Parkinsonism and Parkinson's Disease Overview

<p>Free radicals damaging membranes (D)</p> Signup and view all the answers

<p>It quenches free radicals. (C)</p> Signup and view all the answers

<p>Benserazide (C)</p> Signup and view all the answers

<p>Nigrostriatal degeneration (B)</p> Signup and view all the answers

<p>Environmental factors (D)</p> Signup and view all the answers

<p>1/3 of patients (B)</p> Signup and view all the answers

<p>Angina (B)</p> Signup and view all the answers

<p>1–2 hours (B)</p> Signup and view all the answers

<p>Dyskinesias (A)</p> Signup and view all the answers

<p>Metoclopramide (A)</p> Signup and view all the answers

<p>It acts as a cofactor for dopa-decarboxylase. (D)</p> Signup and view all the answers

<p>Facial tics (A)</p> Signup and view all the answers

<p>Blood pressure regulation (A)</p> Signup and view all the answers

<p>Marked symptomatic improvement in hypokinesia and rigidity (B)</p> Signup and view all the answers

<p>Postural hypotension (D)</p> Signup and view all the answers

<p>The effect is nearly complete in early stages but declines later (A)</p> Signup and view all the answers

<p>Normalization of mood and self-care (A)</p> Signup and view all the answers

<p>Gradual tolerance to its hypotensive and stimulant actions (C)</p> Signup and view all the answers

<p>Dopamine and Glutamate (C)</p> Signup and view all the answers

<p>Facilitating direct pathways with inhibitory effects (C)</p> Signup and view all the answers

<p>It acts as an excitatory transmitter, eliciting nausea (D)</p> Signup and view all the answers

<p>To enhance the efficacy of levodopa therapy (A)</p> Signup and view all the answers

<p>Acute fatal hepatitis (B)</p> Signup and view all the answers

<p>Selegiline (A)</p> Signup and view all the answers

<p>By adjusting the levodopa dose (C)</p> Signup and view all the answers

<p>Rasagiline has a longer duration of action (C)</p> Signup and view all the answers

<p>5 mg with breakfast and lunch (A)</p> Signup and view all the answers

<p>It has minimal side effects compared to other medications (A)</p> Signup and view all the answers

<p>Diarrhoea (C)</p> Signup and view all the answers

<p>6–26 months (A)</p> Signup and view all the answers

<p>Memory loss (C)</p> Signup and view all the answers

<p>It decreases the severity of nausea and vomiting. (A)</p> Signup and view all the answers

<p>They afford dramatic relief in many cases (D)</p> Signup and view all the answers

<p>Iron deficiency anaemia (B)</p> Signup and view all the answers

<p>Severe side effects ranging from mild anxiety to psychosis. (B)</p> Signup and view all the answers

<p>Insomnia and agitation (A)</p> Signup and view all the answers

<p>It prevents dopamine entry into synaptic vesicles. (A)</p> Signup and view all the answers

<p>Rapid switches between good and disabled states. (A)</p> Signup and view all the answers

<p>It might delay the progression of the disorder (A)</p> Signup and view all the answers

<p>They cause postural hypotension that may worsen. (D)</p> Signup and view all the answers

<p>Benzodiazepines, gabapentin or pregabalin (D)</p> Signup and view all the answers

<p>Symptoms appear during physical activity (A)</p> Signup and view all the answers

<p>They retard absorption, extending the availability for degradation. (D)</p> Signup and view all the answers

<p>Occasional 'wearing off' symptoms. (D)</p> Signup and view all the answers

<p>They can range from mild anxiety to severe mental health issues. (B)</p> Signup and view all the answers

Parkinson's disease (PD) is characterized by a deficiency of dopamine (DA) in the striatum, a brain region responsible for controlling muscle tone and coordinating movements.

An imbalance occurs in the striatum between the dopamine (DA) system, which is inhibitory, and the cholinergic system, which is excitatory. This imbalance contributes to the motor symptoms of PD.

While not the primary target, suppressing the cholinergic system using anticholinergics can help restore balance in the striatum and partially alleviate PD symptoms.

The exact cause of the degeneration of nigrostriatal neurons in PD, which produce dopamine, is not fully understood. However, it likely involves multiple factors and is thought to involve free radicals.

The process of dopamine oxidation by enzymes like MAO-B and aldehyde dehydrogenase generates hydroxyl free radicals which are highly reactive and can damage cells. This can contribute to the degeneration of dopamine-producing neurons in PD.

The presence of ferrous iron in the basal ganglia, combined with a decline in natural protective mechanisms like glutathione, leads to an accumulation of free radicals and further damage to cells.

Levodopa (L-DOPA) , a dopamine precursor, is used to treat Parkinson's disease. It works by crossing the blood-brain barrier and supplying dopamine to the brain.

Carbidopa and Benserazide are peripheral decarboxylase inhibitors. They prevent the breakdown of levodopa before it reaches the brain, increasing its effectiveness in the treatment of Parkinson's disease.

Levodopa is a medication used to treat Parkinson's disease. It works by increasing the levels of dopamine in the brain, a neurotransmitter that is deficient in people with Parkinson's disease.

