40 Questions
What is the primary neurotransmitter whose imbalance is associated with Parkinson's disease?
Dopamine
What are the cardinal symptoms of Parkinson's disease?
Tremor at rest, rigidity, postural instability, and bradykinesia
Which neurotransmitter acts as an inhibitory transmitter in the striatum?
Dopamine
Which neurotransmitter imbalance results from the degeneration of neurons supplying dopamine to the striatum in Parkinson's disease?
Dopamine and GABA
What characteristic must be present for the diagnosis of Parkinson's disease?
Tremor at rest
What is the secondary most common degenerative disease of neurons after Alzheimer's disease in the United States?
Parkinson's disease
What is the primary mechanism of action of Levodopa in reducing symptoms of Parkinson's disease?
Conversion to dopamine in its active form
Why is the activity of decarboxylase enhanced by vitamin B6 in the context of Levodopa therapy?
To increase dopamine synthesis in the brain
What intervention can help reduce the risk of postural hypotension associated with Levodopa therapy?
Increasing intake of salt and water
How can dyskinesias caused by Levodopa be managed?
Reducing the dosage of Levodopa
What is the reason for giving additional carbidopa (without levodopa) when experiencing nausea and vomiting with Levodopa therapy?
To reduce nausea and vomiting triggered by activation of dopamine receptors
How do first generation antipsychotic drugs, chlorpromazine, and haloperidol, affect the therapeutic effects of Levodopa?
They decrease the therapeutic effects
Which drug may lead to yellow and orange colored urine as an adverse effect?
Entacapone
What is the primary benefit derived from using Tolcapone in conjunction with Levodopa?
Prolonged availability of Levodopa
Which drug combination is sold as Stalevo for the treatment of Parkinson's disease?
Levodopa/carbidopa/entacapone
What is a black box warning associated with Selegiline?
Increased risk of suicidal thoughts and behaviors in pediatric and young adult patients
Which adverse effect is associated with Rasagiline monotherapy?
Insomnia
What is the primary mechanism of action of Amantadine for the treatment of Parkinson's disease?
Blockade of glutamate receptors
What causes an imbalance between dopamine and acetylcholine in Parkinson's disease?
Degeneration of neurons supplying dopamine to the striatum
Which neurotransmitter is responsible for causing excessive stimulation of neurons in the absence of adequate dopamine?
Acetylcholine
What is the potential toxic protein synthesized by dopaminergic neurons in Parkinson's disease?
Alpha-synuclein
Which drug is NOT included in the initial treatment for mild symptoms of Parkinson's disease?
Carbidopa
What is the most effective therapeutic drug combination for treating more severe symptoms of Parkinson's disease?
Levodopa/Carbidopa
What minimizes the 'wearing off' effect of Levodopa in Parkinson's disease?
Shortening the dosing interval
Which drug is highly selective for D2 and D3 receptors and can be used as monotherapy early in Parkinson's and as an adjunct for advanced Parkinson's?
Ropinirole
Which drug is used as acute treatment of hypo mobility during off episodes in patients with advanced Parkinson's, is not given by mouth, and is not indicated for routine Parkinson's management?
Apomorphine
Which drug should not be used in pregnancy, is used for management of Parkinson's from early to advanced stages, and is known to cause dose-related hallucinations?
Rotigotine
Which drug is a selective irreversible inhibitor of COMT, indicated for use with Levodopa, and increases Levodopa availability by inhibiting COMT?
Entacapone
Which drug is poorly tolerated, a derivative of ergot, and can be used alone in early treatment of Parkinson's and in combination with Levodopa in advanced Parkinson's?
Bromocriptine
Which drug is occasionally used for Parkinson, possibly effective for improving the off times, and associated with adverse effects like valve regurgitations and development of heart failure?
Cabergoline
Which drug used for insomnia in Parkinson's patients is associated with exacerbating dementia due to its anticholinergic effects?
Amitriptyline
Which neurotransmitter imbalance is mainly associated with the development of psychosis in Parkinson's patients?
Dopamine
What is the primary reason for avoiding first-generation antipsychotics in Parkinson's patients with psychosis?
They block receptors for dopamine
Why should quetiapine be considered before clozapine for the treatment of psychosis in Parkinson's patients?
Clozapine increases the risk of agranulocytosis
Which medication combination can be used to manage periodic limb movement in Parkinson's patients?
Pramipexole and Melatonin
Which drug is the only one recommended by AAN guidelines for the treatment of depression in Parkinson's disease?
Amitriptyline
What is the potential risk of using Amitriptyline to treat depression in Parkinson's patients?
Exacerbation of dementia
Which drug should be withdrawn if psychosis develops in a Parkinson's patient and the dosage of levodopa should be reduced?
Pramipexole
Which drug is considered a second-generation antipsychotic option for treating psychosis in Parkinson's patients, but requires monitoring for the potential adverse effect of agranulocytosis?
Clozapine
What is the primary reason for avoiding first-generation antipsychotics in Parkinson's patients with psychosis?
They block receptors for dopamine
Test your knowledge about the use of Pramipexole and Ropinirole in Parkinson's disease treatment, including their benefits, adverse effects, and selectivity. Understand the usage of Pramipexole in early Parkinson's and in combination with Levodopa, as well as the selectivity of Ropinirole.
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