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Antiparkinsons Drugs


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What are 2 factors that help decide which drugs to use for Parkinson's patients?
1)severity of disease
2)ability to tolerate side effects
In Parkinson's, what happens to dopamine and cholinergic levels in the body?
There is decreased dopaminergic activity and increased cholinergic activity.
what are 3 therapeutic strategies for treating Parkinson's?
1) increase dopamine concentration and receptor activity
2) inhibit the metabolism/breakdown of dopamine
3) anticholinergic drugs (reduce cholingergic activity, as an adjunctive therapy
In Parkinson's, can use of drugs eliminate or cure the disease?
NO! drugs can reduce symptoms and improve condition, but cannot fix the problem
what is the name of the drug used in PK that is a metabolic precursor of dopamine?
what drug used in PK is a dopamine agonist?
bromocriptine (parlodel)
what drug for PK inhibits metabolism of dopamine?
selegiline (eldepryl)
what drug used in PK is an anticholinergic?
benztropine (cogentin)
an example of a monoamine oxidase inhibitor is:
what should you know about benztropine?
-used as an adjunct drug in Parkinsons and in drug induced extra-pyramidal disorders (as caused by antipsychotics)
-alleviate tremors and rigidity
-causes mood changes, dry mouth, blurred vision, constipation, and urinary retention
what should you know about selegiline?
(effects, uses)
-used as adjunct therapy with levodopa/carbidopa
-use for slow progression of disease
-causes nausea, dizziness, lightheadedness, abdom. pain, dry mouth, headache, vivid dreams and hallucinations
what should you know about bromocriptine (effects)?
-used with Levodopa
-no effect on pts. who do not respond ot levodopa
-similar side effects to levodopa, except lesson common dyskinesia
-causes hallucinations, confusion, delirium, nausea, ortho. hypotension
what are the main effects (therapeutic and side) for levodopa?
-decrease rigidity and tremors
-tolerance from long term use
-on-off phenomenon
-psychological disorders
-nausea, vomiting, anorexia, tachycardia, post. hypotension
what is carbidopa used in conjunction with?
it is used with levodopa, it inhibits the metabolism of levodopa in the GI tract and peripheral tissues
as OTs, what should we think about with PK pts.?
-work on gait training and balance activities
-help pt. keep function to eliminate need for more drugs
-maintain joint ROM and cardio fitness during drug holidays
Which drug for PK might a pt. take a drug holiday?
Levodopa, because tolerance can develop with long term use
bradykinesia, postural/gait abnormalities, tremors, and muscular rigidity

These are characteristics of what?
Parkinson's Disease
Which is not a sign of Parkinson's?
-impaired speech
-cognitive delays
-shuffling gait
-blank facial expression
-inability to perform skilled tasks
cognitive delays

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