Drugs for Movement Disorders Part 1.docx

**Drugs for Movement Disorders** \#\#\# Slide 1 - Overview 1\. \*\*What is the primary goal of drug therapy for Parkinson\'s disease?\*\* \- A) Reduce dopamine levels \- B) Increase acetylcholine activity \- C) Improve dopaminergic neurotransmission \- D) Block GABA activity \*\*Answer\*\*: C...

**Drugs for Movement Disorders** \#\#\# Slide 1 - Overview 1\. \*\*What is the primary goal of drug therapy for Parkinson\'s disease?\*\* \- A) Reduce dopamine levels \- B) Increase acetylcholine activity \- C) Improve dopaminergic neurotransmission \- D) Block GABA activity \*\*Answer\*\*: C) Improve dopaminergic neurotransmission 2\. \*\*Which of the following is a symptom of Parkinsonism?\*\* \- A) Tachycardia \- B) Bradykinesia \- C) Hypotension \- D) Hyperactivity \*\*Answer\*\*: B) Bradykinesia 3\. \*\*What is a common class of drugs used in the treatment of Parkinson\'s disease?\*\* \- A) Dopamine agonists \- B) Serotonin antagonists \- C) MAO-A inhibitors \- D) SSRIs \*\*Answer\*\*: A) Dopamine agonists \#\#\# Slide 2 - Parkinsonism 4\. \*\*What is the neuroanatomical structure most affected in Parkinson\'s disease?\*\* \- A) Hippocampus \- B) Substantia nigra \- C) Thalamus \- D) Cerebellum \*\*Answer\*\*: B) Substantia nigra 5\. \*\*Which of the following is a characteristic sign of Parkinsonism?\*\* \- A) Hyperactivity \- B) Resting tremor \- C) Tachycardia \- D) Paresthesia \*\*Answer\*\*: B) Resting tremor 6\. \*\*Parkinsonism symptoms can be induced by which class of drugs?\*\* \- A) Antipsychotics \- B) Beta blockers \- C) Benzodiazepines \- D) MAO-B inhibitors \*\*Answer\*\*: A) Antipsychotics \#\#\# Slide 3 - Etiology and Pathogenesis of Parkinsonism 7\. \*\*What is one of the proposed causes of Parkinson\'s disease?\*\* \- A) Oxidative stress \- B) Viral infection \- C) Bacterial infection \- D) Autoimmune disorder \*\*Answer\*\*: A) Oxidative stress 8\. \*\*Mutations in which gene are associated with juvenile Parkinsonism?\*\* \- A) Synuclein gene \- B) Parkin gene \- C) ApoE4 gene \- D) BRCA1 gene \*\*Answer\*\*: B) Parkin gene 9\. \*\*At what age does Parkinson's disease typically manifest?\*\* \- A) 25-35 years \- B) 35-45 years \- C) 50-60 years \- D) 70-80 years \*\*Answer\*\*: C) 50-60 years \#\#\# Slide 4 - Basal Ganglia and Motor Function 10\. \*\*Which brain structure is primarily involved in motor control affected by Parkinson\'s disease?\*\* \- A) Cerebellum \- B) Basal ganglia \- C) Hypothalamus \- D) Medulla \*\*Answer\*\*: B) Basal ganglia 11\. \*\*Which neurotransmitter is deficient in Parkinson's disease, leading to motor dysfunction?\*\* \- A) Serotonin \- B) Dopamine \- C) Acetylcholine \- D) GABA \*\*Answer\*\*: B) Dopamine 12\. \*\*What role does acetylcholine play in Parkinson's disease pathogenesis?\*\* \- A) It inhibits dopamine production \- B) It becomes overactive when dopamine levels drop \- C) It blocks NMDA receptors \- D) It enhances GABA activity \*\*Answer\*\*: B) It becomes overactive when dopamine levels drop \#\#\# Slide 5 - Basal Motor Pathway 13\. \*\*What is the primary effect of dopamine in the basal ganglia?\*\* \- A) Stimulate cholinergic neurons \- B) Inhibit cholinergic neurons \- C) Increase GABA release \- D) Decrease serotonin release \*\*Answer\*\*: B) Inhibit cholinergic neurons 14\. \*\*In Parkinsonism, what happens to the inhibitory pathway of the basal ganglia?