Drugs To Treat Movement Disorders

Front 1

What are the three drugs used to treat restless leg syndrome?

Back 1

Pramipexole

Ropinirole

Rotogotine

Front 2

What are three drugs used to treat drug induced dyskinesias?

Back 2

Reserpine

Tetrabenazine

Trihexyphenidyl

Front 3

What are two drugs used to treat Hunginton's?

Back 3

Reserpine

Tetrabenazine

Front 4

This drug is a precursor to dopamine that crosses the blood brain barrier and is decarboxylated into dopamine.

Back 4

Levodopa

Front 5

What enzyme is responsible for changing levodopa into dopamine in the brain?

Back 5

Dopa decarboxylase

Front 6

What enzyme converts peripheral dopamine into 3-O-methyldopa?

Back 6

Catechol-O-methyltransferase

Front 7

This drug prevents the conversion of L-dopa into dopamine in peripheral tissues (peripheral dopa decarboxylase inhibitor) so more levodopa can get into the brain.

Back 7

Carbidopa

Front 8

Sinemet is a combination of these two drugs:

Back 8

L-dopa, carbidopa

Front 9

Carbidopa increases/decreases peripheral toxicity of levodopa.

Back 9

Increases

Front 10

True or false: levodopa stops progression of Parkinson's Disease.

Back 10

False.

Front 11

Levodopa alleviates all of PD symptoms, especially________________.

Back 11

Bradykinesia

Front 12

Side effects of levodopa are dose dependent, so it is important to try adding _________ or additional ____________ before upping the dose of levodopa.

Back 12

Dopamine agonists

Enzyme inhibitors

Front 13

Dopamine stimulates the ______________ in the brainstem, leading to 80% of patients developing N/V and anorexia.

Back 13

Chemoreceptor trigger zone

Front 14

True or false: anti-emetics can be administered to PD patients experiencing N/V from levodopa.

Back 14

False. They exacerbate the parkinsonism

Front 15

GI distress can be alleviated by taking the drug with ___________ or dividing the ___________.

Back 15

Meals, dose

Front 16

Combining levodopa with _____________ reduces GI stress and allows for toleration of higher doses.

Back 16

Carbidopa

Front 17

80% of patients receiving L-dopa for long periods of time will experience ______________.

Back 17

Dyskinesias

Front 18

What is the most common dyskinesia associated with prolonged dosing with levodopa?

Back 18

Choreoathetosis

Front 19

Behavioral side effects such as depression, anxiety, agitation, delusions, hallucinations and somnolence are more/less common when levodopa is combined with carbidopa.

Back 19

More

Front 20

What three drugs can be used to counteract behavioral effects seen with levodopa?

Back 20

Quietapine, olanzapine, risperidone

Front 21

What drug is used to treat off-period related akinesia as a result of levodopa use?

Back 21

Apomorphine

Front 22

This drug enhances the peripheral breakdown of L-dopa in the absence of carbidopa.

Back 22

Pyridoxine

Front 23

Levodopa cannot be used within 2 weeks of administration of ______________ because it will lead to a hypertensive crisis.

Back 23

Monoamine Oxidase A inhibitor

Front 24

Psychotic patients, patients with closed-angle glaucoma/increased intraocular pressure, and a history of melanoma should not take this drug.

Back 24

Levodopa

Front 25

Selegiline is this type of drug.

Back 25

Monoamine oxidase B inhibitor

Front 26

Rasagiline is this type of drug.

Back 26

Monoamine oxidase B inhibitor

Front 27

This type of drug will inhibit the enzyme that metabolizes dopamine into DOPAC, thus increasing the available dopamine in the brain.

Back 27

Monoamine oxidase B inhibitor

Front 28

Rasagiline/selegiline is more potent at preventing MPTP induced Parkinsonism.

Back 28

Rasagiline

Front 29

Patients taking ___________ or _______________ or eating foods high in ___________ should not take MAO B inhibitors.

