Podcast
Questions and Answers
What is a common side effect reported in 10-18% of patients taking selegiline?
What is a common side effect reported in 10-18% of patients taking selegiline?
Which medication is contraindicated in patients with convulsive disorders?
Which medication is contraindicated in patients with convulsive disorders?
What is the maximum daily dose of Entacapone recommended?
What is the maximum daily dose of Entacapone recommended?
Which of the following medications is longer acting and five times more potent than selegiline?
Which of the following medications is longer acting and five times more potent than selegiline?
Signup and view all the answers
What adverse effects are often worsened when a COMT inhibitor is added to levodopa therapy?
What adverse effects are often worsened when a COMT inhibitor is added to levodopa therapy?
Signup and view all the answers
What interaction does selegiline have that can lead to severe side effects?
What interaction does selegiline have that can lead to severe side effects?
Signup and view all the answers
What is the recommended dose of tolcapone?
What is the recommended dose of tolcapone?
Signup and view all the answers
What is a key concern regarding tolcapone based on reports from Europe?
What is a key concern regarding tolcapone based on reports from Europe?
Signup and view all the answers
What is a common motor symptom of Parkinson's disease?
What is a common motor symptom of Parkinson's disease?
Signup and view all the answers
Which neurotransmitter is associated with excitotoxic neuronal death in Parkinsonism?
Which neurotransmitter is associated with excitotoxic neuronal death in Parkinsonism?
Signup and view all the answers
Which drug was identified in 1967 to produce notable improvement in Parkinson's disease symptoms?
Which drug was identified in 1967 to produce notable improvement in Parkinson's disease symptoms?
Signup and view all the answers
What is the primary cause of degeneration in Parkinson's disease?
What is the primary cause of degeneration in Parkinson's disease?
Signup and view all the answers
What condition can cause drug-induced temporary parkinsonism?
What condition can cause drug-induced temporary parkinsonism?
Signup and view all the answers
Which of the following drugs is classified as a MAO-B inhibitor?
Which of the following drugs is classified as a MAO-B inhibitor?
Signup and view all the answers
What effect does Levodopa primarily have in patients with Parkinson's disease?
What effect does Levodopa primarily have in patients with Parkinson's disease?
Signup and view all the answers
Which of the following is an uncommon form of parkinsonism due to chronic copper poisoning?
Which of the following is an uncommon form of parkinsonism due to chronic copper poisoning?
Signup and view all the answers
Which type of receptors do the D1-like dopamine receptors activate?
Which type of receptors do the D1-like dopamine receptors activate?
Signup and view all the answers
What can occur if Parkinson's disease symptoms remain untreated?
What can occur if Parkinson's disease symptoms remain untreated?
Signup and view all the answers
Which of the following is true regarding the effect of reserpine in Parkinson's disease?
Which of the following is true regarding the effect of reserpine in Parkinson's disease?
Signup and view all the answers
Which substances are included in the category of COMT inhibitors?
Which substances are included in the category of COMT inhibitors?
Signup and view all the answers
What is a noted side effect of glutamate antagonists like Amantadine?
What is a noted side effect of glutamate antagonists like Amantadine?
Signup and view all the answers
Which statement best describes the mechanism of D2-like dopamine receptors?
Which statement best describes the mechanism of D2-like dopamine receptors?
Signup and view all the answers
What is a characteristic of central anticholinergics such as Trihexyphenidyl?
What is a characteristic of central anticholinergics such as Trihexyphenidyl?
Signup and view all the answers
What is a common effect seen with the use of MAO-B inhibitors?
What is a common effect seen with the use of MAO-B inhibitors?
Signup and view all the answers
What is a significant side effect of domperidone that does not develop tolerance?
What is a significant side effect of domperidone that does not develop tolerance?
Signup and view all the answers
What effect do nonselective MAO inhibitors have on dopamine and norepinephrine levels?
What effect do nonselective MAO inhibitors have on dopamine and norepinephrine levels?
Signup and view all the answers
What is the consequence of the excessive dopamine action in the limbic system?
What is the consequence of the excessive dopamine action in the limbic system?
Signup and view all the answers
What condition may arise when levodopa is administered with antihypertensive drugs?
What condition may arise when levodopa is administered with antihypertensive drugs?
Signup and view all the answers
What does the term 'on-off' effect refer to in the context of parkinsonian symptomatology?
What does the term 'on-off' effect refer to in the context of parkinsonian symptomatology?
Signup and view all the answers
How does reserpine affect levodopa action?
How does reserpine affect levodopa action?
Signup and view all the answers
Which drug class is indicated for patients suffering from psychotic illness when using levodopa?
Which drug class is indicated for patients suffering from psychotic illness when using levodopa?
Signup and view all the answers
What might happen to the absorption of levodopa when used with atropine?
