Parkinsonism: Symptoms and Diagnosis! Trivia Knowledge Quiz

1. Peripheral adverse effects of levodopa, including nausea, hypotension, and cardiac arrhythmias, can be diminished by including which of the following drugs in the therapy?

Amantadine

Bromocriptine

Carbidopa

Entacapone

Carbidopa is used in combination with levodopa to enhance its effectiveness and reduce peripheral adverse effects. Carbidopa inhibits the enzyme that breaks down levodopa in the bloodstream, allowing more of it to reach the brain. This reduces the required dose of levodopa, thereby minimizing the occurrence of side effects such as nausea, hypotension, and cardiac arrhythmias. Amantadine and bromocriptine are alternative medications for Parkinson's disease, but they do not specifically address the peripheral adverse effects of levodopa. Entacapone is a COMT inhibitor that prolongs the effects of levodopa but does not directly reduce its adverse effects.

Explanation

Carbidopa is used in combination with levodopa to enhance its effectiveness and reduce peripheral adverse effects. Carbidopa inhibits the enzyme that breaks down levodopa in the bloodstream, allowing more of it to reach the brain. This reduces the required dose of levodopa, thereby minimizing the occurrence of side effects such as nausea, hypotension, and cardiac arrhythmias. Amantadine and bromocriptine are alternative medications for Parkinson's disease, but they do not specifically address the peripheral adverse effects of levodopa. Entacapone is a COMT inhibitor that prolongs the effects of levodopa but does not directly reduce its adverse effects.

2. Concerning the drugs used in parkinsonism. which of the following statements is accurate?

Levodopa causes postural hypotension

Useful therapeutic effects of amantadine continue for several years

The primary therapeutic benefit of antimuscarinic drugs in parkinsonism is their ability to reliever bradykinesia

Dopamine receptor against should not be used in Parkinson's disease prior to a trial of levodopa

Levodopa causes postural hypotension. This means that when taking levodopa, a person may experience a drop in blood pressure upon standing up, leading to dizziness or fainting. This side effect is commonly seen in patients with Parkinson's disease who are treated with levodopa. It is important for healthcare providers to monitor blood pressure and adjust the dosage of levodopa accordingly to minimize the risk of postural hypotension.

Explanation

Levodopa causes postural hypotension. This means that when taking levodopa, a person may experience a drop in blood pressure upon standing up, leading to dizziness or fainting. This side effect is commonly seen in patients with Parkinson's disease who are treated with levodopa. It is important for healthcare providers to monitor blood pressure and adjust the dosage of levodopa accordingly to minimize the risk of postural hypotension.

3. A 51-year-old patient with parkinsonism is being maintained on levodopa-carbidopa with adjunctive use of low doses of Entacapone, but continues to have off-periods of akinesia. The most appropriate drug to rescue the patient is:

Apomorphine

Benztropine

Carbidopa

Selegiline

Selegiline is the most appropriate drug to rescue the patient because it is a selective monoamine oxidase B (MAO-B) inhibitor. MAO-B inhibitors increase the levels of dopamine in the brain by blocking the breakdown of dopamine, thereby enhancing the effects of levodopa-carbidopa therapy. This can help to alleviate off-periods of akinesia in patients with parkinsonism. Apomorphine is a dopamine agonist that can also be used to rescue patients experiencing off-periods, but it is typically used when MAO-B inhibitors are ineffective or not tolerated. Benztropine is an anticholinergic agent that can be used to manage tremors in parkinsonism, but it is not the most appropriate drug for rescuing off-periods. Carbidopa is already being used in combination with levodopa and is not indicated as a rescue medication.

Explanation

Selegiline is the most appropriate drug to rescue the patient because it is a selective monoamine oxidase B (MAO-B) inhibitor. MAO-B inhibitors increase the levels of dopamine in the brain by blocking the breakdown of dopamine, thereby enhancing the effects of levodopa-carbidopa therapy. This can help to alleviate off-periods of akinesia in patients with parkinsonism. Apomorphine is a dopamine agonist that can also be used to rescue patients experiencing off-periods, but it is typically used when MAO-B inhibitors are ineffective or not tolerated. Benztropine is an anticholinergic agent that can be used to manage tremors in parkinsonism, but it is not the most appropriate drug for rescuing off-periods. Carbidopa is already being used in combination with levodopa and is not indicated as a rescue medication.

4. Which of the following anti-Parkinson drugs may cause peripheral vasospasm?

Amantadine

Bromocriptine

Carbidopa

Entacapone

Bromocriptine is an anti-Parkinson drug that may cause peripheral vasospasm. Vasospasm is the narrowing of blood vessels, which can reduce blood flow to certain areas of the body. This side effect of bromocriptine can lead to symptoms such as cold hands and feet, numbness, and pain in the affected areas. It is important for patients taking bromocriptine to be aware of this potential side effect and to report any symptoms to their healthcare provider.

Explanation

Bromocriptine is an anti-Parkinson drug that may cause peripheral vasospasm. Vasospasm is the narrowing of blood vessels, which can reduce blood flow to certain areas of the body. This side effect of bromocriptine can lead to symptoms such as cold hands and feet, numbness, and pain in the affected areas. It is important for patients taking bromocriptine to be aware of this potential side effect and to report any symptoms to their healthcare provider.

5. A patient with parkinsonism is being treated with levodopa. He suffers from irregular, involuntary muscle jerks that affect the proximal muscles of the limbs. Which of the following statements about these symptoms is accurate?

Co-administration of muscarinic blockers prevents the occurrence of dyskinesia during treatment with levodopa

Dyskinesia are less likely to occur if levodopa is administered with carbidopa

Other drugs that activate dopamine receptors can exacerbate dyskinesia in a patient taking levodopa

The symptoms are likely to be alleviated by continued treatment with levodopa

Other drugs that activate dopamine receptors can exacerbate dyskinesia in a patient taking levodopa. This means that if the patient is taking other medications that stimulate dopamine receptors, it can worsen the involuntary muscle jerks that the patient is experiencing. Therefore, caution should be taken when prescribing other drugs that activate dopamine receptors to patients being treated with levodopa for parkinsonism.

Explanation

Other drugs that activate dopamine receptors can exacerbate dyskinesia in a patient taking levodopa. This means that if the patient is taking other medications that stimulate dopamine receptors, it can worsen the involuntary muscle jerks that the patient is experiencing. Therefore, caution should be taken when prescribing other drugs that activate dopamine receptors to patients being treated with levodopa for parkinsonism.

Parkinsonism: Symptoms And Diagnosis! Trivia Knowledge Quiz