Levodopa is more effective in the early stages of Parkinson's disease, with its effectiveness decreasing as the disease progresses.

Levodopa primarily helps resolve motor symptoms like hypokinesia (slow movements) and rigidity, followed by improvement in tremor.

Levodopa can cause side effects like postural hypotension (low blood pressure upon standing), nausea, and vomiting.

Levodopa can improve secondary symptoms of Parkinson's, like gait, handwriting, speech, facial expression, mood, self-care, and interest in life.

Levodopa can cause a 'general alerting response', improving alertness and awareness in people with Parkinson's disease.

Levodopa is a dopamine precursor which is converted into dopamine in the brain to help treat Parkinson's disease.

Levodopa acts as an excitatory neurotransmitter in the brain, while dopamine formed peripherally (outside the brain) can cause nausea and vomiting due to its action in the chemoreceptor trigger zone (CTZ).

A condition where blood pressure drops when standing up, causing dizziness or fainting. It's more common in patients on antihypertensives and usually improves with time.

Levodopa, a precursor to dopamine, is the main drug used to treat Parkinson's disease. This medication works by crossing the blood-brain barrier and providing dopamine to the brain, which is deficient in Parkinson's patients.

The half-life of levodopa in the plasma is very short, requiring frequent doses to maintain therapy effectiveness. The medication's absorption and transformation in the brain is also crucial for its action.

Abnormal movements, like facial tics and involuntary limb movements, can occur in patients taking levodopa. These side effects are dose-related and worsen with time.

Levodopa is metabolized by the enzyme dopa-decarboxylase, and pyridoxal is a necessary component in this process. This conversion to dopamine is essential for the drug's efficacy.

Levodopa can cause a range of cardiovascular side effects, including arrhythmias and exacerbation of angina, especially in patients with pre-existing heart conditions.

Levodopa therapy can alter taste perception. This side effect is often described as a metallic taste, which can be a significant nuisance for some patients.

Some medications, such as phenothiazines and butyrophenones, can diminish the therapeutic effects of Levodopa by blocking dopamine receptors.

This is where the symptoms of Parkinson's disease start to fluctuate, even when taking medication.

This refers to the worsening of Parkinson's symptoms as the effect of medication wears off.

This is when Parkinson's symptoms rapidly shift between being controlled and uncontrolled, like a switch turning on and off.

This is when the patient's symptoms completely disappear or become extremely severe, with no middle ground.

This side effect of levodopa can be very serious, and is one reason why its dosage must be adjusted carefully.

This drug blocks levodopa-induced nausea and vomiting, but doesn't cross the blood-brain barrier, so it doesn't affect levodopa's antiparkinsonian effects.

This drug prevents levodopa from entering synaptic vesicles, thus blocking its action.

This drug prevents the breakdown of dopamine and norepinephrine, which can cause a hypertensive crisis.

Restless legs syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by sensations like tingling, itching, or discomfort. Symptoms typically worsen during periods of rest, especially when trying to sleep, and improve with movement. RLS can be primary (idiopathic) or secondary to conditions like iron deficiency or pregnancy.

Dopamine agonists, like ropinirole and pramipexole, are often the most effective treatment for RLS. These medications work by stimulating dopamine receptors in the brain, helping to reduce the urge to move the legs.

While not the primary treatment option, benzodiazepines, gabapentin, or pregabalin may be used for RLS when other treatments are ineffective. These medications work by calming the nervous system and reducing the urge to move.

MAO-B inhibitors, like selegiline and rasagiline, are medications used to treat Parkinson's disease. They work by inhibiting the enzyme MAO-B, which breaks down dopamine in the brain. This helps to increase dopamine levels and improve symptoms of Parkinson's disease.

The theory behind using selegiline for Parkinson's disease is that it might slow down the progression of the disease by preventing dopamine breakdown and the production of harmful free radicals. However, large studies have not shown significant benefit.

While selegiline hasn't shown consistent benefits for Parkinson's, there is some evidence that another MAO-B inhibitor, rasagiline, may have a neuroprotective effect.

Selegiline can be partly metabolized into amphetamine, which may cause side effects like insomnia and agitation. It's important to be aware of this potential side effect, especially when considering selegiline for treatment.

MAO-B inhibitors can sometimes exacerbate the side effects of levodopa, a common Parkinson's medication. This can lead to increased involuntary movements or psychosis.

A type of drug that inhibits the breakdown of dopamine in the brain. This helps increase dopamine levels and improve symptoms of Parkinson's disease.

A common side effect of MAO-B inhibitors, such as selegiline, is this. It can occur when the drug interacts with other medications.

A specific medication that is a selective MAO-B inhibitor, it's more potent and longer-acting than selegiline, and is given only once daily. It doesn't metabolize into amphetamine.

A type of drug that blocks the enzyme COMT, which breaks down levodopa. This helps make levodopa more effective in the brain.

This is a common adverse effect seen when a COMT inhibitor is added to levodopa. It can be managed by adjusting levodopa dosage.

This medication is a COMT inhibitor but is no longer widely used due to potential risks.

This is a COMT inhibitor that is considered safer than tolcapone.

It's the side effect of COMT inhibitors that occurs in 10-18% of patients using entacapone.