What might happen to the absorption of levodopa when used with atropine?
Signup and view all the answers
What is a characteristic of newer dopaminergic agonists compared to levodopa?
What is a characteristic of newer dopaminergic agonists compared to levodopa?
Signup and view all the answers
Which of the following statements about selegiline is true?
Which of the following statements about selegiline is true?
Signup and view all the answers
What is the terminal half-life of ropinirole?
What is the terminal half-life of ropinirole?
Signup and view all the answers
What type of drug is Bromocriptine classified as?
What type of drug is Bromocriptine classified as?
Signup and view all the answers
How is ropinirole metabolized in the body?
How is ropinirole metabolized in the body?
Signup and view all the answers
Which MAO isoenzyme is predominant in the brain and blood platelets?
Which MAO isoenzyme is predominant in the brain and blood platelets?
Signup and view all the answers
What type of complications are associated with levodopa treatment?
What type of complications are associated with levodopa treatment?
Signup and view all the answers
Which drug might be preferentially used in place of levodopa to potentially slow neuronal degeneration?
Which drug might be preferentially used in place of levodopa to potentially slow neuronal degeneration?
Signup and view all the answers
What is the primary effect of dopaminergic action in the striatum?
What is the primary effect of dopaminergic action in the striatum?
Signup and view all the answers
What role does the basal ganglia modulatory loop serve in motor control?
What role does the basal ganglia modulatory loop serve in motor control?
Signup and view all the answers
What is the effect of a degenerative lesion in SN-PC related to Parkinson's disease?
What is the effect of a degenerative lesion in SN-PC related to Parkinson's disease?
Signup and view all the answers
How does levodopa get absorbed from the small intestines?
How does levodopa get absorbed from the small intestines?
Signup and view all the answers
What factor can affect the bioavailability of levodopa?
What factor can affect the bioavailability of levodopa?
Signup and view all the answers
What occurs when levodopa therapy is initiated in patients?
What occurs when levodopa therapy is initiated in patients?
Signup and view all the answers
What might occur if gastric emptying is slow during levodopa therapy?
What might occur if gastric emptying is slow during levodopa therapy?
Signup and view all the answers
What is one of the outcomes of levodopa therapy regarding prolactin levels?
What is one of the outcomes of levodopa therapy regarding prolactin levels?
Signup and view all the answers
Study Notes
Parkinsonism
- Parkinsonism is an extrapyramidal motor disorder
- Characterized by rigidity, tremor, and hypokinesia
- Secondary symptoms can include posture and gait problems, a mask-like face, drooling, and dementia
- Untreated, symptoms progress to a rigid state, difficulty moving, breathing, and susceptibility to infections or embolisms
- Parkinson's disease (PD) is a progressive degenerative disorder, mostly affecting older adults
- Idiopathic cases are the most common, with some cases having arteriosclerotic or postencephalitic origins. Wilson's disease (copper poisoning) is a rare cause.
- Consistent lesions in PD involve the substantia nigra pars compacta (SN-PC) and the nigrostriatal tract.
- Dopamine deficiency in the striatum disrupts muscle tone and movement coordination
- Imbalance between dopaminergic (inhibitory) and cholinergic (excitatory) systems leads to motor defects
- Cause of nigrostriatal neuron degeneration is multifactorial.
- Free radical damage from DA oxidation, age-related/acquired defects in protective mechanisms, and genetic predisposition are possible causes.
- Mitochondrial dysfunction and environmental toxins may influence the selective degeneration.
- Excitotoxic neuronal death due to glutamate overload is possible via NMDA receptors.
- Drug-induced parkinsonism is common due to neuroleptics, like metoclopramide
- Prior treatment included belladonna alkaloids.
- Levodopa was a breakthrough treatment in 1967
- Levodopa is a precursor to dopamine; necessary for treatment as dopamine doesn't cross the blood-brain barrier.
Classification
- Drugs affecting the brain's dopaminergic system
- Dopamine precursors (Levodopa)
- Peripheral decarboxylase inhibitors (Carbidopa, Benserazide)
- Dopamine agonists (Bromocriptine, Ropinirole, Pramipexole)
- MAO-B inhibitors (Selegiline, Rasagiline)
- COMT inhibitors (Entacapone, Tolcapone)
- Glutamate (NMDA receptor) antagonist (Amantadine)
- Drugs affecting the brain's cholinergic system
- Central anticholinergics (Trihexyphenidyl, Procyclidine, Biperiden)
- Antihistamines (Orphenadrine, Promethazine)
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz explores the characteristics and symptoms of Parkinsonism, an extrapyramidal motor disorder primarily affecting older adults. Dive into the complexities of this condition, including its idiopathic nature, the role of dopamine deficiency, and its progression without treatment. Understand the underlying causes and pathology associated with this often-debilitating disorder.
