University of Baghdad/ College of Medicine 2022-2023: Carbidopa and Levodopa Interaction
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Questions and Answers

Which symptoms are commonly seen in Parkinson's disease?

  • Tremors only
  • Bradykinesia, rigidity, rabbit syndrome (correct)
  • Mild tremor, rabbit syndrome, migraine
  • Mild tremor, severe tremor, headache

What is the impact of exposure to dopamine-receptor blocking agents?

  • Improves motor function
  • Increases dopamine levels
  • May cause Parkinsonism within 6 months (correct)
  • Has no effect on the motor system

How do mild cases of drugs-induced Parkinsonism typically respond to treatment?

  • Worsen despite treatment
  • Require immediate surgery
  • Frequently remit after stopping the drug (correct)
  • Improve with increased drug dosage

Why are elderly patients more susceptible to drugs-induced Parkinsonism?

<p>Increased vulnerability to side effects of medications (A)</p> Signup and view all the answers

What is the primary aim of drug therapy in Parkinson's disease?

<p>Restore balance between dopamine and cholinergic neurons (A)</p> Signup and view all the answers

What is the current status of surgical procedures for Parkinson's disease?

<p>Varying success at prolonging degeneration (B)</p> Signup and view all the answers

How can wearing-off in Parkinson's be managed according to the text?

<p>Adding or changing medication, dose, or schedule (B)</p> Signup and view all the answers

What term is used to describe the return or worsening of Parkinson's symptoms before the next dose of levodopa is due?

<p>Wearing-off (A)</p> Signup and view all the answers

What is one method mentioned in the text to increase the time spent 'on' and decrease 'off' periods in Parkinson's?

<p>Changing dose frequency or timing of medication (B)</p> Signup and view all the answers

What type of drug can be added to medication to extend the duration of benefit of levodopa according to the text?

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

What change can be made to the formulation of levodopa to provide controlled release?

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

Which part of the brain is rich in dopamine and dopamine receptors?

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

What type of symptoms are associated with Parkinson's disease?

<p>Resting tremor, cogwheel rigidity, bradykinesia, gait abnormalities (C)</p> Signup and view all the answers

What is the main neurotransmitter affected by Parkinson's disease?

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

What are parkinsonism symptoms mainly caused by?

<p>Certain drugs or brain injuries (A)</p> Signup and view all the answers

At what age does Parkinson's disease usually start to affect individuals?

<p>Past middle age, entering their 60s or later years (B)</p> Signup and view all the answers

What type of disorder is Parkinson's disease classified as?

<p>Motor (neurodegenerative) disorder (B)</p> Signup and view all the answers

What is the main function of carbidopa when used in combination with levodopa?

<p>Inhibiting dopa decarboxylase in the periphery (B)</p> Signup and view all the answers

How does carbidopa affect the dose of levodopa required for therapeutic levels in the brain?

<p>Decreases the amount of levodopa needed (A)</p> Signup and view all the answers

Which adverse side effect of levodopa therapy is specifically reduced by the addition of carbidopa?

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

In Parkinson's disease patients, what is the typical pattern of response to levodopa-carbidopa therapy over time?

<p>Initial improvement followed by declining response after 3-5 years (A)</p> Signup and view all the answers

Which symptom of Parkinson's disease is least affected by levodopa-carbidopa therapy?

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

What effect does pyridoxine have on levodopa?

<p>Abolishes its therapeutic effect (B)</p> Signup and view all the answers

Why is gradual withdrawal from levodopa-carbidopa therapy recommended?

<p>To prevent sudden worsening of symptoms (D)</p> Signup and view all the answers

Which type of drugs block the action of levodopa by blocking dopamine receptors?

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

How does domperidone influence the effects of levodopa?

<p>Abolishes nausea and vomiting (B)</p> Signup and view all the answers

Which drug acts as a direct dopamine agonist on dopamine receptor sites in the substantia nigra?

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

What is a unique characteristic of bromocriptine compared to levodopa and amantadine?

<p>May be effective for a longer duration (B)</p> Signup and view all the answers

In addition to treating Parkinson's disease, what condition is ropinirole also used for?

<p>Restless leg syndrome (A)</p> Signup and view all the answers

What is the primary mechanism of action of Rasagiline in treating Parkinson's disease?

<p>Increasing dopamine levels by inhibiting monoamine oxidase type B (MAO-B) (D)</p> Signup and view all the answers

Why is Rasagiline associated with fewer peripheral adverse effects compared to other drugs?

<p>It inhibits monoamine oxidase type B (MAO-B) primarily in the CNS (C)</p> Signup and view all the answers

What is a potential consequence of administering Selegiline above recommended doses?

<p>Increased risk of hypertensive crises (C)</p> Signup and view all the answers

How does Selegiline impact dopamine levels in the brain?

<p>Increasing dopamine levels by selectively inhibiting MAO-B (A)</p> Signup and view all the answers

How does Selegiline interact with levodopa when used together?

<p>Enhances the actions of levodopa and reduces the required dose (B)</p> Signup and view all the answers

What is a crucial aspect of care for patients with Parkinson's disease due to its degenerative effects?

