Parkinson's Disease Overview
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Questions and Answers

What side effect is associated with the use of amantadine?

  • Orthostatic hypotension (correct)
  • Insomnia
  • Nausea
  • Weight gain

    • How does amantadine compare to levodopa in terms of efficacy?

  • More efficacious than levodopa
  • Less efficacious than levodopa (correct)
  • Significantly more effective than levodopa
  • Equally efficacious as levodopa

    • What is one of the potential psychiatric side effects of high doses of amantadine?

  • Paranoia
  • Hallucinations (correct)
  • Anxiety
  • Depression

    • Which of the following is an antimuscarinic agent in antiparkinsonism therapy?

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

    What effect does the blockage of cholinergic transmission have in antimuscarinic therapy?

    <p>Balances the dopamine/acetylcholine ratio (C)</p> Signup and view all the answers

    Which adverse effects are less common with amantadine compared to levodopa?

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

    What is a known effect of amantadine at maximum dopamine release levels?

    <p>No effect (C)</p> Signup and view all the answers

    What type of agents are benztropine and biperiden classified as?

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

    What is the primary role of carbidopa when administered with levodopa?

    <p>It inhibits dopamine decarboxylase in peripheral tissues. (B)</p> Signup and view all the answers

    How does levodopa affect the central nervous system (CNS)?

    <p>It is converted to dopamine after crossing the blood-brain barrier. (D)</p> Signup and view all the answers

    What is a significant limitation of levodopa treatment on its own?

    <p>The relief it provides lasts only while the drug is present in the body. (B)</p> Signup and view all the answers

    What happens to levodopa after administration if carbidopa is not included?

    <p>It has an increased likelihood of being metabolized in peripheral tissues. (C)</p> Signup and view all the answers

    Which of the following accurately describes dopamine in relation to levodopa?

    <p>Levodopa is converted to dopamine after it is transported into the CNS. (C)</p> Signup and view all the answers

    What is one of the consequences of administering levodopa without carbidopa?

    <p>Increased side effects from peripheral metabolism. (D)</p> Signup and view all the answers

    In the absence of carbidopa, what undesirable effect is likely associated with levodopa?

    <p>Higher levels of metabolism in the GI tract. (D)</p> Signup and view all the answers

    Why is carbidopa considered beneficial when used with levodopa?

    <p>It allows more levodopa to reach the CNS without being metabolized. (B)</p> Signup and view all the answers

    What is the primary reason antipsychotic drugs are contraindicated in Parkinson's disease?

    <p>They block dopamine receptors. (B)</p> Signup and view all the answers

    Which of the following statements about selegiline is true?

    <p>It increases dopamine levels in the brain. (A)</p> Signup and view all the answers

    What can happen if selegiline is given above recommended doses?

    <p>It may cause severe hypertensive crises. (C)</p> Signup and view all the answers

    What effect do atypical antipsychotics have when used in low doses for patients on levodopa?

    <p>They treat levodopa-induced psychotic symptoms. (C)</p> Signup and view all the answers

    What is a potential side effect of long-term selegiline use if administered in the afternoon?

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

    How much more potent is rasagiline compared to selegiline?

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

    What occurs as a result of selegiline's action in the brain?

    <p>Increase in dopamine levels. (A)</p> Signup and view all the answers

    What is the consequence of combining levodopa with selegiline?

    <p>Reduction in the required dose of levodopa. (D)</p> Signup and view all the answers

    What is the primary reason barbiturates have largely been replaced by benzodiazepines?

    <p>Barbiturates cause tolerance and physical dependence. (D)</p> Signup and view all the answers

    Which barbiturate is known for its very short duration of action and is primarily used to induce anesthesia?

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

    How do barbiturates enhance GABAergic transmission?

    <p>By prolonging the duration of chloride channel openings (A)</p> Signup and view all the answers

    Barbiturates can interact with which receptors to exert their sedative-hypnotic effects?

    <p>GABAA receptors (D)</p> Signup and view all the answers

    Which of the following affects the classification of barbiturates?

