Chapter 4 BNF (Movement Disorders) Flashcards
What is parkinsons disease?
progressive dopamine deficiency in the nigrostriatal pathway
what are the motor symptoms in parkinsons disease?
hypokinesia
bradykinesia
rigidity
tremor
what are the non motor symptoms in parkinsons disease?
dementia
depression
sleep disturbance
who must the patient notify after diagnoses of parkinson’s disease?
DVLA
Why must parkinsons disease medication never be stopped abruptly?
Akinesia
NMS
Whats first line in parkinson’s disease with symptoms that affect quality of life?
LEVODOPA
What is first line in parkinson’s disease with symptoms that do not affect quality of life?
LEVODOPA
MAO-B inhibitors
Non-ergot derived dopamine agonists
What can be offered for Dyskinisea and motor fluctuations in parkinsons disease?
MAO-B
Non ergot DA
COMT inhibitors
What can be given for Advanced Parkinsons disease?
Apomorphine IV or SC
What are the side effects of Apomorphine?
N and V
How is Apomorphine induced nausea and vomiting treated? What must you be careful of?
Domperidone
both drugs cause QT prolongation
What are the 4 hallmarks of levodopa side effects?
end of dose deterioration
impulse disorder
excessive sleeping
motor complications
what are the 4 hallmarks of non ergot da side effects?
hypotension
worse impulse control
psychotic symptoms
fibrolytic reactions (worse with ergot)
What is the notable risk with MAO-B inhibitors?
Hypertensive crises
What are the side effects with COMT inhibitors?
hepatotoxicity (tolcapone) colour urine (entacapone)
