Parkinson's disease

Card Set Information

Author:
timothy.pdlt
ID:
212364
Filename:
Parkinson's disease
Updated:
2013-04-09 05:12:01
Tags:
PD
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Description:
therapeutics, side-effects, drug interaction
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  1. GoT of PD Tx
    • minimize s/s
    • maintain QoL
    • prolong survival
  2. Cardinal S/S of PD
    • coarse tremor
    • cogwheel rigidity (jerky resistance to passive movement)
    • bradykinesia
    • postural changes (usually later)
  3. Non-motor complications of PD and management
  4. S/E of DA Tx (LDOPA/carbidopa 100mg/25mg TID)
    • confusion
    • hallucination
    • N/V
    • orthostatic hypotension
    • red urine
  5. Motor fluctuations with long-term Tx (3-5years)
    • 1. wearing-off effect: breakthrough s/s near the end of dose interval
    • 2. peak dose dyskinesia: involuntary movements after dose
    • 3. on-off phenomenon: random breakthrough s/s (not related to dose timing)
  6. Management of LDOPA motor complications
  7. Strategies to delay LDOPA Tx
    • 1. selegiline (selective irreversible MAO-B inhibitor): delays need for LDOPA, doesn't increase mortality
    • 2. rasagiline (irreversible MAO-B>>MAO-A) inhibitor: improves s/s and slow progression
    • 3. DA agonist:
    • a. ropinirole: decreased dyskinesia complications when given as initial Tx
    • b. pramipexole: decreased dyskinesia complications when given as initial Tx
  8. S/E of selegiline/rassagiline
    • hallucinations
    • insomnia
    • somnolence
    • parethesia
    • N/V
    • edema
  9. S/E of DA agonist (esp. pramipexole)
    • more hallucinations
    • more somnolence
    • more edema

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