Answer 31

Entacapone, tolcapone

Question 32

COMT inhibitors MOA

Answer 32

Prolong effect of dopamine by blocking COMT enzyme, which eliminates dopamine

Question 33

COMT inhibitors uses

Answer 33

Used as adjuncts to levodopa/carbidopa

Question 34

Entacapone use

Answer 34

Help manage fluctuations in response to levodopa, mild COMT inhibitor

Question 35

Tolcapone side effects

Answer 35

Liver damage and liver failure, potent COMT inhibitor

Question 36

COMT inhibitors side effects

Answer 36

Dizziness, dyskinesia, hyperkinesias, akathisia, nausea, anorexia, diarrhea, orthostatic hypotension, sleep disorders, excessive dreaming, somnolence, muscle cramps

Question 37

COMT inhibitors contraindications

Answer 37

Pregnancy (cat C) lactation

Question 38

Tolcapone contraindications

Answer 38

Liver dysfunction

Question 39

COMT inhibitors precautions

Answer 39

Hypertension, hypotension, decreased hepatic or renal function

Question 40

COMT inhibitor interactions

Answer 40

MAOI increases toxicity risk of both drugs, adrenergic drugs increase risk of cardiac symptoms

Question 41

What should be used in older patients to treat Parkinson’s

Answer 41

Antihistamines to produce fewer adverse reactions

Question 42

Cholinergic blockers for Parkinson’s side effects

Answer 42

Dry mouth, blurred vision, dizziness, Mild nausea, nervousness

Question 43

Cholinergic blocking drugs used for Parkinson’s contraindications

Answer 43

Angle closure glaucoma, pyloric or duodenal obstruction, peptic ulcers, prostatic hypertrophy, achalasia, myasthenia gravis and megacolon

Question 44

Cholinergic blocking drugs for Parkinson’s precautions

Answer 44

Tachycardia, cardiac arrhythmias, hypertension, hypotension, tendency towards urinary retention, decreased liver or kidney function, obstructive disease of urinary system or GI tract, or elderly

Question 45

Cholinergic blocking drugs for Parkinson’s interactions

Answer 45

Amantadine increases anticholinergic effects, increased digoxin serum levels, haloperidol increases psychotic behavior, phenothiazines increase anticholinergic effects

Question 46

Cholinergic blocking drugs used for Parkinson’s ex

Answer 46

Benztropine, diphenhydramine, trihexyphenldyl