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Flashcards in Parkinson Disease Deck (45)
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1
Q

Main neurotransmitter involved in PD

A

dopamine (lack of)

2
Q

When do motor symptoms of PD usually occur

A

~80% of dopamine-producing cells are damaged

3
Q

What symptoms can present first? Motor or non-motor?

A

Non-motor

4
Q

Motor symptoms

A

bradykinesia (slow movement)
Shaking and tremor
rigidity
balance trouble

5
Q

Non-motor symptoms

A
loss of smell
constipation
sleep difficulties
low mood
orthostatis
6
Q

Brain region involved in PD

A

substania nigra (brain stem)

7
Q

Psychiatric condition common in PD

A

depression

8
Q

Preferred treatments for depression in PD

A

TCA’s (secondary amines) –> desipramine, nortriptyline

SSRI (could contribute to tremor)

9
Q

Drugs that can be used for psychosis in PD

A

Quetiapine (low risk of movement disorder among APs)

Pimavanserin (Nuplazid) - 5HT2a/2c inverse agonist

10
Q

Levodopa MOA

A

precursor of dopamine; replaces dopamine

11
Q

Carbidopa MOA

A

inhibits dopa decarboxylase and prevent levodopa from being metabolized

12
Q

Sinemet CR tablets cannot be cut (t/f)

A

False, can be cut

cannot be crushed or chewed

13
Q

Amount of carbidopa required to inhibit dopa decarboxylase

A

70-100 mg/day

14
Q

Rytary

A

carbidopa/levodopa ER cap

15
Q

Main side effects of sinimet

A
nausea
dizziness
orthostasis
dyskinesias
brown./dark urine
16
Q

Comtan

A

entacapone

17
Q

Comtan MOA

A

COMT inhibitor, prevents peripheral and central conversion of levodopa

18
Q

Stalevo

A

Entacapone + carbidopa levodopa

19
Q

Stalevo tablet strength

A

12.5 mg carbidopa
50 mg levodopa
200 mg entacapone

20
Q

Neupro

A

Rotigotine patch

21
Q

Main side effects of dopamine agonist

A

Somnolence (daytime)
Nausea
dizziness
Hallucinations

22
Q

Apokyn

A

Apomorphine

23
Q

Apokyn uses

A

Dopamine agonist
For severe disease as a rescue for “off” periods

IV given prn

24
Q

Sinemet should not be used with this class of drugs

A

Non selective MAO inhibitors

25
Q

Amantadine MOA

A

Blocks presynaptic dopamine reuptake, which increases dopamine release

26
Q

Selegiline
Rasagiline
Safinamide moa

A

Selective MAO-B inhibitor, inhibits the breakdown of dopamine

27
Q

Xadago

A

Safinamide

28
Q

Comtan MOA

A

COMT inhibitor, prevents peripheral and central conversion of levodopa

29
Q

Stalevo

A

Entacapone + carbidopa levodopa

30
Q

Stalevo tablet strength

A

12.5 mg carbidopa
50 mg levodopa
200 mg entacapone

31
Q

Neupro

A

Rotigotine patch

32
Q

Main side effects of dopamine agonist

A

Somnolence (daytime)
Nausea
dizziness
Hallucinations

33
Q

Apokyn

A

Apomorphine

34
Q

Apokyn uses

A

Dopamine agonist
For severe disease as a rescue for “off” periods

IV given prn

35
Q

Sinemet should not be used with this class of drugs

A

Non selective MAO inhibitors

36
Q

Amantadine MOA

A

Blocks presynaptic dopamine reuptake, which increases dopamine release

37
Q

Selegiline
Rasagiline
Safinamide moa

A

Selective MAO-B inhibitor, inhibits the breakdown of dopamine

38
Q

Xadago

A

Safinamide

39
Q

Eldepyrl

A

selegiline cap

40
Q

Zelapar

A

selegiline ODT

41
Q

Anticholinergics used in PD

A

Benztropine (Cogentin)

Trihexyphenidyl

42
Q

When to use anticholingerics in PD?

A

PD with tremor as only/primary symptoms

use in younger pts (On BEERS list)

43
Q

PD Drugs that require renal dosing

A

pramipexole

amantadine

44
Q

Northera

A

Droxidopa

used to treat orthostatic hypotension

45
Q

Apokyn containdications

A

do not use with 5ht3 antagonist (Zofran, etc) –> severe hypotension

Apokyn causes severe n/v
use trimethobenzamide to pre-treat for n/v

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