Final: Parkinson’s Disease

Question 1

Goal of treatment of Parkinson’s Disease

Answer 1

Restore balance between cholinergic and dopaminergic activity in brain

Question 2

Levodopa/Carbidopa (Dopaminergic Agent: Dopamine Synthesis)

Answer 2

Dopamine synthesis medication

Increases levels of dopamine in substantia nigra, restores balance between inhibitory and stimulating neurons

Mainstay treatment for Parkinson’s

Crosses blood brain barrier and converted to dopamine. Combined with Carbidopa which decreases amount of levodopa needed to reach therapeutic levels

Effective for 2-5 years in relieving Parkinson’s symptoms

Adverse effects: Dyskinesias, orthostatic hypotension, psychosis, arrhythmias, melanoma, instruction for small meals (avoid high protein), nutriments (avoid pyroxidine foods, Vitamin B6), no OTC vitamins, effects of color of urine/sweat (may darken = harmless), n/v administer with food

Question 3

Selegiline (Monoamine Oxidase-B Inhibitors)

Answer 3

Inhibits MAO which helps to breakdown catecholamines including dopamine

Absorbed in GI tract, metabolized in liver, excreted in urine

Due to risk of MAOI-induced hypertension educate patients to report severe headaches or any unusual symptoms

Adverse effects:
Meals: avoid tyramine foods; Morning (take before noon - can cause insomnia)
Added to levodopa/carbidopa
On alert for hypertensive crisis
Billions of medication interactions

Question 4

Benztropine (Anticholinergics)

Answer 4

Absorbed from GI tract
Peak in 1-4 hours
Metabolized in liver and excreted in cellular pathways
Crosses placenta and enters breast milk

Adverse effects: Disorientation, confusion, memory loss, nervousness, light-headedness, dizziness, depression, blurred vision, mydriasis, dry mouth, constipation, urinary retention, urinary hesitation, flushing, decreased sweating