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50 Cards in this Set

  • Front
  • Back
rhythmic/oscillatory movement around a joint
resting tremor
1) parkinson's dz
2) rigidity
3) impairment of volitional move.
essential tremor
postural tremor
intentional tremor
1) brain stem/cerebellar lesion
2) alcohol/drug toxicities
involuntary muscle jerks, unpredictable
1) hereditary
2) volitional activity impairement
slow, writhing abnoramal move.
postural abnormality - asso. with sustained, abnormal move.
sudden, abnormal "coordinated" move.
choronic, multiple tics?
Gilles de la Tourrette's syndrome
symptoms of Parkinson's dz
1) tremor
2) bradykinesia
3) rigidity
4) characteristic gait/ postural abnormality
characteristics of parkinson's
1) choronic
2) progressive
3) begins in middle/late life
4) affects all ethnic group
5) equal gender distribution
frequency population over 65 yrs
1 per 100 persons
neuronal loss in parkinson's
loss of "substantia nigra pars compacta cells" cause reduced "nigral-striatal dopamine input" to the putamen
D-1 mediated direct pathway
loss of an striatal excitatory dopamine input
D-2 mediated, indirect pathway
loss of an striatal inhibitory dopamine input
cause of parkinson's?
possible causes of parkinson's?
1) environmental toxin
2) endogenous toxins
clinical manifestations of parkinson's
1) tremor
2) rigidity
3) bradykinesia - akinesia (severe)
4) flat affect
5) blepharoclonus
6) blepharospasm
7) drooling
8) voice: hypophonic, poorly modulted
9) small, tremulous handwriting
10) festinating gait
11) tapping over the glabella
12) depression
13) impaired cognitive function (dementia in advanced cases)
1) does not cross BBB
2) ineffective if administered peripherally
1) crosses the BBB
2) metabolic precursor dopamine
3) enters neuronal cells and is decarboxylated to dopamine
D1 receptor
1) anedyl cyclase stimulation
2) increase cAMP levels
3) located in substantia nigra zona compacta
D2 receptor
1) adenyl cyclase inhibition
2) decreases cAMP levels
3) postsynaptic localization on striatal neurons
Levodopa (Dopar)is given with?
carbidopa (Lodosyn) = dopa decarboxylase inhibitor
Levodopa is given with Carbidopa to decrease?
peripheral decarboxylation of levodopa
L-dopa is most effective in diminishing?
bradykinesia (improves all parkinson's dz symptoms)
SE of levodopa
1) GI prob.
dyskinesias include
1) chorea
2) ballismus
3) athetosis
4) dystonia
5) myoclonus
6) tics
7) tremor
other medications for parkinson's
1) Selegiline (Deprenyl)
2) Amantadine (Symmetrel)
3) Anticholinergics
Selegiline (Deprenyl)
1) selective monoamine oxidase B inhibitor
2) prolongs L-dopa effect
Amantadine (Symmetrel)
1) antiviral drug
2) may influence dopamine release, reuptake, synthesis
1) improve rigidity, tremor
2) not used as much now
1) Bentropine (Cogentin)
2) Biperiden (Akineton)
3) Orphenadrine (Norflex)
4) Procyclidine (Kemadrin)
5) Trihexyphenidyl (Artane)
physiologic postural tremor (normal) is increased by?
1) thyrotoxicosis
2) isoproterenolol (Isuprel)
3) Epinephrine
4) anxiety
5) fatigue
drug-induced normal physiologic tremor?
1) bronchodilators
2) tricyclic antidepressants
3) lithium
4) possible beta2 receptor mediation
essential tremor
1) postural tremor
2) possible beta 1 receptor mediation
medications for essential tremor
1) beta blockers
2) Primidone (Mysoline) = anticonvulsants
3) Alprazolam (Xanax)
intentional tremor
1) caused by toxic rx to alcohol and other drugs (phenytoin)
Huntington's disease
1) dominant
2) inherited
3) progressive chorea in dementia
4) adult onset
dopamine/Ach/GABA basal ganglia imbalance (too much dopamine?)
anti-dopaminergic agents to reduce chorea
1) Reserpine
2) Phenothiazines
3) Butyrophenones (Haloperidol)
cause of chorea
1) thyrotoxicosis
2) hypoCa
3) lupus erythematosus
4) hepatic cirrhosis
5) polycythemia vera rubra
drug-induced chorea
1) L-dopa
2) antimuscarinics
3) lithium
4) phenytoin
5) oral contraceptives
6) amphetamine
tx for ballismus
dopamine-blocking agents
1) Perphenazine
2) Haloperidol
tx for athetosis and dystonia
1) not usually satisfactory
2) Diazepam
3) high-dose antimuscarinic agents
4) L-dopa
5) Baclofen
6) Phenothiazines
7) Amantadine
tx for tics, Tourette's syndrome
phenothiazines cause
acute dyskinesia/dystonia
Tardive dyskinesia
1) consequence of long-term antipsychotic drug tx
newer antipsychotic agents that do not appear to cause tardive dyskinesia
1) Olanzapine
2) Risperidone
Wilson's disease
1) recessive, inherited copper metabolism error
2) reduced serum copper/ceruloplasmin
3) > copper concentration in brain and viscera
tx for Wilson's disease
1) Penicillamine (Dimethylcysteine) = copper chelating agent
2) Trientine (Syprine) = chelating
3) Zinc accetate = > copper excretion
4) zinc sulfate = < copper absorption