Parkinson's Disease Meds

Question 1

When you heard the Parkinson’s disease what comes to mind?

Answer 1

• Dopamine
• Tremors

Question 2

What does the Extrapyramidal motor system do?

Answer 2

• It helps regulate involuntary movements and muscle tone.

Question 3

What is Substantia nigra

Answer 3

• This the Extrapyrmidal system that releases Dopamine
• Means Black substance

Question 4

What happens to the patient when a neuron dies (Parkinson’s Disease)?

Answer 4

• Parkinson’s disease causes and imbalance of the two neurotransmitters (Dopamine & Acetylcholine)
  * Too little Dopamine
  * Too much Acetylcholine

Question 5

Complications of Parkinson’s disease?

Answer 5

• Motor problems
• Dementia
• Sleep disturbance
• Difficulty smelling
• Depression

Question 6

Signs of Parkinson’s Disease

Answer 6

(TRAP) mnemonic

• Tremors (shakiness)
• Rigidity (Stiffness, jerkiness)
• Akinistia (Can’t sit still)
• Postural (Instability)

Question 7

Since Parkinson’s disease causes an imbalance in the brain, What effect will the medications have on a Parkinson’s patient?

Answer 7

• The drug will:-
  * Increase dopamine
  * Decrease acetylcholine

Question 8

Which medications do we give to help treat Parkinson’s disease?

Answer 8

• Dopamine Agonists
• Selegiline
• Anticholinergics

Question 9

How do the Dopamine Agonist medications work?

Answer 9

• They also increase the Dopamine activities in the brain.

(Since the Parkinson’s disease causes low dopamine)

Question 10

What are the Dopamine Agonist Medications?

Answer 10

• Carbidopa/Levodopa
• Pramipexole
• Ropinirole

Question 11

What do the Dopamine Agonists do?

Answer 11

• They help treat Parkinson’s disease
• They are prescribed for Restless leg syndrome (RLS).

(if its used for RLS its only given at night)

Question 12

Which Dopamine Agonist medications can cross the Blood Brain Barrier?

Answer 12

Levodopa

Question 13

Why can’t we give a Parkinson’s disease patient Dopamine?

Answer 13

• Because Dopamine cannot cross the Blood Brain Barriers, so the Pt has to take Levodopa to help cross the Blood Brain Barrier before it is converted to Dopamine after it crosses.

Question 14

What does Carbidopa do?

Answer 14

• It helps prevent Levodopa from converting into Dopamine before it crosses the Blood Brain Barrier, Because Dopamine cannot cross the BBB.
• It wont cross the BBB, but helps the Levodopa to cross the BBB

Question 15

High yield concepts of Dopamine Agonists?

Answer 15

• Purpose of Carbidopa.
• Orthostatic Hypotension
• Psychiatric issues (Paranoia, hallucinations & Impulse issues)
• Food interactions (Iron, Proteins & Vitamin B6)

Question 16

What food should a one avoid whe taking a Dopamine Agonist?

Answer 16

• Iron
• Protein
• Vitamin B6

Question 17

What does Selegiline do?

Answer 17

• It treats Parkinson’s disease.
• The transdermal version id prescribed fro Depression.

Question 18

Selegiline is part of the?

Answer 18

MAO-B inhibitors

(They only prevent the breakdown of Dopamine)

Question 19

High yield concepts of Selegiline?

Answer 19

• Food Interactions (Avoid foods with Tyramine)
• Drug interactions (Dopamine & MAOIs)

Question 20

How do the Anticholinergics work?

Answer 20

• They also treat extrapyramidal effects.
• They decrease the levels of Acetylcholine in the brain, by blocking the Acetylcholine receptors.

(Since Parkinson’s disease causes too much Acetylcholine)

Question 21

What are the examples of Anticholinergic Medications?

Answer 21

• Benztropine.
• Trihexyphenidyl

Question 22

High yield concepts of Anticholinergic medications?

Answer 22

• Can’t See
• Can’t Spit
• Can’t Pee
• Can’t defecate
• Drowsiness