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21 Cards in this Set
- Front
- Back
according the jeons notes, what is a big cause of of parkinsons disease? what does this compound lead to? |
MPTP, which is a neurotoxin precursor ROS and cell death |
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what factors show a positive correlation with PD? what shows an inverse correlation? |
pesticide exposure, heavy metal exposure, rural living, well water cigarette smoking, caffeine consumption |
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what can help you diagnose PD? what are the four signs of PD? what is unqiue about the resting tremor? |
positive response to dopamine agonist therpay, unified parkinsons disease rating scale, PaT scan resting tremor, bradykinseia, rigidity, gait/postural instability it will dissapear when using muscle |
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what are the non motor symptoms of PD? is the goal of PD to cure it? |
neuropsychiatric, sleep disorder, fatigue, sensory symptoms, autonomic dysfunction, Gi symtoms no cure, just want to alleviate symptoms |
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what cancer are PD patients more prone to getting? specific percaution of the anticholergics? what symptom are the anticholergics mainly used for? |
melanoma hyperthermia and anhidrosis (decreased sweating) tremor |
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is carbodopa ever used alone? should you take IR carbodopa with or without food? what about ER? can food affect it? |
no, always combined with levodopa with either or high calorie or high fat food can decrease absoption |
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what is carbodopa contraindicated in? what symtoms does it treat well? |
MAOIs bradykinesia, rigidity...not tremor |
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when should you never use the dopamine agonists? what is unique about the adminstration of apomorphine? when is it indicated? |
in patients with a major psychotic disorder, may excarerbate psychosis sc injection undersupervision and use with an antiemtic, but not a 5ht3 antagonist because of qt prolongation for acute intermittent treatment of OFF episodes |
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what dopamine agonist has the most side effects? what shold you do if you fail a dopamine agonsit? when should you use a dopamine agonist? |
bromocriptine try another in this same class initial therapy to delay use of dopa drugs, or can be added to dopa for dyskinseia |
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what are the comt inhibitors contraindicated in? what comt inhibitor has a bbw for heptatox? when should you use the comt inhibitors? when should these be discontinued ? |
maois tolcapone adjunct with dopa to treat end of dose wearing off if tried for 3 months an no improvement |
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what are the maois contraindicated in? what is unique about the indications for selegine patch? when is best to use maois? |
cyclobenazpirne, detromorphan, st jons wort only used for PD not MDD patients that want to delay dopa therapy or reduce off periods when added as adjunctive therapy |
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what condition can amandtadine worsen? when is it best to use this drug? can you develop toerance to this drug? |
hf, it causes edema to treat levodopa induced dykinsesias yes, try to do a drug holiday |
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what 3 factors should be considered when initiating treatment of PD? why is l dopa therapy delayed if possible? |
severity of disease, clinical presentation, age of patient can cause dyskinesias |
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what two drugs may cause insomina? what does too much dopamine cause? |
selegiline and amantadine dyskinesia |
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how should you treat early wearing off? |
switch from CR to IR decreae dose and increase frequency of l dopa add adjuctive therapy (comt inhbitor) |
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how do you treat delayed on time? |
crush l dopa, use oral disintegrating tablet, or compond liquid if on IR switch to CR take l dopa on empty stomach and decrease protien consider intermittent apomorphine |
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how do you treat unpredictable off time |
add oral disintegrating l dopa or liquid add comt inhibitor try a different dopamine agonists as ajuvant consider continuous infusion of l dopa |
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how do you treat freezing? |
on freezing- reduce l dopa dose or use botulinum toxin off freezing- increase l dopa dose or add dompamine agonist |
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what is chorea? how can you treat this? |
jery involunatry movements of hips face adjust l dopa dose add amantadine decrease l dopa dose when adding ajuntive therapy |
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what is early morning dystonia? how do you treat it |
involtary muscle spasms that cause twisting add sinemet CR or dopamine agonist at bedtime add morning IR dopa with or without CR dose |
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what is diphasic dyskinesia? how do you treat it? |
involatry movements occur at both peak and trough of l dopa avoid l dop CR, use liquid add dopamine agonist, amatandine or comt increase dopa dose and fequency |