\*\* \- A) It becomes overactive due to dopamine deficiency \- B) It becomes underactive due to acetylcholine excess \- C) It becomes overactive due to serotonin deficiency \- D) It becomes underactive due to excessive dopamine \*\*Answer\*\*: A) It becomes overactive due to dopamine deficiency 15\. \*\*What symptom arises from an imbalance between dopamine and acetylcholine in Parkinson's disease?\*\* \- A) Tremor \- B) Hyperactivity \- C) Hypertension \- D) Paresthesia \*\*Answer\*\*: A) Tremor \#\#\# Slide 6 - Parkinsonism Pathophysiology 16\. \*\*What neurotransmitter imbalance is critical in Parkinson's disease?\*\* \- A) Dopamine and serotonin \- B) Dopamine and acetylcholine \- C) GABA and norepinephrine \- D) Acetylcholine and glutamate \*\*Answer\*\*: B) Dopamine and acetylcholine 17\. \*\*What role does GABA play in the motor dysfunction seen in Parkinsonism?\*\* \- A) GABA becomes overactive due to excess acetylcholine \- B) GABA becomes underactive due to dopamine loss \- C) GABA increases dopamine production \- D) GABA stimulates serotonin release \*\*Answer\*\*: A) GABA becomes overactive due to excess acetylcholine 18\. \*\*How does dopamine deficiency affect GABAergic signaling in Parkinson's disease?\*\* \- A) Increases inhibitory control of muscles \- B) Reduces motor inhibition \- C) Enhances motor function \- D) Reduces acetylcholine signaling \*\*Answer\*\*: A) Increases inhibitory control of muscles \#\#\# Slide 7 - Parkinsonism Treatment Goals 1\. \*\*What is the primary goal of treatment in Parkinsonism?\*\* \- A) Decrease acetylcholine activity \- B) Increase dopaminergic neurotransmission \- C) Increase GABA levels \- D) Decrease serotonin activity \*\*Answer\*\*: B) Increase dopaminergic neurotransmission 2\. \*\*Which drug class is the most commonly used to increase dopamine levels in Parkinson's disease?\*\* \- A) Anticholinergics \- B) Dopamine agonists \- C) SSRIs \- D) MAO inhibitors \*\*Answer\*\*: B) Dopamine agonists 3\. \*\*Which neurotransmitter is overactive in Parkinsonism due to dopamine deficiency?\*\* \- A) GABA \- B) Acetylcholine \- C) Serotonin \- D) Norepinephrine \*\*Answer\*\*: B) Acetylcholine \#\#\# Slide 8 - Dopamine Pathway Targets 4\. \*\*Which drug prevents the peripheral conversion of levodopa to dopamine?\*\* \- A) Selegiline \- B) Carbidopa \- C) Amantadine \- D) Entacapone \*\*Answer\*\*: B) Carbidopa 5\. \*\*What is the mechanism of action of MAO-B inhibitors in Parkinson's disease?\*\* \- A) Block dopamine receptors \- B) Inhibit dopamine breakdown \- C) Increase GABA activity \- D) Stimulate serotonin release \*\*Answer\*\*: B) Inhibit dopamine breakdown 6\. \*\*Which medication inhibits the COMT enzyme to increase levodopa's availability in the brain?\*\* \- A) Entacapone \- B) Bromocriptine \- C) Carbidopa \- D) Selegiline \*\*Answer\*\*: A) Entacapone \#\#\# Slide 9 - Carbidopa/Levodopa 7\. \*\*What is the role of Carbidopa in the Carbidopa/Levodopa combination?\*\* \- A) It increases dopamine release in the brain \- B) It inhibits peripheral conversion of levodopa to dopamine \- C) It blocks the breakdown of acetylcholine \- D) It enhances the release of GABA \*\*Answer\*\*: B) It inhibits peripheral conversion of levodopa to dopamine 8\. \*\*Levodopa is most effective in relieving which Parkinson's symptom?\*\* \- A) Tremors \- B) Bradykinesia \- C) Dyskinesia \- D) Postural instability \*\*Answer\*\*: B) Bradykinesia 9\. \*\*Levodopa absorption can be delayed by which dietary component?\*\* \- A) High-fat meals \- B) High-protein meals \- C) High-carbohydrate meals \- D) Vitamin B12 \*\*Answer\*\*: B) High-protein meals \#\#\# Slide 10 - Carbidopa/Levodopa Formulations 10\. \*\*Which formulation of Carbidopa/Levodopa is used for on-demand relief of motor fluctuations?