Parkinson's Flashcards
(24 cards)
PD?
Idiopathic progressive neurodegenerative disorder.
What type of neurons are depleted in PD?
Loss of dopaminergic neurons.
Where does the pathology occur?
Substantia nigra
Basal ganglia
What are some classic motor symptoms of PD?
Tremor
Rigidity
Akinesia
Postural control
Difficulty initiating movements: cognitive and motor, decreased amplitude
What are some non motor symptoms?
Fatigue
Cognitive dysfunciton
Difficulty sleeping
What are the 3 medications for PD?
1) Carbidopa/Levodopa 25/100 (Sinemet)
2) Carbidopa/Levodopa (50/200)
3) Azilect
What classification is Levodopa?
Enzyme inhibitor & Agonist
What classification is Carbidopa?
Enzyme inhibitor
What classification is Azilect?
Monoamine oxidase-B inhibitor
MAOB
MOA of Carbidopa/Levodopa?
Converted to dopamine by dopadecarboxylase to attach to dopamine receptor
MOA of Azilect?
Reduces/slows the breakdown of dopamine, resulting in increased levels of dopamine in the brain
Clinical application of Carbidopa/Levodopa?
More dopamine available in the brain allows for better movement
Clinical application of Azilect?
Less dopamine broken down in the brain allows for better movement
Common adverse reactions?
GI upset
Orthostatic hypotension
Dyskinesia
Psychosis
Potential interactions of Carbidopa/Levodopa?
w/ MAOB, severe elevation of BP
Potential interactions of Azilect?
Antidepressants that increase serotonin levels
Amphetamines and VC increases HTN events
How does Carbidopa/Levodopa work together?
Carbidopa acts as a transporter for L-dopa to cross BBB
What are two other agonist drugs for PD?
Mirapex and Requip
What are limitations to PD drugs?
Response to medication changes over time, meds may need to be increased due to less responsive
What is our role as PT?
Know the signs if drugs are effective for our patients and time accordingly to have an effective treatment session
As drug lose effectiveness what can be educated?
Off times increase may need to change the dose, change the drug, add a drug, timing of meds
The longer the patient is on the drug timing is much more important. T/F? Why?
True. Difficult to raise blood levels back up to therapeutic levels
What two drugs are neuroprotective, slows down degeneration?
Azilect & Mirapex
What percentage of dopamine do you lose before there are S&S?
60-80%
