Final Pharmacy Exam > Parkinsons > Flashcards

Parkinsons Flashcards

(53 cards)

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1
Q

What is the main thing about dopamine and parkinsons

A

Remember NO DOPE!

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2
Q

What are the risk factors of developing parkinsons

A

head trauma
male
age
neuroleptic meds

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3
Q

What are the motor symptoms associated with parkinsons

A

TRAP

Tremor
Rigidity
Akinesia
Postural Instibility

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4
Q

What are the NON motor symptoms associated with parkinsons

A

Depression
Apathy
Antipsychotics
Dellusion

Sleep disturbances

Excess salivation

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5
Q

What could some differential diagnosis be of parkinsons

A

antipsychotics
antiemetics
lithium

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6
Q

What is one of the MAIN non drug treatments with parkinsons

A

speech and language therapy

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7
Q

What diet advise do we need to advise patients who have parkinsons and any carers

A

protein majority in evening meal and avoid ultra high protein diets

vit d supplementation

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8
Q

What drugs are used to treat parkinsons

A

Levodopa
Levodopa + benseraside
Levodopa + carbidopa

Comt inhibitors
MAOB inhibitors

Dopamine agonists (non ergot derived)
Dopamine agonists (ergot derived)

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9
Q

Why is levodopa often given with either benserazide or carbidopa

A

to prevent the peripheral breakdown body so that it can get to the brain and cross the blood brain barrier.

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10
Q

Name some non ergot derived dopamine agonists

A

pramipexole
ropinirole
rotigotine

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11
Q

Name some ergot derived dopamine agonists

A

Pergolide
Bromocriptine
Cabergoline

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12
Q

Name some COMT inhibitors

Alcapone COMT crime

A

Tolcapone
Entacapone
Opicapone

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13
Q

Name some MAOB inhibitors

MAO the lawn in straight lines

A

Selegiline
Rasagiline
Safinamide

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14
Q

If a patient has motor symptoms of parkinsons that do not affect quality of life what drugs are available to them

A

Levodopa

Non ergot derived dopamine receptor agonists

MAOB inhibitors

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15
Q

If a petient develops dyskinesia despite levodopa what drugs can we offer them

A

Non ergot derived dopamine receptor agonists

MAOB inhibitors

COMT inhibitors as adjunct to levodopa

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16
Q

When might we consider giving an ergot derived dopamine receptor agonist

A

we can use when a patient has dyskinesia and a non ergot derived dopamine receptor agonist is not working

LAST LINE

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17
Q

when giving an ergot derived dopamine receptor agonist with what drug must it always be used as an adjunct to

A

levodopa

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18
Q

when might amantadine be considered

A

patient with dyskinesia that is not responding well to therapy

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19
Q

What is the optimal time to take a levodopa dose

A

1 hour before food or two hours after as it can affect absorption

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20
Q

what are the side effects of levodopa

4 Ds

A

Gi
Drowsy
Dystonia
Dyskinesia
Discoloured urine (brown/red/black)
Postural hypotension

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21
Q

what colour can levodopa combinations turn the urine

A

brown
red
black

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22
Q

in what age group is dyskinesia a more common side effect of levodopa

Study These Flashcards
A

younger patients

23
Q

What is the on off effect

Study These Flashcards
A

when levodopas management stops working often due to irregular levodopa levels

24
Q

what can the on off effect of levodopa be helped by

Study These Flashcards
A

dopamine receptor agonists

25
what is the levodopa contraindicated in
concominant use of mao-b inhibitor Glaucoma (angle - closure)
26
If we are swapping from a levodopa combination to another how long between doses should we wait
12 hours
27
if we are swapping from an immediate release formulation of a levodopa combination to a MR how long we increase the dose interval by
30-50%
28
if we are swapping from an immediate release formulation of co-beneldopa how long must we increase the dose interval by
30%
29
What are non ergot derived dopamine agonists also licensed for aside from parkinsons
restless leg syndrome
30
which of the non ergot derived dopamine agonist has a patch that is applied once daily
rotigotine
31
which non ergot derived dopamine agonist has a increased halflife of 8 - 12 hours in over 65
pramiprexole
32
if a pt is to start on ergot derived dopamine agonists what tests will they have done before starting
esr -> inflammatory marker renal function chest radiograph
33
what side effects can ergot derived dopamine agonists cause
pituitary enlargement vision disturbances gi bleed Hypotension Dyskinesia
34
what alternative indications may ergot derived dopamine agonists be used for
prevention of lactation suppression of lactation prolactinaemia
35
what ergot derived dopamine agonist should not be used in pregnancy
cabergoline
36
how often should someone on cabergoline receive pregnancy tests
every month
37
when do we avoid bromocriptine in pregnancy
if their is hypertensive disorders due to risk of hypertensive crisis same in postnatal
38
What is a risk of all dopamine agonists
risk of binge eating hypersexuality gambling
39
which drug class has a once daily dosing for parkinsons
MAOB inhibitors
40
when should we avoid MAOB inhibitors
Gi ulcers Postural hypotension Tyramine containing foods Antidepressants
41
what foods contain tyramine
aged cheese wine beans yeast products e.g. marmite
42
what antidepressant should be stopped 5 weeks before
fluoxetine
43
what antidepressant should be stopped 2 weeks before
sertraline
44
what is the regular rule of stopping antidepressants before treating a MAOB Inhibitors
1 week
45
what effect does linezolid have on monoamine oxidaze b inhibitors
increases side effects serotonin syndrome
46
if a patient is to start linezolid what should happen to the monoamine oxidaze inhibitor
stopped 14 days before
47
what other medication class is used as an adjunct to levodopa
comt inhibitor
48
what are the side effects of comt inhibitors
orthostatic hypotension hallucination gi sleep disturbances
49
what is the rule on continuing treatment with COMT inhibitors
Continue only if improvement after 3 weeks due to a risk of hepatic dysfunction
50
what colour may comt inhibitors turn your urine tolcapone opicapone entacapone
orrange yellow
51
when do we have to measure the LFTs for a pt on COMT inhibitor
2 weekly for 1 year 4 weekly for 6 months 8 weekly thereafter
52
what drug should be used if vomitting side effects
DOMPERIDONE NOT METOCLOPRAMIDE
53
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