Back 29

Meperidine (narcotic painkiller)

Anti-depressants (SSRIs, tricyclics)

Tyramine

Front 30

This class of drug may reduce mild on-off or wearing off phenomena, but will potentiate the adverse effects of L-dopa.

Back 30

MAO B inhibitor

Front 31

Tolcapone is this type of drug.

Back 31

Catechol-O-Methyltransferase Inhibitor

Front 32

Entacapone is this type of drug.

Back 32

Catechol-O-Methyltransferase INhibitor

Front 33

This drug prevents 3-O-Methyldopa from competing with levodopa for transporters on the BBB.

Back 33

Catechol-O-Methyltransferase Inhibitors

Front 34

This drug is useful in patients taking L-dopa who are experiencing fluctuations (on-off time).

Back 34

Catechol-O-Methyltransferase inhibitor

Front 35

Which drug, entacapone or tolcapone, decreases metabolism of levodopa in both the periphery and CNS?

Back 35

Tolcapone

Front 36

What is the black box warning associated with tolcapone?

Back 36

Increased liver hepatotoxicity

Use only with signed consent

Front 37

Where does entacapone decrease levodopa metabolism?

Back 37

Periphery

Front 38

This class of drugs produce dyskinesias, nausea, confusion and orange urine. To prevent these side effects, the dose of the accompanying drug (levodopa) must be lowered 30% for the first 48 hours

Back 38

Catechol-O-methyltransferase inhibitor

Front 39

This drug is the combination of levodopa, carbidopa and entacapone.

Back 39

Stalevo

Front 40

This drug is an antiviral that increases the release of dopamine through an unknown MOA.

Back 40

Amantadine

Front 41

This drug reduces bradykinesia, rigidity and tremor, but its benefits are short lived (last only weeks).

Back 41

Amantadine

Front 42

Adverse effects of this drug include restlessness, depression, insomnia, hallucinations and livedo reticularis. The drug must be discontinued if these side effects occur.

Back 42

Amantadine

Front 43

Bromocriptine is this type of drug.

Back 43

Dopamine Receptor Agonist (ergot derived)

Front 44

Pergolide is this type of drug.

Back 44

Dopamine Receptor Agonist (ergot derived)

Front 45

Bromicriptine is used to treat ______________

Back 45

Hyperprolactinemia

Front 46

Pramipexole is this type of drug.

Back 46

D3 dopamine receptor agonist

Front 47

Ropinirole is this type of drug.

Back 47

D2 dopamine receptor agonist

Front 48

Rotigotine is this type of drug.

Back 48

D2/D3 dopamine receptor agonist

Front 49

This class of anti-PD drug does not require enzyme conversion and has no toxic metabolites. It also has fewer adverse drug reactions and a lower incidence of response fluctuations and/or dyskinesias.

Back 49

Dopamine receptor agonist

Front 50

Initial treatment with a dopamine receptor agonist is in addition to these two drugs. The dose of the agonist is increased/decreased over time.

Back 50

Levodopa, carbidopa, increased

Front 51

Late treatment for PD with a dopamine receptor agonist occurs when levodopa has produced _______________.

Back 51

End of dose akinesia

Front 52

Mental disturbances of dopamine receptor agonists are more/less severe than with L dopa (somnolence, sudden sleep attacks, confusion, hallucinations, delusions).

Back 52

More

Front 53

This drug induces anorexia/N/V (should be taken at meals), postural hypotension at initiation and dyskinesias that can be reversed b reducing the dose.

Back 53

Dopamine receptor agonist

Front 54

This is the result of the use of L-dopa and dopaminergic agonists together. It involves the compulsive use of dopaminergic drugs in male patients, cyclical mood disorders, tolerance and impulse control disorders (hypersexuality and gambling).

Back 54

Dopaminergic Dysregulation Syndrome

Front 55

This syndrome is similar to cocaine withdrawal; anxiety, panic attacks, depression, sweating, nausea, pain, fatigue, dizziness and drug craving.

