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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

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

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

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

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

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

what is carbodopa contraindicated in?




what symtoms does it treat well?

MAOIs




bradykinesia, rigidity...not tremor

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

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

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

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

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

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

what two drugs may cause insomina?




what does too much dopamine cause?



selegiline and amantadine




dyskinesia

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)

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

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

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

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

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



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