1what is the primary cause of parkinsons
degeneration of dopaminergic neurons in substantia nigra
2pts with parkinsons have to much _____ influence
AcH
3T/F
dopamine can cross the BBB
falsssseeeeeee
4what needs to be dosed with dopamine to cross BBB
levodopa
5What does carbidopa do?
inhibits dopa decarboxylase
prevents premature conversion
6Oral administration of dopamine is NOT effective in the treatment of Parkinson disease because dopamine is
unable to pass from the blood stream into the brain
7t/f
L-DOPA will cross BBB and be converted to dopamine
trueeee
8what are the side effects of L-Dopa?
GI irritation, hypotension, Psychotropic, behavioral effects, dyskinesia, freezing of gait
9what is caused by a decreased response of Ldopa towards the end of their dose cycle?
end of dose akinesia
10what type of ldopa is used to treat the "off" or freezing episodes
inhaled L-Dopa
11after ____ years of L-DOPA Benefits may be lost, or dyskinesias become intolerable
4 to 5
12t/f
L-DOPA is effective in treating Parkinson disease because it crosses the BBB where it is them converted to dopamine
true
13t/f
Common side effects of L-DOPA include GI irritation, hypotension, hallucinations, behavioral effects, dyskinesias, and freezing of gait
true
14t/f
Patients may experience good effects from L-DOPA initially, but fluctuations in response and eventual loss of effects can occur after several years
true
15What do COMT inhibitors do?
protects LDOPA in the body allowing it to reach the brain
(inhibits breakdown of dopamine by catechol-o-methyltransferase. When carbidopa is given to inhibit decarboxylase, COMT production is increased to compensate. So COMT inhibitors are useful along with CD/LD.)
16What do anticholinergics do?
Decrease acetylcholine influence
may help ↓ rigidity and tremor
17what do MAO-B inhibitors
Inhibit monoamine oxidase type B (MAO-B)
prolong dopamine effects in brain
18what does Amantadine (Symmetrel) do?
Antiviral agent... antiparkinson effects discovered by chance
↓'d chance of dyskinesias
Blocks NMDA receptor in brain... decreases influence of excitatory amino acids (glutamate)
19what is the optimal treatment time for therapy and pts taking parkinson meds?
30-60 minutes AFTER
20Although the cause of PD is not known, free-radicals might be the cause of damage to substantia nigra neurons, and anti-oxidant therapies might ultimately be discovered that delay or prevent this condition
cool