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Clin Med 2 > Parkinson Disease > Flashcards

Parkinson Disease Flashcards

1
Q

What type of disease is Parkinson?

A

Neurodegenerative

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2
Q

What are the classic symptoms of Parkinson disease? (4)

A
  • rigidity
  • resting tremor
  • bradykinesia
  • postural instability
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3
Q

What is the primary cause of Parkinson?

A

degeneration of the dopaminergic neurons in the substania nigra

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4
Q

What does decreased dopamine result in with PD patients?

A

increased ACH

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5
Q

What are the other neurotransmitters affected by PD?

A

GABA, glutamate, 5-HT

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6
Q

What is the rationale for levodopa therapy?

A

Attempt to increase dopamine content in the basal ganglia

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7
Q

True or False:

A direct administration of dopamine is ineffective because of the BBB

A

True

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8
Q

What provides a precursor to dopamine allowing it to cross the BBB?

A

levodopa (L-dopa)

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9
Q

What is the drug given in conjunction with L-dopa?

A

carbidopa

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10
Q

What does carbidopa do in the body?

A

inhibits dopa decarboxylase; prevents premature conversion of L-dopa allowing it to cross the BBB

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11
Q

Does cabidopa cross the BBB?

A

negative ghost rider

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12
Q

What are the problems L-dopa causes with therapy? (5)

A
  • GI irritation
  • hypotension
  • behavioral effects
  • dyskinesia
  • “freezing” of gait
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13
Q

What is end-of-dose akinesia?

A

A deceased response of L-dopa toward the end of cycle of the drug

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14
Q

What is the on-off phenomenon?

A

response to L-dopa fluctuates within dose cycle

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15
Q

What is the most serious problem with L-dopa therapy?

A

diminished response with long term use

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16
Q

When will the benefits possibly be lost?

A

After 4-5 years of L-dopa therapy

17
Q

What are dopamine agonists?

A

Synthetic dopamine that cross the BBB with direct stimulating effects on the dopamine receptors in the brain

18
Q

True false:

Dopamine agonists have a longer half life

A

True

19
Q

True false:

Having a longer half life makes the drug more stable

A

True

20
Q

Can Dopamine agonists be used as initial treatment in early PD?

A

Yeppers

21
Q

Common problems associated with Dopamine agonists? (4)

A
  • nausea/vomiting
  • confusion/hallucinations
  • postural hypotension
  • increased dyskinesia
22
Q

What is COMT?

A

It is an enzyme that breaks down L-dopa in peripheral tissue

23
Q

What do COMT inhibitors allow for?

A

Allow for more L-dopa to reach the brain

24
Q

True False:

COMT inhibitor can be combined with L-dopa and carbidopa in treatment

A

True

25
Q

What are the common problems associated with COMT inhibitor therapy? (3)

A
  • GI distress
  • Orthostatic hypotension
  • Increased dyskinesia
26
Q

What do anticholinergic agents do?

A

Decreases acetylcholine influence; may help decrease rigidity and tremor

27
Q

True False:

Anticholinergic agents are used with limits because of their side effects

A

True; they have a “package” of side effects

28
Q

What are the “package” of side effects?

A
  • dry mouth
  • constipation
  • urinary retention
  • Fast/increased HR
29
Q

What do MAO-B inhibitors do?

A

Inhibit monamine oxidase type B; Prolongs dopamine effects in the brain

30
Q

True False:

MAO-B inhibitors are combined with L-dopa to increase and prolong effects of dopamine in the brain

A

True

31
Q

What are the major problems of MAO-B inhibitors?

A

NO major concerns

32
Q

What is Amantadine (symmetrel)?

A

It is an antiviral agent that has antiparkinson effects

33
Q

What was Amantadine (symmetrel) originally developed for?

A

To treat the flu

34
Q

What does Amantadine (symmetrel) do?

A

It blocks NMDA receptors in the brain, decreasing the influence of excititory amino acids (glutamate)
- it decreases the chance of dyskinesias in PD patients

35
Q

What are the main problems with Amantadine (symmetrel)? (3)

A
  • orthostatic hypotension
  • psychotropic effects
  • skin discoloration
36
Q

Is Amantadine (symmetrel) a common drug?

A

Not really but it is gaining ground

37
Q

What is the optimal treatment time after taking antiparkinson drugs?

A

30-60 minutes after ingesting the meds

38
Q

True False:

It is very important to coordinate rehab sessions with the drugs

A

Dats da truth

Clin Med 2 (5 decks)

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