PD/AD Flashcards
(47 cards)
What are common anticholinergic side effects?
Blurred vision, confusion, constipation, dry mouth, memory difficulty, sleepiness, urinary retention, narrow-angle glaucoma
Anticholinergic side effects can significantly impact patient quality of life.
What is Parkinson’s Disease (PD) a disorder of?
The EXTRAPYRAMIDAL SYSTEM
This system is responsible for the coordination of movement.
What is the etiology of Parkinson’s Disease?
True etiology is unknown but associated with low dopamine levels.
Dopamine is crucial for movement regulation.
What are the cardinal motor features of Parkinson’s Disease?
- Rigidity
- Postural instability
- Bradykinesia
- Tremor at rest
These features are essential for diagnosis.
What is L-dopa (levodopa) combined with to enhance its effects?
Carbidopa
Carbidopa prevents L-dopa from being converted to dopamine in the periphery.
What are the effects of high oxidative stress in dopaminergic neurons?
Increased dopamine degradation, increase in hydroxyl and hydroperoxyl radicals, decrease in glutathione antioxidants.
Oxidative stress contributes to neuronal damage in PD.
What factors are associated with a lower risk of Parkinson’s Disease?
Cigarette smoking, caffeine
These substances may have neuroprotective effects.
What factors are associated with a higher risk of Parkinson’s Disease?
Pesticide exposure, genetics
These factors may contribute to mitochondrial dysfunction and oxidative stress.
What is the pathophysiology of Parkinson’s Disease?
Degeneration of dopaminergic neurons in the nigrostriatal pathway.
This pathway is crucial for voluntary movement control.
What are Lewy bodies in Parkinson’s Disease composed of?
Clumps of protein alpha-synuclein
These are characteristic findings in the brains of PD patients.
What are non-motor symptoms of Parkinson’s Disease?
- Depression
- Anxiety
- Cognitive impairment
- Dysphagia
- Psychosis
Non-motor symptoms significantly affect quality of life.
What is the goal of treatment in Parkinson’s Disease?
Improve motor and nonmotor symptoms for the best quality of life.
Treatment is individualized based on symptom severity.
What is the most effective drug for symptomatic treatment of Parkinson’s Disease?
Carbidopa/L-dopa (Sinemet)
It is the cornerstone of PD management.
What are the adverse reactions of anticholinergics?
Anticholinergic effects, confusion, drowsiness
These effects can be especially intolerable in the elderly population.
What is the mechanism of action for dopamine agonists?
Stimulate dopamine receptors (D1, D2, D3)
They are often used for mild-to-moderate impairment.
What is the potential side effect of dopamine agonists?
Nausea, confusion, drowsiness, hallucinations, lower extremity edema, orthostatic hypotension
Monitoring for these side effects is crucial.
What should be avoided when taking MAO-B inhibitors?
Tyramine foods (e.g., aged cheeses, cured meats)
Avoiding these foods is essential to prevent hypertensive crisis.
What is the role of amantadine in Parkinson’s Disease treatment?
NMDA-receptor antagonist, may block dopamine reuptake
It is used to manage symptoms like tremor and rigidity.
What is the recommended approach for managing ‘wearing off’ periods in Parkinson’s Disease?
Increase frequency of carbidopa/L-dopa or add COMT inhibitor, MAO-B inhibitor, or dopamine agonist
This strategy helps smooth out medication effects.
What are common interactions with Carbidopa/L-dopa?
Contraindicated with non-selective MAO inhibitors, antipsychotics, and metoclopramide
These interactions can lead to severe side effects.
What is the effect of COMT inhibitors on L-dopa?
Enhance central L-dopa bioavailability and manage ‘wearing off’ by 1-2 hours
They are used to prolong the effects of L-dopa.
What is the primary treatment for acute freezing episodes in Parkinson’s Disease?
Apomorphine (subcutaneous short-acting) or L-dopa dry powder inhalation
These provide rapid relief during episodes.
What is the mechanism of action of MAO-B inhibitors?
Prolong dopamine action by irreversibly inhibiting MAO-B
This helps to sustain dopamine levels in the brain.
What is the recommended dose adjustment for Pramipexole in patients with renal impairment?
CrCl 30-50 mL/min → 0.125 mg TID;
CrCl <15 mL/min → 0.125 mg QD
Adjustments are necessary to prevent toxicity.