\*\* \- A) Rytary \- B) Duopa \- C) Parcopa \- D) Inbrija \*\*Answer\*\*: D) Inbrija 11\. \*\*Which Carbidopa/Levodopa formulation is available in an extended-release capsule?\*\* \- A) Rytary \- B) Sinemet CR \- C) Duopa \- D) Parcopa \*\*Answer\*\*: A) Rytary 12\. \*\*What is the most common side effect of long-term Carbidopa/Levodopa therapy?\*\* \- A) Bradykinesia \- B) Dyskinesia \- C) Hypertension \- D) Psychosis \*\*Answer\*\*: B) Dyskinesia \#\#\# Slide 11 - Dopamine Agonists 13\. \*\*What is a major advantage of dopamine agonists over levodopa in Parkinson\'s disease?\*\* \- A) Higher symptomatic benefit \- B) Lower incidence of dyskinesia \- C) Increased acetylcholine activity \- D) Longer duration of action \*\*Answer\*\*: B) Lower incidence of dyskinesia 14\. \*\*Which of the following is a dopamine agonist?\*\* \- A) Selegiline \- B) Pramipexole \- C) Carbidopa \- D) Tolcapone \*\*Answer\*\*: B) Pramipexole 15\. \*\*Dopamine agonists are particularly useful in treating which symptom of Parkinson's?\*\* \- A) Tremors \- B) On-off phenomena \- C) Hyperactivity \- D) Hypertension \*\*Answer\*\*: B) On-off phenomena \#\#\# Slide 12 - MAO-B Inhibitors 16\. \*\*MAO-B inhibitors work by:\*\* \- A) Inhibiting the breakdown of dopamine in the brain \- B) Stimulating dopamine release from neurons \- C) Blocking acetylcholine receptors \- D) Enhancing the release of serotonin \*\*Answer\*\*: A) Inhibiting the breakdown of dopamine in the brain 17\. \*\*Which of the following is a common side effect of MAO-B inhibitors?\*\* \- A) Hypertension \- B) Nausea \- C) Bradycardia \- D) Dyskinesia \*\*Answer\*\*: B) Nausea 18\. \*\*Which MAO-B inhibitor is known to have neuroprotective effects?\*\* \- A) Selegiline \- B) Rasagiline \- C) Pramipexole \- D) Tolcapone \*\*Answer\*\*: B) Rasagiline \#\#\# Slide 13 - COMT Inhibitors 19\. \*\*Which COMT inhibitor is associated with hepatotoxicity?\*\* \- A) Entacapone \- B) Tolcapone \- C) Carbidopa \- D) Selegiline \*\*Answer\*\*: B) Tolcapone 20\. \*\*COMT inhibitors are primarily used to:\*\* \- A) Reduce motor fluctuations \- B) Increase serotonin levels \- C) Block GABA release \- D) Reduce dopamine breakdown in the brain \*\*Answer\*\*: A) Reduce motor fluctuations 21\. \*\*What is a harmless but common side effect of COMT inhibitors?\*\* \- A) Yellowing of the skin \- B) Red-brown discoloration of urine \- C) Hair loss \- D) Increased salivation \*\*Answer\*\*: B) Red-brown discoloration of urine \#\#\# Slide 13 - Carbidopa/Levodopa Side Effects 1\. \*\*Which side effect is commonly associated with long-term use of Carbidopa/Levodopa?\*\* \- A) Bradycardia \- B) Dyskinesia \- C) Hyperactivity \- D) Hypotension \*\*Answer\*\*: B) Dyskinesia 2\. \*\*Which strategy is used to reduce dyskinesia in patients taking Carbidopa/Levodopa?\*\* \- A) Increasing the dose \- B) Adding a dopamine agonist \- C) Stopping the medication immediately \- D) Adding a beta-blocker \*\*Answer\*\*: B) Adding a dopamine agonist 3\. \*\*Carbidopa/Levodopa is contraindicated in patients with which condition?\*\* \- A) Open-angle glaucoma \- B) Closed-angle glaucoma \- C) Hypertension \- D) Depression \*\*Answer\*\*: B) Closed-angle glaucoma \#\#\# Slide 14 - Motor Complications of Levodopa 4\. \*\*What phenomenon is characterized by a sudden loss of Levodopa effectiveness, unrelated to dose timing?\*\* \- A) On-off phenomenon \- B) Wearing-off phenomenon \- C) Tachyphylaxis \- D) Tolerance \*\*Answer\*\*: A) On-off phenomenon 5\. \*\*Which approach may reduce the \"wearing-off\" effect of Levodopa?