Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

62 Cards in this Set

  • Front
  • Back
What is myoclonus?

What is it usually due to?
Brief muscle contraction

Usually secondary to meds of metabolic change (esp. renal failure)
Treatment for myoclonus
Treat underlying cause

5-hydroxytryptophan w/ carbidopa
(useful when due to hypoxic brain injury)
What types of drugs may exacerbate myoclonus?
Seizure drugs
What is the treament for tics?
What drugs can often cause tremors (3)?
Treatment for non-PD tremors (5)
Can be relieved by small amounts of EtOH
Non-selective beta-blocker

If severe, Deep Brain Stimulation
What is dystonia?
Painful, abnormal muscle contractions
Entails simultaneous agonist/antagonist muscle groups contracting
Eyelids closing
(within category of dystonia)
Meige Syndrome
Facial, jaw spasm

(within category of dystonia)
Spasmodic torticollis
Neck/shoulder dystonia
Treatment options for focal dystonia (3)
Botulinum toxin
Mechanism of Baclofen
GABA-B agonist
Treatment options for torsion dystonia (2)
High dose anti-cholinergics
Stereotactic surgery
Side effect of Baclofen
Chorea vs. athetosis
Chorea -- faster, dance-like

Athetosis -- slower, more serpentine
Treatment of chorea/athetosis due to Wilson's disease
Penicillamine - copper chelator
Treatment options for chorea/athetosis (3)
Mechanism of tetrabenazine
Antagonist @ VMAT2 site
Decreases DA levels in vesicles
What is the risk entailed in using reserpine?
HIGH depression/suicide risk
How can the dose-limiting SE of baclofen be reduced?
Continuous, intrathecal baclofen administration
Treatment options for spasticity (4)
Botox (BUT, will need larger doses)
What is the mechanism of Tizanadine in spasticity?
Alpha-1 antagonism
What is the difference in receptor specificity between BDZs and baclofen?
Baclofen - GABA-B

After when do you start seeing PD motor symptoms?
After 50 - 70% of nigrostriatal DA neurons are lost
Where are most D1/D2 receptors located?
Basal ganglia
What is the structural difference between D1 and D2 receptors (2)?
3rd cytoplasmic loop
Length of cytoplasmic carboxy terminus
What is the function of D1?
Increaeses many ion currents
(does so via stimulating adenylate cyclase)
What G-protein does D1 couple with?
What G-protein does D2 couple with?
What is the function of D2?
Increases K influx (hyperpolarization)
(does so via inhibiting adenylate cyclase)
What receptor is responsible for the psychiatric effects of DA agonists?

Where is it primarily located?

Activation of what DA receptors is needed for maximum motor improvement?
Simultaneous activation of D1 & D2
Why is 3-O-methyl-DOPA important?
It competes w/ L-DOPA for uptake
What can abrupt withdrawal of L-DOPA induce?
Severe akinetic-rigid syndrome similar to NMS
Mechanism of Pergolide
Weak D1 agonist
10x stronger D2 agonist

NOTE: this is an ergot derivative like bromocriptine
Mechanism of Bromocriptine
Mixed D1 agonist/antagonist
D2 agonist
Mechanism of Pramipexole and Ropinirole
Highly selective D2 agonists
What subtype of D2 does pramipexole prefer?
Why are pramiprexole and ropinirole rarely used in early PD?
Because they don't activate BOTH D1 & D2
(they only activate D2)
What additional beneficial effects does pramipexole have (2)?
Neuroprotection - slows loss of DA terminals
What type of drugs are tolcapone and entacapone?
COMT inhibitors
What beneficial effects do COMT inhibitors cause?
Reduce required L-DOPA dosage
Prolong "on" time by 1 - 2 hrs.

NOTE: these are effective only in a minority
What is the very serious potential side effect of tolcapone?
Fatal hepatic necrosis

LFTs have to be obtained every two weeks
When does any neuroprotective effect of selegline wear off?
In about 2 years
Mechanism of amantadine in PD
Increased DA release from DA terminals
What is needed in order for amantadine to be effective in PD?
(hint: this is why it is used in early PD)
NEED existing DA neurons
What is a side effect of amantadine in PD?
Confusion in the elderly
What symptoms of PD can amantadine treat?
What type of drugs are benztropine and trihexyphenidyl?
What do benztropine and trihexyphenidyl do in PD?
Block tremor
Can also be helpful for freezing
What are the side effects of anti-cholinergics?
Peripheral - dry mouth, constipation, etc.

Central - memory loss, confusion
What can clozapine and quietapine do in PD?
Both -- suppress L-DOPA induced dyskinesia

Quietapine -- reduce psychosis assoc. w/ DA agonists
What is apomorphine?
"Oldest" D2 agonist
D2 > D1 activity, BUT ACTS ON BOTH
What could apomorphine be used for in PD?
For acute bradykinesia
Effects of DBS (2)
Treats dyskinesias
Smoothes out treatment fluctuations
What are the benefits of starting PD therapy w/ DA agonist instead of L-Dopa?
Fewer dyskinesias
What is the time frame of efficacy for PD treatment as a whole?
5 - 10 years

ALL of the drugs, so far, eventually fail
What drugs treat ocular gaze palsies?
Treatment options for Shy-Drager syndrome (3)
Increase salt intake
Alpha-agonist for BP
What is corticonigral degeneration manifested as?
Limb apraxia
UMN symptoms
What is striatonigral degeneration manifested as?
Progressive bradykinesia W/O rigidity or tremor
What is olivopontocerebellar atrophy manifested as?
Bulbar CNS deficits