Parkinson’s Disease Flashcards
(25 cards)
Tx for patients whose motor symptoms do affect their QOL
levodopa with either
- carbidopa (co-carldopa)
- benserazide (co-beneldopa)
How much should you reduce the dose by switching from modified-release levodopa to dispersible co-beneldopa?
30%
What causes parkinsons disease?
death of dopaminergic cells of the substantia nigra in the brain
What are the motor symptoms of parkinsons?
- Hypokinesia (small movements)
- bradykinesia (slow movements)
- rigidity
- tremor
- postural instability
What are the non-motor symptoms of Parkinson’s?
- Dementia
- Depression
- Sleep Disturbances
- Bladder and bowel dysfunction
- Speech and language difficulties
- Swallowing problems
- Weight loss
Tx patients whose motor symptoms don’t affect their QOL
- dopamine agonist (non-ergot derived)
- levodopa
- monoamine oxidase B inhibitors
Examples of dopamine agonist (non-ergot derived)
pramipexole, ropinirole, rotigotine
Tx for patients who develop dyskinesia or motor fluctuations despite optimal therapy
add an adjuvant to their levodopa:
- dopamine agonist (non-ergot derived)
- monoamine oxidase B inhibitors
- COMT inhibitors
levodopa side-effects
- impulse disorders (increased libido, compulsive spending, binge eating)
- sudden onset of sleep (treat with modafinil)
What colour does levodopa turn urine?
Red
How to treat hypotension non-ergot derived dopamine receptor agonist?
Midodrine
How to treat the sudden onset of sleep associated with levodopa?
modafinil
non-ergot derived dopamine receptor agonist side-effects
pramipexole, ropinirole, rotigotine
- hallucinations
- impulse disorders (more risk than levodopa)
- hypotension
rotigotine patch counselling
- avoid external heat
- do not use same site within 14 dayS
Examples of monoamine oxidase B inhibitors (slimey)
rasagiline, selegiline, safinamide And phenylephrine
monoamine oxidase B inhibitors side-effects
- hypertensive crisis with phenylephrine
-does not interact with ramine rich foods - this is MOA-A inhibitors
Pseudoephedrine, phenylephrine, ephedrine- found in decongestants
- can cause hypertensive crisis (A severe and sudden rise in blood pressure)
Pseudoephedrine, phenylephrine, ephedrine- found in decongestants
- can cause hypertensive crisis (A severe and sudden rise in blood pressure)
Examples of COMT inhibitors
entacapone, opicapone, tolcapone
What are side effects of COMT inhibitors?
Increases sympathetic side effects
- increases risk of CVD events (ischaemic heart disease and MI)
What colour can entacapone turn your urine?
Brown/Red
anti-Parkinson’s medications risk
neuroleptic malignant syndrome
- treated with Bromocriptine
treating rapid eye movement sleep disorder
clonazepam or melatonin
treating psychotic symptoms Associated with
Quetiapine
treating Parkinson’s disease dementia
rivastigamine
