PCOL 12-2 Parkinson's

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Questions and Answers

What is the main neuropathological feature of Parkinson's disease?

Accumulation of tau protein in the cerebral cortex

Progressive dopaminergic neuron death in substantia nigra (correct)

Presence of abnormal beta-amyloid protein in the brain

Loss of cholinergic neurons in the hippocampus

What is the estimated average disease duration of Parkinson's disease?

10 years

5 years

20 years (correct)

30 years

Which clinical triad is characteristic of Parkinson's disease?

Chorea, athetosis, dystonia

Myoclonus, dyskinesia, akathisia

Tremor during movement, muscle weakness, ataxia

Tremor at rest, muscle rigidity, bradykinesia (correct)

Which enzyme is responsible for metabolizing L-DOPA to dopamine in dopaminergic neurons?

Aromatic L-amino acid decarboxylase (AADC) Signup and view all the answers

Which enzyme inhibitors are used to allow a higher percentage of L-DOPA to reach the central nervous system?

Entacapone and Benserazide Signup and view all the answers

Which formulation of L-DOPA is administered via percutaneous endoscopic gastrostomy in advanced stages of Parkinson's disease?

Duo-DOPA Signup and view all the answers

Which of the following is a side effect associated with dopamine agonists used in the treatment of Parkinson's disease?

Reversible cardiac fibrosis Signup and view all the answers

Which stage of L-DOPA administration is characterized by the development of hyperkinesia/dyskinesias and lack of response?

Late-stage (6 – 10 years) Signup and view all the answers

Which type of dopamine agonists are normally used in early stages of Parkinson's disease to limit the total dopamine dose and prevent dyskinesias?

Non-ergot-derived Signup and view all the answers

What is the purpose of using Rytary, a formulation of L-DOPA, in the treatment of Parkinson's disease?

To provide immediate and slow-release L-DOPA with carbidopa Signup and view all the answers

Which side effect is specifically associated with dopamine agonists used in the treatment of Parkinson's disease?

Excessive daytime sleepiness Signup and view all the answers

What is a potential issue with dopamine agonists and L-DOPA in Parkinson's disease treatment?

Activation of the reward center leading to addiction Signup and view all the answers

Which medication is administered via injection in the treatment of Parkinson's disease?

Apomorphine Signup and view all the answers

What is a potential contraindication for dopamine agonists in Parkinson's disease treatment?

DA antagonists (antipsychotics, anti-emetics) Signup and view all the answers

Why is early diagnosis important in finding a cure for Parkinson's disease?

To identify tractable targets Signup and view all the answers

Study Notes

Parkinson's Disease Overview

Main neuropathological feature: Lewy bodies containing alpha-synuclein aggregates.
Estimated average disease duration: 15 years, but can vary significantly among individuals.
Characteristic clinical triad: Tremor, rigidity, and bradykinesia.

Treatment and Mechanisms

Enzyme responsible for metabolizing L-DOPA to dopamine: Aromatic L-amino acid decarboxylase (AAAD).
Enzyme inhibitors used: Carbidopa and Benserazide help increase L-DOPA availability in the CNS.
Formulation administered via percutaneous endoscopic gastrostomy: Enteral L-DOPA.

Side Effects and Challenges

Side effects associated with dopamine agonists: Nausea, postural hypotension, and, rarely, impulse control disorders.
Stage of L-DOPA administration characterized by hyperkinesia/dyskinesias: Late-stage therapy, often referred to as “wearing-off phenomenon.”
Type of dopamine agonists used in early stages: Ergot-derived agonists, limiting overall dopamine exposure to reduce dyskinesias.

Additional Treatments and Considerations

Purpose of Rytary formulation: Provides extended release of L-DOPA to manage symptoms more consistently throughout the day.
Specific side effect tied to dopamine agonists: Impulse control disorders leading to compulsive behaviors.
Potential issue with treatment: Risk of motor fluctuations and the development of dyskinesias.

Medications and Contraindications

Medication injected for treatment: Apomorphine, used for acute management of symptoms.
Potential contraindication for dopamine agonists: History of psychosis or severe mental health conditions.
Importance of early diagnosis: Enhances treatment effectiveness and could lead to more successful interventions in disease progression.

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Description

Test your knowledge of Parkinson's disease with this quiz. Explore key facts about this progressive neurodegenerative movement disorder, its clinical triad, risk factors, and impact on individuals and society.