Parkinson's Disease Flashcards
(15 cards)
What is the path-physiology behind Parkinson’s disease?
progressive reduction in dopamine in the basal ganglia
leads to disorders of movement
Describe the typical presentation of parkinsons.
older man with gradual onset of symptoms
asymmetrical symptoms
What is the classic triad of Parkinson’s symptoms?
rigidity - resting, passive movement
pin rolling tremor - gets worse when patient is distracted
bradykinesia - slowness of movement, difficulty initiating it and a shuffling gate
What are the classic features of Parkinson’s disease?
reduced facial movements
depression
sleep disturbance and insomnia
loss of sense of smell
postural instability
cognitive impairment and memory problems
Give the names of 4 Parkinson plus syndromes.
multiple system atrophy
dementia with Lewy bodies
progressive supra nuclear palsy
corticobasal degeneration
What parkinsons plus syndrome presents with parkinsons symptoms, ataxia, postural hypotension, constipation, abnormal sweating, and sexual dysfunction?
multiple systems atrophy
What parkinsons plus syndrome presents with parkinsons symptoms, visual hallucinations, delusions, REM sleep disorders, and fluctuating consciousness?
dementia with Lewy bodies
What scan can be used to distinguish between parkinsons and differentials?
dopamine transporter scan
What is used to treat parkinsons ?
levodopa - synthetic dopamine
COMT inhibitors
dopamine agonists
monoamine oxidase B inhibitors
What medication is typically prescribed with levodopa and why?
a peripheral decarboxylase inhibitor e.g., carbidopa and benzerazide
stops it from being metabolised in the body before it reaches the brain
What are the side effects of levodopa?
dyskinesia (abnormal movements associated with motor activity)
e.g., dystonia (excessive muscle contractions cause abnormal postures), chorea (abnormal involuntary movements that can be jerking), athetosis (involuntary twisting)
What drug can be given to manage the dyskinesia associated with levodopa?
amantadine
What drug can be taken with levodopa to slow its breakdown and extend its duration of action?
enteracapone
When are dopamine agonists used? What is the main potential side effect?
less effective then levodopa for reducing symptoms so used prior to levodopa and then in addition to reduce the required dose
main side effect = pulmonary fibrosis
what type of drug are selegiline and rasagiline?
monoamine oxidase inhibitors
