32 Questions
Which symptom may occur when a dopamine agonist is introduced and can be minimized by taking the medication with meals?
Anorexia
What is an indication for discontinuing treatment with dopamine agonists?
Cardiac arrhythmias
Which symptom of Parkinson's disease or dopaminergic treatment is more common and severe with dopamine receptor agonists than with levodopa?
Psychiatric reactions
What may lead to compulsive gambling, shopping, betting, and sexual activity in patients on dopamine agonists?
Activation of D2 or D3 dopamine receptors
Which side effect is NOT associated with Amantadine use?
Cardiac arrhythmias
Which adverse effect is typical of Acetylcholine-Blocking drugs?
Drowsiness
Which medication provides temporary relief of off-periods of akinesia in Parkinson's patients?
Apomorphine
Which adverse effect of Levodopa can be minimized by taking the drug in divided doses, with or immediately after meals, and by increasing the total daily dose very slowly?
Nausea and vomiting
What is a common side effect of Amantadine that responds to diuretics?
Peripheral edema
What percentage of patients may experience postural hypotension, especially in the early stage of treatment with Levodopa?
About 80%
Patients receiving Levodopa may experience a wide variety of side effects. Which cardiac arrhythmia has been described in some patients?
Atrial fibrillation
What type of dyskinesias occur in up to 80% of patients taking Levodopa?
Chorea and ballismus
What is dopamine dysregulation syndrome characterized by?
Compulsive overuse of dopaminergic medication
Why should Levodopa not be given to patients taking monoamine oxidase A inhibitors or within 2 weeks of their discontinuance?
Can result in hypertensive crises
What is Punding as described in the text?
Sorting and lining up objects
How do pharmacologic doses of pyridoxine (vitamin B6) affect the metabolism of levodopa?
Prevent therapeutic effect
What is the mechanism through which reserpine causes parkinsonian symptoms?
By depleting brain dopamine
Which drug causes irreversible parkinsonism through destruction of dopaminergic neurons in the nigrostriatal tract?
MPTP
How do type B monoamine oxidase inhibitors (MAOIs) protect against MPTP neurotoxicity in animals?
By decreasing dopamine activity in the brain
Why does dopamine not have a therapeutic effect in parkinsonism when given into the peripheral circulation?
It fails to cross the blood-brain barrier
Which characteristic differentiates Ropinirole from Pramipexole and Rotigotine?
Metabolized by CYP1A2
In what way does Rotigotine differ in administration compared to Pramipexole and Ropinirole?
Delivered through a skin patch
Which statement is true regarding the neuroprotective effect of Pramipexole?
It enhances neurotrophic activity in mesencephalic dopaminergic cell cultures
Which drug interaction concern is specific to Ropinirole and not associated with Pramipexole or Rotigotine?
Reduced clearance with warfarin and caffeine
What is the primary difference between monoamine oxidase A and monoamine oxidase B?
Monoamine oxidase A metabolizes norepinephrine, serotonin, and dopamine; monoamine oxidase B metabolizes dopamine selectively.
Why should patients avoid taking safinamide or other monoamine oxidase B inhibitors along with tramadol?
To prevent a risk of serotonin syndrome due to excess serotonin levels.
How does selegiline enhance the antiparkinsonism effect of levodopa?
By inhibiting the breakdown of levodopa in the liver.
What distinguishes rasagiline from selegiline in terms of their neuroprotective effects?
Rasagiline has stronger neuroprotective effects than selegiline.
What adverse event should be carefully monitored when rasagiline, selegiline, or safinamide are used in combination with tricyclic antidepressants or serotonin reuptake inhibitors?
Serotonin syndrome
Which statement accurately describes the differences between tolcapone and entacapone?
Tolcapone has only peripheral effects while entacapone has both central and peripheral effects.
Which adverse effect of CATECHOL-O-METHYLTRANSFERASE (COMT) inhibitors is specifically related to increased levodopa exposure?
Confusion
Why should tolcapone not be used in patients with abnormal liver function test results?
It has been associated with death from acute hepatic failure.
Test your knowledge on the adverse effects associated with dopamine agonists, such as anorexia, nausea, vomiting, constipation, dyspepsia, reflux esophagitis, peptic ulceration, postural hypotension, cardiac arrhythmias, and peripheral edema. Learn how to minimize these effects and manage them effectively.
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