11th Edition By Jacqueline Burchum; Laura Rosenthal
true of false: we understand with precision how CNS drugs produce their effects -
ANSWER: false
the ______ can protect the CNS from toxic substances, but can also block entry of
medications into the CNS - ANSWER: blood brain barrier
the CNS often goes through _____ changes during prolonged drug exposure. The
result can be _____ therapeutic effects, ______ side effects, ______, and physical
_______ - ANSWER: adaptive, increased, decreased, tolerance, dependence
Parkinson's Disease is a neurodegenerative disorder that produces characteristic
motor symptoms: tremor at rest, _______, postural _______, and ______ - ANSWER:
rigidity, instability, and bradykinesia
In addition to motor symptoms, PD can cause nonmotor symptoms, including
autonomic dysfunction, sleep disturbances, ________, psychosis, and ______ -
ANSWER: depression and dementia
the primary pathology in PD is..... - ANSWER: degeneration of neurons in the
substantia nigra that supply dopaime to the striatium
the result of PD is.... - ANSWER: imbalance between dopamine and ACh
motor symptoms of PD are primarily treated with drugs that.... - ANSWER: directly or
indirectly activate dopamine receptors, but drugs that block cholinergic receptors
can also be used
what drug is the most effective drug for treatment of motor symptoms of
parkinson's disease? - ANSWER: levodopa (combined with carbidopa)
levodopa relieves motor symptoms by undergoing conversion to ______ in surviving
nerve terminals in the ______ - ANSWER: dopamine and striatum
the enzyme that converts levodopa to dopamine is called a______ - ANSWER:
decarboxylase
acute loss of response to levodopa occurs in two patterns: - ANSWER: gradual
wearing off- which develops at the end of the dosing interval AND abrupt loss of
effect ("on-off" phenomenon) that can occur at any time during the dosing interval
, the principal adverse effects of levodopa are.... - ANSWER: nausea, dyskinesias,
hypotension, and psychosis
first generation antipsychotic drugs effect on levodopa - ANSWER: block doapmine
receptors in the striatum and can thereby negate the effects of levodopa
second generation antipsychotic drugs effect on levodopa - ANSWER: clozapine and
quetiapine do not block dopamine receptors in the striatum, and hence can be used
safely to treat levodopa-induced psychosis
combining levodopa with a nonselective _______ can result in a hypertensive crisis -
ANSWER: MAO inhibiter
because _____ compete with levodopa from absorption from the intestine and for
transport across the BBB, _____ meals can reduce therapeutic effects - ANSWER:
amino acids, high protein
carbidopa enhances the effects of levodopa by preventing.... - ANSWER:
decarboxylation of levodopa in the intestine and peripheral tissues
Can carbidopa cross the BBB? - ANSWER: no! this is why it does not prevent the
conversion of levodopa to dopamine in the brain
pramipexole is a _________ for motor symptoms. It can be used ____ in early PD or
______ in advanced PD - ANSWER: first line drug, alone, combined with levodopa
pramipexole and other dopamine agonists relieve motor symptoms by causing
_______ of dopamine receptors in the striatum - ANSWER: direct activation
the major adverse effects of pramipexole are..... and they result from excessive
activation of dopamine receptors - ANSWER: nausea
dyskinesia (when combined with levodopa)
postural hypotension (when combined with levodopa)
hallucinations
entacapone, a COMT inhibitor, is combined with levodopa to ______ levodopa's
effect. the drugs ______ the metabolism of levodopa by COMT in the ______ and
______, thereby making ____ levodopa available to the brain - ANSWER: enhance,
inhibits, peripheral tissues and intestine, more
selegiline enhances responses to levodopa by __________, the brain enzyme that
inactivated dopamine - ANSWER: inhibiting MAO-B
anticholinergic drugs can do what for PD patients? - ANSWER: relieve symptoms by
blocking cholinergic receptors in the striatum