Charlton- Pharm for Parkinsons

Question 1

Main symptoms of Parkinson’s

Answer 1

pill rolling tremor
hypokinesia- cogwheel rigidity
muscular rigidity- shuffling gait

Question 2

Major site affected in Parkinson’s

Answer 2

nigrostriatal pathway signified by the presence of lewy bodies

Question 3

Other systems affected in Parkinson’s

Answer 3

• Locus ceruleus
• hypothalamus
• dorsal motor nucleus of vagus
• sympathetic ganglia
• adrenal medulla

Question 4

Parksinon’s main biochemical pathway damaged

Answer 4

• depletion of nigrostriatal dopamine

- increased acetylcholinergic activity

Question 5

Minor biochemical changes in Parkinson’s

Answer 5

• depletion of tyrosine hydroxylase
• depletion of melanin pigments
• decreased norepinephrine and serotonin

Question 6

Goal of Drugs for PD

Answer 6

• increase dopamine
• stimulate DA receptors
• enhance of DA release/availability
• muscarinic cholinergic antagonists
• block adenosine receptors

Question 7

2 L-dopa drugs

Answer 7

LARODOPA
DOPAR

• most effective bc it crossess BBB

Question 8

side effects of L -dopa

Answer 8

hallucinations
orthostatic hypotension
confusion

Question 9

L-dopa Adjuvants

Answer 9

LAAD/AADC inhibitors
COMT inhinbitors
MAO inhibitors

Question 10

L-Aromatic acmino acid decarboxylase (LAAD)

Answer 10

Carbidopa

Benserazide

Question 11

CARBIDOPA

BENSERAZIDE

Answer 11

• allow more L-dopa to reach the brain

- decreases the dosage of L-dopa needed

Question 12

Carbidopa/levodopa dosage forms

Answer 12

sinemet
atamet
PARCOPA

Question 13

COMT inhibitors

Answer 13

Entacapone (COMTAN)

Tolcapone (TASMAR)

Question 14

MAO inhitiors

Answer 14

Selegiline/deprenyl (ELDEPRYL)

ZELEPAR
ENSAM

LADOSTIGIL

TRANYLCYPROMINE
PHENELZINE

Question 15

DA receptor agonists

Answer 15

Ropinirole (REQUIP)
Pramipexole (MIRAPEX)
Bromocryptine (PARLODEL)
Pergolide (PERMAX)

Lisuride
Carbergoline

Apomorphine (APOKYN)

Question 16

Enhancer dopamine release

Answer 16

Amandadine (STMMETREL)

Question 17

Muscarinic cholinergic antagonists

Answer 17

Benztropine mesylate (COGENTIN)
Trihexyphenidyl (ARTANE)
Diphenhydramine HCl (BENADRYL)

Question 18

Muscarinic cholinergic antagonists

Answer 18

Benztropine mesylate (COGENTIN)
Trihexyphenidyl (ARTANE)
Diphenhydramine HCl (BENADRYL)
Procyclidine (KEMADRIN)
Biperiden (Akineton)
Ethopromazine (PARSIDOL, PARSITAN) not in USA

Question 19

anticholinergic agents main function

Answer 19

decrease tremor

Question 20

Alzheimer’s disease main pathophysiology

Answer 20

• loss of basal nucleus of Meynert

- loss of septal Ach neurons

Question 21

Risk factors for AD

Answer 21

• chromosome 21, 14 and 1

Question 22

treatment goal of AD

Answer 22

• augment cholinergic functions

Question 23

best treatment for AD

Answer 23

inhibitors of acetylcholinesterase

Question 24

Inhibitors of Acetylcholine esterase

Answer 24

Donepezil (ARICEPT)
Rivastigmine (Excelon)
Galantamine (REMINYL, RAZADYNE)
Tacrine (COGNEX)

Physostigmine
Memantine (NAMENDA)

Question 25

Huntington's Disease cause

Answer 25

- genetic cause CAG - Caudate loses Ach and GABA? - loss of striatal Medium spiny neurons (MSN

Question 26

Huntingon symptoms

Answer 26

choreiform movements

Question 27

Huntingon symptoms

Answer 27

choreiform movements | depression

Question 28

Huntington's treatment (depression)

Answer 28

fluoxetine

Question 29

Huntington's treatment (psychosis)

Answer 29

carbamazepine clozapine haloperidol

Question 30

Huntington's treatment (movement disorders)

Answer 30

reserpine | tetrabenazine

Question 31

Huntington's treatment (anxiety)

Answer 31

benzodiazepines

Question 32

ALS main degeneration

Answer 32

degeneration of UMN and LMN in corticospinal and corticobulbar tracts

Question 33

ALS main degeneration

Answer 33

degeneration of UMN and LMN in corticospinal and corticobulbar tracts - occulomotor and pyramidal neurons are mostly spared

Question 34

ALS drugs

Answer 34

``` Riluzole (RILUTEK) Benzodiazepines Clonazepam (KLONIPIN) Tizanidine (ZANFLEX) Dantroline (DANTRIUM) ```