Parkinson's Disease Flashcards Preview

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Flashcards in Parkinson's Disease Deck (24)
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1
Q

Which neurotransmitter is deficient in Parksinson’s Disease?

A

Dopamine

2
Q

What are the symptoms of Parkinson’s Disease

A

Motor Sx - hypokinesia, bradykinesia, rigidity, rest tremor and postural instability

Non-motor Sx - dementia, depression, sleep disturbances, bladder and bowel dysfunction, speech and language change, swallowing problems and weight loss

3
Q

Name the drug classes that can be used to treat Parkinson’s Disease

A

Levodopa - + carbidopa (Sinemet) or + benserazide (Madopar)

Dopamine Receptor Agonists

- Non ergot dervied -> Pramipexole, ropinorole, rotigotine, amantadine (weak) and apomorphine

  • Ergot dervied - bromocriptine, carbergoline and pergolide

MAO-B Inhibitors - selegiline and rasaligine

COMT Inhibitors - Entacapone and tolcapone

4
Q

Which Parkinson’s med can colour urine reddish/brown

Which Parkinson’s med can stain urine orange

A

Entacopone - reddish/brown

Levodopa - Orange

5
Q

Which drug is used to treat advanced PD - how is it given?

A

Apomorphine (SC intermettient or infusion)

  • administer domperidone 2 days before and then discountinue ASAP as both can cause QT prolongation - arrhthymias (MHRA advice assessment and ECG monitoring, weigh up pros/cons)
  • Levodopa intenstinal gel - severe Parkinson’s Sx
  • Deep brain stimulation
6
Q

What class of PD has a MHRA alert and what is it

A

Ergot-dervied dopamine agonists - fibrrotic reactions (retroperitoneal, pulmonary and pericardial)

7
Q

Counselling for entacpone

A
  • Can colour urine red/brown
  • Avoid iron preps 2 hours before/after
8
Q

Side effects of Levodopa

A
  1. Impulse control disorders
  2. Excessive sleeping, sudden onset of sleep
  3. Motor complications - dyskinseia and response fluctuations
  4. End of dose deterioation w shorter length of benefit (switch to MR)
9
Q

DRA are associated with more X symptoms compared to levodopa

A

Motor

10
Q

Side effects of DRA

A
  1. Impulse control disorders
  2. Excessive sleepiness and sudden onset of sleep
  3. Psychotic Sx
  4. Hypotensive reaction in first few days
11
Q

Important intereactions of MAO-B Inhibitors

A

Hypertensive crisis

Pseudoephredine, phenylrphrine, xylometazoline, oxymetalozine (OTC preps: nose decongestants)

Adrenaline, NA, methylphenidate, amphetamines, b2 agonists - sympathomimetics (increase BP)

12
Q

Interactions of COMT inhibitors

A

sympathomimetics - adrenaline, NA, MAOIs (tranlcypromapine)

13
Q

What is used to treat day-time sleepiness - how often reviewed

(which group of people to avoid this drug in)

A

Modanifil - yearly

Pregnancy

14
Q

Drug to treat rapid eye movement sleep behaviour disorder (RBD)

A

Clonazepam or melatonin

15
Q

Drug to treat postural hypotension

A

Midodrine, fludrocortisone

16
Q

Drug to treat dementia in PD

A

Rotigotine

17
Q

Drooling of saliva PD

A

Glycopyrronium

specialis - botulinum toxin A

18
Q

Dopamine agonists cause more what compared with levodopa?

A

Psychiatric side effects

19
Q

Which antimuscarinic drug can be used to treat parkinson side effects of antipsychotics?

A

Procyclidine

20
Q

If a patient who drives develops Parkinsons who do they need to inform?

A

DVLA

21
Q

First line treatment for Parkinsons patients who’s motor symptoms affect their quality of life

A

Levodopa

22
Q

First line treatment for Parkinsons patients who’s motor symptoms do NOT affect their quality of life

A

levodopa, non-ergot dervived dopamine agonists (e.g. Ropinorole, Pramipexole, Rotigotine) or MAOBi (rasagiline or Selegilline)

23
Q

Why should abrupt withdrawal of Levodopa be avoided?

A

Neuroleptic malginant syndrome

24
Q
A