\*\* \- A) Switching to immediate-release formulation \- B) Increasing the dose frequency \- C) Decreasing the dose frequency \- D) Stopping Levodopa altogether \*\*Answer\*\*: B) Increasing the dose frequency 6\. \*\*What is a potential complication of a \"drug holiday\" with Levodopa?\*\* \- A) Severe immobility \- B) Increased effectiveness \- C) Weight gain \- D) Bradycardia \*\*Answer\*\*: A) Severe immobility \#\#\# Slide 15 - Dopamine Agonists 7\. \*\*Which dopamine agonist can be administered as a transdermal patch for Parkinson's disease?\*\* \- A) Pramipexole \- B) Ropinirole \- C) Rotigotine \- D) Bromocriptine \*\*Answer\*\*: C) Rotigotine 8\. \*\*What is a common side effect of dopamine agonists, particularly Pramipexole and Ropinirole?\*\* \- A) Sedation \- B) Hypertension \- C) Impulse control disorders \- D) Weight gain \*\*Answer\*\*: C) Impulse control disorders 9\. \*\*Dopamine agonists are preferred in early Parkinson's disease due to which of the following?\*\* \- A) They are neuroprotective \- B) They are associated with a lower incidence of motor fluctuations \- C) They work faster than Levodopa \- D) They cause fewer side effects \*\*Answer\*\*: B) They are associated with a lower incidence of motor fluctuations \#\#\# Slide 16 - Dopamine Agonist Side Effects 10\. \*\*Which of the following side effects is common with dopamine agonists like Ropinirole and Pramipexole?\*\* \- A) Nausea and vomiting \- B) Severe hallucinations \- C) Profound bradycardia \- D) Extreme hyperactivity \*\*Answer\*\*: A) Nausea and vomiting 11\. \*\*Which behavior might be seen in patients on dopamine agonists?\*\* \- A) Excessive gambling \- B) Sedation \- C) Weight loss \- D) Decreased libido \*\*Answer\*\*: A) Excessive gambling 12\. \*\*Why should dopamine agonists be used with caution in patients with recent myocardial infarction?\*\* \- A) Increased risk of bradycardia \- B) Risk of arrhythmias \- C) Hypertension \- D) Profound hypotension \*\*Answer\*\*: B) Risk of arrhythmias \#\#\# Slide 17 - MAO-B Inhibitors 13\. \*\*What is the primary mechanism of action of MAO-B inhibitors in Parkinson's disease?\*\* \- A) Enhancing acetylcholine release \- B) Preventing dopamine degradation \- C) Inhibiting glutamate \- D) Increasing serotonin production \*\*Answer\*\*: B) Preventing dopamine degradation 14\. \*\*Which MAO-B inhibitor is associated with fewer cardiovascular side effects?\*\* \- A) Selegiline \- B) Rasagiline \- C) Tolcapone \- D) Entacapone \*\*Answer\*\*: B) Rasagiline 15\. \*\*At high doses, which enzyme does Selegiline begin to inhibit, increasing the risk of hypertension?\*\* \- A) MAO-A \- B) COMT \- C) Acetylcholinesterase \- D) GABA \*\*Answer\*\*: A) MAO-A \#\#\# Slide 18 - COMT Inhibitors 16\. \*\*What is the main benefit of adding COMT inhibitors to a Parkinson\'s treatment regimen?\*\* \- A) Reducing Levodopa side effects \- B) Prolonging the effects of Levodopa \- C) Enhancing dopamine synthesis \- D) Blocking glutamate release \*\*Answer\*\*: B) Prolonging the effects of Levodopa 17\. \*\*Which COMT inhibitor is associated with a higher risk of hepatotoxicity?\*\* \- A) Entacapone \- B) Tolcapone \- C) Rasagiline \- D) Amantadine \*\*Answer\*\*: B) Tolcapone 18\. \*\*What harmless side effect might patients experience when taking Entacapone?\*\* \- A) Reddish-brown urine \- B) Blue-tinted skin \- C) Yellowing of the eyes \- D) Increased saliva production \*\*Answer\*\*: A) Reddish-brown urine