Pharmacology 46 Parkinsons
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| First described by Dr. James Parkinson in 1817 as a "shaking palsy". | Parkinsons Disease (M2/49)
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| Clinical signs and symptoms of PD result when ______% of dopaminergic neurons are lost. | 80% (M2/50)
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| If PD present with postural instability and gait difficult - more _______ progression. | rapid (M2/50)
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| Without dopamine neurons, dopamine can't inhibit cholinergic neurons. Cholinergic neurons form excitatory synapses and no dopamine to inhibit _______ neurons. So unopposed _______, which manifests as tremors. | cholinergic acetycholine (M2/51)
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| Found in patient w PD. Proteins that clump together inside neurons in the midbrain. Unknown whether they damage neurons or if they are result of damaged neurons. | Lewy bodies (M2/51)
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| If Lewy bodies are present, ______ _______ is also present. | neuronal degeneration (M2/51)
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| Does Dopamine cross the blood brain barrier? | No (M2/54)
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| What drug can be given as a dopamine precursor and is a metabolic precursor of dopamine and does cross the blood brain barrier? | Levodopa (M2/55)
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| Levodopa is decarboxylated to dopamine while it's still in the periphery, need larger doses, lot of side effects from dopamine floating around, and ____ years limited use. | 5 years (M2/56)
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| Most common neurodegenerative disorder after Alzheimer's Disease. | Parkinson's Disease 503
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| Damage to neurons by amyloid results in excess _________ & diminished ________ in the basal ganglia in PD. | acetylcholine dopamine 503
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| To improve symptoms of PD, the medications must be able to cross the _____ _____ ______ without being metabolized in the periphery. | blood brain barrier 504 (M2/54)
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| Black box warning from FDA indicates antipsychotics (Seroquel & Abilify) should not be used in PD b/c appear to increase the risk of death in _____ ______ patients. | older dementia 506
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| Used for acute treatment of episodes of immobility known as freezing in PD. | Apomorphine injection 506
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| Reduce tremor, rigidity, and drooling, older drugs with limited use in PD. | Anticholinergices 506
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| What are the initial drugs for the first line of PD? | levodopa, dopamine agonists, rasagiline 506
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| Less likely than levodopa to cause dyskinesias or motor fluctuations, may be given with or before levodopa. | Dopamine agonists 506
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| All PD patients will eventually need _____/______. | carbidopa/levodopa 506
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| Side effects include confusion, blurred vision, dry mouth, constipation, urinary retention, hallucinations, and psychosis | Anticholinergics (M2/63) worse in older adults
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