Back 55

Dopamine Agonist Withdrawal Syndrome

Front 56

What is the only way to resolve dopamine agonist withdrawal syndrome?

Back 56

Resume agonists

Front 57

This drug is a potent dopamine agonist that provides temporary relief of off-periods of akinesia in patients on dopamine therapy. It induces nausea, so it must be pretreated with an anti-emetic.

Back 57

Apomorphine

Front 58

What is the anti-emetic used to pretreat nausea associated with the administration of apomorphine?

Back 58

Trimethobenzamide

Front 59

Benzotropine mesylate is this type of drug.

Back 59

ACh blocker

Front 60

Trihexyphenidyl is this type of drug.

Back 60

ACh blocker

Front 61

ACh blockers improve tremor and rigidity, but have little effect on ___________.

Back 61

Bradykinesia

Front 62

This type of surgery can relieve conspicuous tremor. (Thalamotomy, posteroventral pallidotomy)

Back 62

Ablative surgery

Front 63

When applied to the thalamus, this treatment can relieve tremor.

Back 63

Deep brain stimulation

Front 64

This opioid resembles heroin and causes parkinsonian features.

Back 64

MPTP

Front 65

This phenomena involves an unpleasant, creeping discomfort that occurs when relaxed (sitting or laying down), giving the patient the urge to move.

Back 65

Restless leg syndrome

Front 66

What is the treatment for restless leg syndrome?

Back 66

Dopamine agonists

Ropinirole, pramipexole, rotigotine

Front 67

Long-term exposure to dopamine receptor blockade can lead to ______________.

Back 67

Drug induced dyskinesias

Front 68

These drugs are associated with drug induced dyskinesias.

Back 68

1st generation antipsychotics (haliperidol, fluphenazine)

Metoclopramide (anti-emetic)

Front 69

Benztropine, diphenhydramine, trixhexyphenidyl and diazepam are used to prevent acute ________ attacks associated with _________________.

Back 69

Dystonic, Drug induced dyskinesias

Front 70

These drugs that interfere with dopamine signaling are used to treat tardive dyskinesia associated with drug associated dyskinesias.

Back 70

Reserpine, tetrabenazine, trixhexyphenidyl

Front 71

What are the last resort treatments for tardive dyskinesia?

Back 71

Phenothiazines

Butyrophenones

Front 72

Huntington's disease is an autosomal dominant/recessive disorder involving a gain of function/loss of function mutation of the __________ gene.

Back 72

Dominant, gain of function, huntingtin

Front 73

Huntington's Diseases is the result of an unstable _________ repeat on chromosome _.

Back 73

Glutamine, 4

Front 74

The gain of function toxicity associated with Huntington's disease causes _______ neurons to die in the basal ganglia. This may be caused by excessive ____________ toxicity.

Back 74

GABA, glutamate

Front 75

This disease involves excessive glutamate signaling, leading to an influx of Ca2+ into the postsynaptic neurons and ROS, mitochondrial dysfunction and cell death.

Back 75

Huntington's

Front 76

Huntington's disease involves progressive __________, twitching, lack of ____________ and involuntary ___________. It also shows cognitive decline.

Back 76

Chorea, coordination, movements

Front 77

Treatment of Huntington's Chorea involves impairing ___________ neurotransmission.

Back 77

Dopaminergic

Front 78

Tetrabenazine is this type of drug.

Back 78

MAO 2 transporter inhibitor

Front 79

What is a major adverse effect of tetrabenazine?

Back 79

Suicide and depression

Front 80

These antipsychotics can be used to treat chorea associated with Huntington's.

Back 80

Haloperidol, chlorpromazine, risperidone, olanzapine

Front 81

Quietapine, risperidone, olanzapine, haloperidol and buspirone can be used to treat _______________ with Huntington's.

Back 81

Psychiatric symptoms

Front 82

Depression associated with Huntington's can be treated with:

Back 82

Tricyclic antidepressants

SSRIs