front 1 Parkinson disease (PD) is a | back 1 neurological disorder |
front 2 PD occurs when | back 2 neurons in the substantia nigra (a part of the brain) die or become impaired |
front 3 The neurons that die or become impaired produce | back 3 the neurotransmitter dopamine which allows smooth, coordinated function and movement of body muscles |
front 4 Pathophysiology of PD | back 4 less dopamine --> less instructions to the brain --> movement problems (TRAP symptoms) |
front 5 Symptoms of PD (TRAP) | back 5 tremor: when resting rigidity: in legs, arms, trunk and face akinesia/bradykinesia: lack of/ slow start in movement postural instability: imbalance, falls |
front 6 What can be used to measure involuntary movements from medications | back 6 The Abnormal Involuntary Movement Scale (AIMS) |
front 7 Dopamine blocking drugs that can worsen PD | back 7 phenothiazines (prochlorperazine), butyrophenones (haloperidol), first and second generations antipsychotics, metoclopramide |
front 8 Psychosis can occur with | back 8 advanced disease or can be due to side effects of drug treatment |
front 9 Preferred antipsychotic for psychosis due to low risk of movement disorders | back 9 quetiapine |
front 10 ______ has a low risk of worsening movement disorders but has a high risk of seizures, agranulocytosis and other serious complications | back 10 clozapine |
front 11 MOA of Nuplazid | back 11 5HT2A/2C receptor inverse agonist (FDA approved to treat hallucinations and delusions in PD) |
front 12 Rapid withdrawal of levodopa or dopamine agonist can lead to a condition called | back 12 neuroleptic malignant syndrome (NMS) |
front 13 Prodrug of dopamine and is the most effective agent | back 13 levodopa |
front 14 Why is carbidopa given with levodopa | back 14 to prevent the peripheral metabolism of levodopa, which would destroy most of the drug before it crosses the blood-brain barrier |
front 15 MOA of carbidopa/levodopa | back 15 levodopa is the precursor of dopamine, carbidopa inhibits dopa decarboxylase enzyme preventing peripheral metabolism of levodopa |
front 16 Brand name of carbidopa/levodopa | back 16 Sinemet |
front 17 if this test is positive, carbidopa/levodopa should be discontinued due to hemolysis risk | back 17 Coombs test |
front 18 Brand name of carbidopa/levodopa ER | back 18 Rytary (can take whole or sprinkle on a small amount of applesauce) |
front 19 Side effects of carbidopa/levodopa | back 19 can cause brown/black/dark discoloring of urine/saliva/sweat, priapism, orthostatis, psychosis, hallucinations, xerostomia |
front 20 How many mg/day of carbidopa is required to inhibit dopa decarboxylase | back 20 70-100 mg/day |
front 21 MOA of COMT inhibitors | back 21 increase the duration of action of levodopa; inhibit the enzyme catechol-O-methyltransferase (COMT) to prevent peripheral conversion of levodopa |
front 22 Which drugs are COMT inhibitors | back 22 entacapone, opicapone, tolcapone |
front 23 Brand name of entacapone | back 23 Comtan |
front 24 Brand name carbidopa/levodopa/entacapone | back 24 Stalevo |
front 25 How many of entacapone is needed with each dose of carbidopa/levodopa | back 25 200 mg PO |
front 26 Brand name of opicapone | back 26 Ongentys |
front 27 Brand name of tolcapone | back 27 Tasmar |
front 28 Drugs thats are dopamine agonist | back 28 pramipexole, ropinirole, rotigotine, apomorphine |
front 29 Brand name for pramipexole | back 29 Mirapex |
front 30 Brand name of ropinirole | back 30 Requip XL |
front 31 Brand name of rotigotine | back 31 Neupro (patch) |
front 32 How to apply neupro (patch) | back 32 apply once daily at the same time each day to the stomach, thigh, hip, side of body, shoulder or upper arm; do not use the same site for at least 14 days |
front 33 Which dopamine agonist is used as a "rescue" movement drug for "off" periods | back 33 apomorphine (injection) |
front 34 MOA of amantadine | back 34 blocks dopamine reuptake into presynaptic neurons and increases dopamine release from presynaptic fibers, primarily used to treat TD associated with peak-dose of carbidopa/levodopa |
front 35 Brand name for amantadine | back 35 Gocovri |
front 36 amantadine can cause | back 36 cutaneous reaction called livedo reticularis (reddish skin mottling) |
front 37 MOA of selective MAO-B inhibitors | back 37 blocks the breakdown of dopamine which increases dopaminergic activity |
front 38 Drugs that are MAO-B inhibitors | back 38 selegiline, rasagiline, safinamide |
front 39 Brand name selegiline | back 39 Emsam |
front 40 Brand name of rasagiline | back 40 Azilect |
front 41 What are centrally acting anticholinergics used for in PD | back 41 tremors |
front 42 MOA of istradefylline | back 42 adenosine receptor antagonist |
front 43 Brand name istradefylline | back 43 Nourianz |
front 44 alpha/beta agonist that is used for neurogenic orthostatic hypotension | back 44 droxidopa |
front 45 Brand name for droxidopa | back 45 Northera |
front 46 While taking MAO-B inhibitors, what foods should you avoid | back 46 foods high in tyramine, including aged or matured cheese, air-dried or cured meats, sauerkraut, fava |