    <p>Their duration of action (A)</p> Signup and view all the answers

    Which barbiturate is classified as long-acting and used to treat seizures?

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

    Which of the following actions do barbiturates NOT perform?

    <p>Enhance dopamine transmission (C)</p> Signup and view all the answers

    What hallmark side effect is associated with the withdrawal of barbiturates?

    <p>Severe withdrawal symptoms (B)</p> Signup and view all the answers

    What is the primary characteristic of dopaminergic neurons in the substantia nigra?

    <p>They modulate the activity of a large number of cells. (C)</p> Signup and view all the answers

    Which neurotransmitter is responsible for the hyperpolarization of neurons in the neostriatum?

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

    What is the consequence of the reduction of dopamine actions in the corpus striatum?

    <p>Increased risk of Parkinson's disease symptoms (D)</p> Signup and view all the answers

    What role does the neostriatum play in the basal ganglia system?

    <p>It receives inhibitory signals from the substantia nigra. (B)</p> Signup and view all the answers

    What is the primary age group affected by the incidence mentioned in Parkinson’s disease cases?

    <p>Individuals over the age of 65 (B)</p> Signup and view all the answers

    The binding of GABA opens which ion channel, contributing to neural hyperpolarization?

    <p>Chloride ion channel (C)</p> Signup and view all the answers

    How do dopaminergic neurons in the substantia nigra primarily operate?

    <p>They exhibit tonic firing rather than phasic firing. (A)</p> Signup and view all the answers

    What is an incorrect association regarding the functions of the neostriatum?

    <p>It is the primary site for dopamine production. (D)</p> Signup and view all the answers

    Study Notes

    Parkinson's Disease

    • Cause of Parkinson's Disease is unknown for most patients.
    • Destruction of dopaminergic neurons in the substantia nigra leads to a reduction of dopamine actions in the corpus striatum.
    • Substantia nigra is the source of dopaminergic neurons, a part of the extrapyramidal system.
    • Neostriatum is connected to the substantia nigra by neurons that secrete the inhibitory transmitter GABA.
    • Dopamine is an inhibitory neurotransmitter, while acetylcholine is excitatory.
    • Imbalance in the dopamine/acetylcholine ratio can be corrected by blocking cholinergic transmission, which augments dopaminergic transmission.
    • Antimuscarinic agents are much less efficacious than levodopa and play an adjuvant role in antiparkinsonism therapy.
    • Amantadine may cause restlessness, agitation, confusion, and hallucinations.
    • Levodopa is less effective than levodopa, and tolerance develops more readily but has fewer side effects.
    • Antipsychotic drugs are generally contraindicated in Parkinson's disease because they block dopamine receptors which may augment parkinsonian symptoms.

    Levodopa

    • Levodopa is a dopamine precursor that is actively transported into the CNS and converted to dopamine.
    • Carbidopa is a dopamine decarboxylase inhibitor that does not cross the blood–brain barrier, it enhances the actions of levodopa and reduces the dose needed.
    • Levodopa-induced psychotic symptoms can be treated by atypical antipsychotics, in low doses.

    Selegiline and Rasagiline

    • Selegiline (Deprenyl) selectively inhibits monoamine oxidase (MAO) type B (metabolizes dopamine) at low to moderate doses.
    • Selegiline at recommended doses has little potential for causing hypertensive crises, but at high doses it may lead to severe hypertension.
    • Rasagiline is an irreversible and selective inhibitor of brain MAO type B with 5 times the potency of selegiline.

    GABA Receptors

    • GABA is an inhibitory neurotransmitter that binds to GABA receptors.
    • The binding of GABA causes chloride ion channels to open.
    • Entry of chloride ions makes the neuron more difficult to depolarize, reducing neural excitability.

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    Description

    Explore the complexities of Parkinson's Disease in this quiz, which delves into the unknown causes, the role of dopaminergic neurons, and the critical balance between dopamine and acetylcholine. Understand the mechanisms of treatment options, including antimuscarinic agents and levodopa. Test your knowledge on this significant neurological disorder.

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