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Parkinson's disease
- neurodegenerative disease affecting muscle control and coordination
- develops gradually - barely noticeable tremor in one hand
- tremor is prominent feature, however disorder also causes a slowing or freezing of movement
- due to loss of the neurotransmitter dopamine in substantia nigra dopaminergic neurons
- occurs around age 45 and affects men more than women
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Cause of Parkinson's disease
unknown but may include environmental factors or heredity
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Symptoms of Parkinson's disease
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Treatment of Parkinson's disease
- dopaminergic medications - Levadopamine (L-dopa)
- dopamine agonists - Pramipexole or ropinirole
- monoamine oxidase B (MAO-B) inhibitors - Selegiline or rasagiline
- anticholinergics (muscarinic receptor antagonists) - Benzotropine or trihexyphenidyl
- benzotropine or trihexyphenidyl
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Levadomaine (L-dopa) in Parkinson's
- dopaminergic
- effective, naturally occurring substance found in body
- converted in the brain to dopamine
- given with carbidopa to protect levodopa from premature conversion to dopamine outside the brain and to minimize nausea
- becomes less effective, tendency of disease to wax and wane
- side effects include dyskinesia and orthostatic hypotension
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Pramipexole or ropinirole
- dopamine agonists
- activates dopamine receptors
- side effects include hallucinations, orthostatic hypotension, hypersomnia, increased compulsive behaviors and water retention
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Selegiline or rasagiline
- monoamine oxidase B inhibitors (MAO-B)
- prevent breakdown of naturally occurring dopamine and dopamine coverted from L-dopa
- side effects include confusion, headache, hallucination, dizziness, hypertensive crisis
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Benzotropine or trihexyphenidyl
- anticholingergics (muscarinic receptor antagonists)
- used to control tremore associated with Parkinson's disease
- side effects include impaired memory, confusion, constipation, dry mouth and eyes and impaired urination
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Essential tremor
- involuntary shaking movement
- small, rapid movements - more than 5/sec affecting hands, arms, head, eyelids or other muscle
- confused with Parkinson's
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Causes of essential tremor
- cerebellar damage
- age-related
- neurological disorders
- heredity
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Treatment of essential tremor
- beta-adrenergic receptor antagonists
- anxiolytics
- botulinum toxin type A injections (Botox)
- anticonvulsants or anti-seizure medications
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Huntington's disease (chorea)
- progressive neurodegenerative disease causing dementia and abnormal muscle activity
- autosomal dominant hereditary trait caused by a defect on chromosome 4 that leads to excess dopamine production, acetylcholine insufficiency and loss of gamma-aminobutyric acid (inhibitor neurotransmitter)
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Physical disabilities with Huntington's disease
- speech loss
- difficulty in swallowing
- involuntary jerky movements
- twisting motions
- muscle spasms
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Personality changes in Huntington's disease
- carelessness
- poor judgment
- impaired memory
- mental incompentence
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Treatment of Huntington's disease
- dopamine receptor antagonists - Haloperidol or phenothiazine
- side effects include lethargy, parkinsonism (dose increase until intolerable or undesierable adverse effects occur)
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