Fran's Pharmacology Exam #1 Chapter 21

Front 1

_______ disease is the second most common degenerative nerve disease

Back 1

Parkinson's

Front 2

The most commonly prescribed drug for Parkinson's is

Back 2

Levodopa

Front 3

The most effective therapy for Parkinson's is a combination of Levodopa and ________

Back 3

Carbidopa

Front 4

Parkinson's damages the ________ system: a complex neuronal network that regulates movement.

Back 4

Extrapyramidal

Front 5

The complete absence of movement is called ______

Back 5

Akinesia

Front 6

PD causes degeneration of neurons in the substantia nigra, resulting in an imbalance of ______ and ______

Back 6

Dopamine, Acetylcholine

Front 7

Inadequate Dopamine causes ACh to be unopposed, causing excessive stimulation of neurons that release ______

Back 7

gamma-aminobutyric acid (GABA)

Front 8

Overactivity of ______ causes the motor symptoms that characterize PD.

Back 8

GABA

Front 9

Non-motor symptoms of PD include

Back 9

autonomic dysfunction, depression, psychosis, and dementia

Front 10

The goal of the drugs used to treat PD is to restore balance between _____ and _____

Back 10

Dopamine, ACh

Front 11

Motor symptoms are treated by drugs that activate _____ receptors, or block ______ receptors.

Back 11

Dopamine, Cholinergic

Front 12

Drugs that activate Dopamine receptors are called

Back 12

Dopaminergic Agents

Front 13

Drugs that block ACh receptors are called

Back 13

Anticholinergic Agents

Front 14

Which group of drugs (Dopaminergic Agents or Anticholinergic Agents) are more widely employed to treat PD?

Back 14

Dopaminergic Agents

Front 15

Which popular PD drug promotes dopamine synthesis?

Back 15

Levodopa

Front 16

Which drugs prevent dopamine breakdown?

Back 16

Inhibitors of monoamine-oxidase B (MAO-B)

Front 17

These drugs activate dopamine receptors directly

Back 17

Dopamine agonists (DA)

Front 18

An oral non-ergot dopamine agonist, ______ is a first-line drug for motor symptoms of PD.

Back 18

Pramipexole

Front 19

Adverse effects of Pramipexole include

Back 19

nausea, dyskinesia, postural hypotension, and hallucinations—result from excessive activation of dopamine receptors.

Front 20

_______ is a COMT inhibitor that is combined with levodopa to enhance levodopa effects. The drug inhibits metabolism of levodopa by COMT in the intestine and peripheral tissues, thereby making more levodopa available to the brain.

Back 20

Entacapone

Front 21

_______ and ______enhance responses to levodopa by inhibiting MAO-B, the brain enzyme that inactivates dopamine

Back 21

Selegiline and rasagiline

Front 22

__________relieve symptoms of PD by blocking cholinergic receptors in the striatum.

Back 22

Anticholinergics

Front 23

__________promotes dopamine release (and may also block dopamine reuptake).

Back 23

Amantadine

Front 24

The inhibitors of ________ enhance the effects of levodopa by blocking its degradation.

Back 24

catecholamine-O-methyltransferase (COMT)

Front 25

All of the ______ ______share the same mechanism: blockade of muscarinic receptors in the striatum.

Back 25

Anticholinergic Agents

Front 26

Initial treatment of patients with mild symptoms should begin with ______ or ______

Back 26

Selegiline, Rasagiline

Front 27

For patients with more severe symptoms, treatment should begin with either ______ or a ______ ______

Back 27

Levodopa, Dopamine Antagonist

Front 28

Long term treatment with Levodopa can cause ______ ______ ______, which are basically involuntary movements.

Back 28

Drug-induced dyskinesias

Front 29

A loss of symptom relief after long term Levodopa treatment is known as an ______ ______

Back 29

"off" time

Front 30

A brief interruption in treatment (eg, 10 days) is called a ______ ______

Back 30

Drug Holiday

Front 31

In PD patients, neurotransmission is disrupted primarily in the ______, an important component of the extrapyramidal system.

Back 31

Striatum

Front 32

Neurons that supply dopamine to the striatum originate in the ______ ______

Back 32

Substantia nigra

Front 33

Near the end of the Levodopa dosing interval _____ _____ indicates that drug levels have declined to subtherapeutic levels

Back 33

"wearing off" (or gradual loss)

Front 34

Abrupt loss of effect (on-off phenomenon) may be triggered by a meal high in _______

Back 34

Protein

Front 35

_________ enhances the effects of levodopa by preventing decarboxylation of levodopa in the intestine and peripheral tissues

Back 35

Carbidopa

Front 36

An alkaloid found in plants and used in some dopamine agonist drugs is called ______

Back 36

Ergot

Front 37

Dopamine Agonists are divided into two groups. What are they?

Back 37

Ergot derivatives and Non-Ergot derivatives

Front 38

T or F: Ergot derivatives are preferred over non-ergot derivatives in treating Parkinson's.

Back 38

False: Non-ergot derivatives are highly selective for dopamine receptors and thus have fewer side effects than ergot derivatives that activate other receptors

Front 39

What two ergot derivatives activate serotonergic and alpha-adrenergic receptors causing nightmares, agitation, and delusions?

Back 39

bromocriptine and cabergoline

Front 40

pramipexole, ropinirole, and apomorphine are examples of

Back 40

non-ergot derivatives

Front 41

"Sleep attacks" are a major adverse effect of what drug?

Back 41

Pramipexole

Front 42

Drugs that inhibit the metabolism of Levodopa are known as ____ _____

Back 42

COMP Inhibitors

Front 43

T or F: Of the two COMP Inhibitors, Entacapone is preferred over Tolcapone.

Back 43

True: Entacapone is safer and more effective than Tolcapone.

Front 44

Selegiline and rasagiline enhance responses to levodopa by inhibiting ________, the brain enzyme that inactivates dopamine.

Back 44

MAO-B

Front 45

_________drugs alleviate symptoms by blocking muscarinic receptors in the striatum, thereby improving the functional imbalance between dopamine and ACh.

Back 45

Anticholinergic

Front 46

T or F: Anticholinergic are used as second-line therapy for tremors and have been used since 1867 making them the oldest medicines to treat Parkinson's

Back 46

True