<p>Psychological and physical support (C)</p> Signup and view all the answers

What type of drugs have been proven to be more effective than anticholinergics in the treatment of parkinsonism?

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

What is recommended to extend the duration of benefit of levodopa therapy?

<p>Additional dopaminergic agents (B)</p> Signup and view all the answers

How can wearing-off complications in Parkinson's disease be managed effectively?

<p>Adding COMT inhibitors to the regimen (C)</p> Signup and view all the answers

What role do drug protocols play in the care of patients with Parkinson's disease?

<p>Provide guidance for drug administration and monitoring adverse effects (D)</p> Signup and view all the answers

What is the main purpose of adding drugs that prevent the breakdown of levodopa within the body?

<p>To extend the duration of benefit of levodopa (D)</p> Signup and view all the answers

How can wearing-off in Parkinson's disease be managed by changing the formulation of levodopa?

<p>By providing a controlled release of levodopa (A)</p> Signup and view all the answers

What is the benefit of adding a dopamine agonist to the medication regimen in Parkinson's disease?

<p>To extend the duration of benefit of levodopa (B)</p> Signup and view all the answers

How does changing the timing of medication administration help with managing wearing-off in Parkinson's disease?

<p>By optimizing the effectiveness of levodopa doses (D)</p> Signup and view all the answers

In what way can adding another class of drug, such as a dopamine agonist, aid in managing wearing-off in Parkinson's disease?

<p>By extending the effectiveness of levodopa (B)</p> Signup and view all the answers

What is the primary aim of therapy in Parkinson's disease, as mentioned in the text?

<p>Addressing the imbalance between declining dopamine and dominant cholinergic neurons (D)</p> Signup and view all the answers

How does gradual withdrawal from levodopa-carbidopa therapy impact patient management?

<p>It helps in avoiding motor complications like wearing-off (C)</p> Signup and view all the answers

What characteristic differentiates bromocriptine from levodopa and amantadine?

<p>Acts as a direct dopamine agonist on dopamine receptor sites in the basal ganglia (C)</p> Signup and view all the answers

How are mild cases of drugs-induced Parkinsonism likely to respond to treatment?

<p>By experiencing immediate remission upon cessation of offending drugs (B)</p> Signup and view all the answers

What is the primary function of Entacapone in combination with carbidopa-levodopa therapy?

<p>Increase plasma concentration and duration of action of levodopa (A)</p> Signup and view all the answers

How does the inhibition of COMT by Entacapone and Tolcapone affect levodopa metabolism?

<p>Enhances central uptake of levodopa and increases brain dopamine concentrations (D)</p> Signup and view all the answers

What is the main purpose of using carbidopa in combination with levodopa therapy?

<p>To reduce peripheral conversion of levodopa to dopamine (D)</p> Signup and view all the answers

In patients on levodopa-carbidopa therapy, what role do Entacapone and Tolcapone play in managing 'wearing-off' phenomena?

<p>Reduce the symptoms of 'wearing-off' (A)</p> Signup and view all the answers

What distinguishes Entacapone from Tolcapone in their pharmacological profiles?

<p>Differences in adverse effect profiles and pharmacokinetics (A)</p> Signup and view all the answers

Why is it important to monitor hepatic function in patients taking tolcapone?

<p>To reduce the risk of fulminating hepatic necrosis (B)</p> Signup and view all the answers

Which adjunctive agent for Parkinson's disease has replaced tolcapone due to its lack of associated toxicity?

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

What is the main benefit of central anticholinergics like benztropine in the treatment of Parkinson's disease?

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

In patients with Parkinson's disease who do not respond to levodopa, which drug category is ineffective?

<p>Dopamine receptor agonists (B)</p> Signup and view all the answers

What is the primary reason for the ineffectiveness of dopamine receptor agonists in patients who have not responded to levodopa?

<p>They are unable to replace levodopa's effects (A)</p> Signup and view all the answers

What is the primary reason for recommending gradual withdrawal from levodopa-carbidopa therapy?

<p>To minimize the risk of developing levodopa-induced dyskinesias (C)</p> Signup and view all the answers

Which neurotransmitter is mainly affected in Parkinson's disease?

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

What is the goal of adding carbidopa to levodopa therapy?

<p>To prevent levodopa metabolism before it reaches the brain (B)</p> Signup and view all the answers

What is a common strategy to manage wearing-off complications in Parkinson's disease?

<p>Administering levodopa more frequently throughout the day (A)</p> Signup and view all the answers

Which complication is specifically reduced by combining carbidopa with levodopa therapy?

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

What is the impact of exposure to dopamine receptor-blocking agents in individuals with Parkinson's disease?

<p>Worsening of motor symptoms (C)</p> Signup and view all the answers

'Wearing-off' phenomena in Parkinson's disease refer to:

<p>'On-off' fluctuations in symptom control throughout the day (A)</p> Signup and view all the answers

'On-off' fluctuations in Parkinson's refer to:

<p>'Rebound' effects after medication wears off (A)</p> Signup and view all the answers
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