Term
| What dopamine receptors are located in the globus pallidus |
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Definition
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Term
| How does MPTP cause damage to the brain |
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Definition
Monoamine Oxidase degrades MPTP to MPP+
MPP+ blocks Complex I in Mitochondria Free radical formation that overwhelms glutathione reduction systems
The oxidative damage localizes in the dopanergic system bc MPTP is transported into cells by the dopamine transporter |
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Term
| What are the clinical signs of Parkinson's |
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Definition
Tremor
Rigidity
Bradykinesia
Problems Intiating Walking
Absence of Facial Expression
Cognitive(Dementia)
Depression |
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Term
| What are the side effects of Sinemet or Atamet? Which is very common? |
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Definition
Dykinesia(Most Common-80%): Grimacing, Restless feet<-> Chorea
Psychiatric: Hallucinations |
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Term
| What are the contraindications to sinemet use? |
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Definition
Psychosis
Open Angle Glaucoma
Cardiac disease
Peptic Ulcer Disease
Melanoma
Nonspecific MAO-I's |
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Term
| What is a treatment option for patients where sinemet wears off before the next dose |
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Definition
| combine short and long acting preps |
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Term
What are the adverse effects of Bromocryptine?
What are the advantages? |
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Definition
Adverse
MI, Erythromelalgia, Digital vasospasm
Dyskinesia less than sinemet
Hallucinations more common than sinemet
Fibrosis of organ lining
Advantage
Less dyskinesia, less fluctuations |
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Term
| What is the cause of the response fluctuations in long-term parkinson's |
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Definition
| Higher dopamine release and shorter half life and therapeudic Window narrows as disease progresses |
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Term
| What is the only MAO-I safely used with L-dopa |
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Definition
| Selegiline bc it is MAO-B selective, however high doses can show MAO-A blockage |
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Term
| Use of Selegiline is contraindicated with what other drugs? |
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Definition
Trycyclic Anti-depressants
SSRI's
Meperidine(Narcotic Analgesic) |
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Term
What is the mechanism of Amantadine use in parkinson's?
When is it used?
Adverse Effects?
What are the contraindications? |
|
Definition
Dopamine release in striatum
Block Muscarinic and Glutamate Receptors
Use: Dopa dyskinesia
Adverse:
Livido reticularis
Peripheral edema
Hallucinations
Contraindications: CHF and Seizures |
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Term
| Side effects of anticholinergics used in parkinson's |
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Definition
Anticholinergic effects
Dyskinesias
Hallucinations |
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Term
| What are the COMT-I's used in parkinson's and when are they used in parkinson's |
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Definition
Tolcapone
Entacapone
Used in Wearing-off Phenomenon to allow doses of L-dopa to remain in the brain for longer duration
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|
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Term
| What needs to be monitored with tolcapone use |
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Definition
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Term
| What are the first and last symptoms alleviated by parkinson's treatment |
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Definition
First: Mood and Vigor
Last: Tremor |
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Term
| If administered together, how does Carbidopa affect the concentration of L-Dopa in the brain? |
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Definition
| Peripheral inhibition increases L-dopa levels in the brain |
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Term
| Concern with the use of Sinemet and MAO-I A inhibitors in combo? |
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Definition
| Hypertensive crisis bc of increased norepinephrine production |
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