What are the 3 cardinal signs used for diagnosing Parkinson’s disease?
- Tremor at rest (pill-rolling)- stop with movement
- Cogwheel rigidity
- Bradykinesia
Diagnosis is made with 2 out of 3 signs present.
What does tremor at rest indicate in Parkinson’s disease?
First sign of disease
The tremor subsides with movement.
Define cogwheel rigidity in the context of Parkinson’s disease.
short, shuffling gait (stiffness)
What is bradykinesia?
Slow movement, patients may ‘freeze’
It is one of the cardinal signs of Parkinson’s disease.
What does ON/OFF refer to in Parkinson’s medication management?
- ON: Meds are working (movement)
- OFF: Meds aren’t working (no movement)
This indicates the effectiveness of medication at any given time.
How does levodopa interact with protein?
Competes with protein, not with meals
This is important for timing medication with food intake.
What is Sinemet?
Levodopa-carbidopa (1st line treatment)
It is a common medication used in the treatment of Parkinson’s disease.
List some add-on medications for Parkinson’s disease. -4
- Ropinirole
- Rasagiline
- COMT inhibitors
- Amantadine
These medications can be used alongside levodopa.
What is the purpose of PEG-j in Parkinson’s treatment?
Consistent medication and bypass stomach
It helps manage dysphagia and medication absorption.
What does DBS stand for in Parkinson’s treatment?
Deep Brain Stimulation
It is a surgical option for managing symptoms.
What are some symptoms associated with Parkinson’s disease? -7
- Pain (morning cramping)
- Orthostatic hypotension
- Depression/Anxiety
- Impaired cognition
- Dysphagia
- Sialorrhea
- Gastroparesis
These symptoms can significantly affect quality of life.
What are the red flags indicating end-of-life (EOL) concerns in Parkinson’s patients? -5
- Swallowing problems
- First aspiration pneumonia
- Recurrent infections
- Regular falls
- Impaired cognition
These signs may indicate a decline in health status.
what is very important regarding med admin in PD
no delays! -timely
Prevent freeze
auditory/visual stimuli
must keep moving
what meds to avoid with PD -5
TCA- late stage
metoclopramide
risperidone
haloperidol
anticholinergics (when ↓cognition)
how to treat Pain in PD-3
Tylenol, baclofen, Botox
triggers for orthostatic hypotension in PD -3
heat, large meal, alcohol
how to treat orthostatic hypotension in PD (pharm and non)
avoid triggers,
domperidone, midodrine
how to treat depression in PD-3
often masked
SSRI, TCA in early stages
how to treat anxiety in PD
SSRI
signs of impaired cognition in PD-3 (psych)
psychosis to dementia, visual hallucinations, paranoia
how to treat cognition in PD -2
rivastigmine, quetiapine
how to treat GI issues in PD -2
Dysphagia- peg feedings
Gastroparesis - domperidone
