Parkinsons

Question 1

Dopamine blocking drugs that can worsen PD

4 total

Answer 1

1. Prochloperazine
2. Halopiridol
3. Risperidone
4. Metcopramide

Question 2

Primary treatment of PD?

Answer 2

Replace dopamine

Question 3

What is the preferred antipsychotic in PD?

Answer 3

Quitiapine due to the reduced risk of movement disorders

Question 4

Preferred Drug treatment for PD?

Answer 4

Levodopa prodrug of dopamine most effective

Question 5

What is given with levodopa and why?

Answer 5

Carbidopa prevents peripheral metabolism of levodopa

Question 6

Why are dopamine agonists commonly given in PD?

Answer 6

Reduces off periods and limits dyskinisia (abnormal movements)

Question 7

What is the dose of carbidopa that is needed to hibit dopa decarboxylase?

Answer 7

70-100 mg/day

Question 8

Sinemet or Sinemet CR

Answer 8

Levo/carbidopa

Question 9

Notes about Sinemet?

Answer 9

CR tab can be cut in half but dont crush or chew

Question 10

4 SEs of Sinemet?

Answer 10

1. Nausea
2. Dizziness
3. Orthostatis
4. Dyskinesia

Question 11

Sinemet can cause what?

Answer 11

Brown black or dark urine

Positive combs test discontinue: hemolysis

Question 12

What do COMT inhibitors do?

Answer 12

Increase duration of action of levodopa

Question 13

Dosing of COMT inhibitors?

Answer 13

200 mg PO with each levo/carbi dose

Question 14

2 dopamine agonists used in PD?

Answer 14

Pramipexole

Ropinorole

Question 15

Neupro?

Answer 15

Rotigotine patch

dopamine agonists

Question 16

Neupro patch instructions?

Answer 16

Apply once daily dont use the same spot for at least 14 days

remove before MRI

aovid if allergic to sulfites

Question 17

Apomorphine contra?

Answer 17

DOnt used with 5HT3s severe hypotension

Question 18

How is the apomorphine dose written?

Answer 18

mL not mg

Question 19

Contraindications to SInemet?

Answer 19

Dont use with non-selective MAOs

Iron and protein rich food decrease absoprtion

Question 20

Selective MAO B inhibitors?

Answer 20

Selegiline

Question 21

COntaindications to MAO B

Answer 21

COmbo with other MAOs including other MAOs linezolid, opioids, SNRIs,

Xadago severe hepatic impairment

Question 22

2 warnigns for MAO Bs?

Answer 22

Serotonin syndrome

HTN

Question 23

WHen should selegiline be taken?

Answer 23

Can be activating dont take at night

Question 24

Cogentin?

Answer 24

Benztropine

Central acting anticholinergic

Question 25

What score on the MMSE is considered a memory disorder?

Answer 25

\<24

Question 26

What can cause acute memory impairment?

Answer 26

Centrally acting anticholinergics

Question 27

What vitamin has shown some benefit for alzheimerz?

Answer 27

VIt E

Question 28

Gingko?

Answer 28

Also thought to help memory but increases bleeding risk

Question 29

8 drugs that can worsen dementia?

Answer 29

1. Antihistmines, antiemetics 2. Antipyschotics 3. barbiturates 4. BZDs 5. Central acting anticholnergics benztropine 6. Peripheral anticholinergics oxybutynin 7. Skeleta muscle relaxants 8. Other CNS depressants

Question 30

What is used for pharmacotherapy in dementia?

Answer 30

Acetylcholenesterases donepezil used alone or with memantine for severe stages

Question 31

What is donepezil taken?

Answer 31

Can cause nausea taken at night for that reasons If insomonia is present can take in the morning if issue

Question 32

Namzaric?

Answer 32

Donepezil/Memantine Pts stablaized with 10 mg donepezil can switch to combo `

Question 33

Namenda?

Answer 33

Memantine can be used alone or in combo with donepezil

Question 34

Aricept?

Answer 34

Donepezil

Question 35

What do acetylcholinesterases inhibitors do?

Answer 35

inhibit central active acetylcholinesterase this cause an increase in acetylcholine

Question 36

Warning for Aricept?

Answer 36

Bradycardia

Question 37

SEs of Aricept?

Answer 37

Insomnia and Nausea

Question 38

What AcH formulations do what?

Answer 38

Exelon patch and donepezil ODT have less GI SEs

Question 39

ER capsules or Namzaric?

Answer 39

Do not crush or chew but can be opened and sprinkled on applesauce

Question 40

Caution for acetylcholinesterase Inhibitors?

Answer 40

Caution with other drugs that lower HR and with other drugs that can cause dizziness Drugs that have anticholinergic effects can reduce efficacy of these drugs

Question 41

Exelon

Answer 41

Rivastigmine

Question 42

Exelon patch use instructions?

Answer 42

Saem time each day to the upper or lower back, or upper arm or chest rotate sites