1. How do you manage Parkinson’s disease in early stages?
Answer: Dopamine agonists or MAO-B inhibitors are commonly used in early Parkinson’s disease.
Explanation: Early treatment aims to control symptoms while delaying long-term complications associated with levodopa therapy,
such as dyskinesias.
2. What is the most effective therapy for Parkinson’s disease?
Answer: Levodopa combined with carbidopa.
Explanation: Levodopa converts to dopamine in the brain and is the most effective medication for improving bradykinesia and
rigidity. Carbidopa reduces peripheral breakdown and side effects.
3. What medications are used to treat off-times including wearing-off experiences?
Answer: COMT inhibitors (entacapone), MAO-B inhibitors (selegiline, rasagiline), dopamine agonists, and inhaled levodopa or
apomorphine.
Explanation: These medications prolong dopamine action or provide rapid symptom relief when levodopa effects fade before the
next dose.
4. Adverse effects of pramipexole?
Answer: Nausea, dizziness, hallucinations, daytime sleepiness, orthostatic hypotension, and impulse-control disorders.
Explanation: Pramipexole is a dopamine agonist, and excess dopaminergic stimulation can affect both movement and behavior.
5. Which medication is the safest choice for someone on oral contraceptives?
Answer: Levetiracetam.
Explanation: Levetiracetam has minimal drug interactions and does not significantly reduce oral contraceptive effectiveness.
6. What is the purpose and timing of serum drug levels?
Answer: Serum drug levels monitor therapeutic range and toxicity; levels are usually drawn at trough time just before the next dose.
Explanation: Measuring trough levels helps ensure adequate medication concentration while minimizing adverse effects.
7. Phenytoin drug interactions?
Answer: Phenytoin is a strong CYP450 inducer that decreases effectiveness of oral contraceptives, warfarin, and many other drugs.
Explanation: Increased liver enzyme activity speeds up metabolism of many medications.
8. What can happen when you take phenytoin and oxcarbazepine together?
Answer: Increased toxicity or altered drug levels may occur.
Explanation: Both medications affect hepatic enzymes, leading to unpredictable serum concentrations and increased CNS side
effects.
9. What is first-line therapy for migraines and headaches?
Answer: NSAIDs and acetaminophen for mild-to-moderate migraines; triptans for moderate-to-severe migraines.
Explanation: Initial therapy depends on symptom severity and patient response.
Answer: Dopamine agonists or MAO-B inhibitors are commonly used in early Parkinson’s disease.
Explanation: Early treatment aims to control symptoms while delaying long-term complications associated with levodopa therapy,
such as dyskinesias.
2. What is the most effective therapy for Parkinson’s disease?
Answer: Levodopa combined with carbidopa.
Explanation: Levodopa converts to dopamine in the brain and is the most effective medication for improving bradykinesia and
rigidity. Carbidopa reduces peripheral breakdown and side effects.
3. What medications are used to treat off-times including wearing-off experiences?
Answer: COMT inhibitors (entacapone), MAO-B inhibitors (selegiline, rasagiline), dopamine agonists, and inhaled levodopa or
apomorphine.
Explanation: These medications prolong dopamine action or provide rapid symptom relief when levodopa effects fade before the
next dose.
4. Adverse effects of pramipexole?
Answer: Nausea, dizziness, hallucinations, daytime sleepiness, orthostatic hypotension, and impulse-control disorders.
Explanation: Pramipexole is a dopamine agonist, and excess dopaminergic stimulation can affect both movement and behavior.
5. Which medication is the safest choice for someone on oral contraceptives?
Answer: Levetiracetam.
Explanation: Levetiracetam has minimal drug interactions and does not significantly reduce oral contraceptive effectiveness.
6. What is the purpose and timing of serum drug levels?
Answer: Serum drug levels monitor therapeutic range and toxicity; levels are usually drawn at trough time just before the next dose.
Explanation: Measuring trough levels helps ensure adequate medication concentration while minimizing adverse effects.
7. Phenytoin drug interactions?
Answer: Phenytoin is a strong CYP450 inducer that decreases effectiveness of oral contraceptives, warfarin, and many other drugs.
Explanation: Increased liver enzyme activity speeds up metabolism of many medications.
8. What can happen when you take phenytoin and oxcarbazepine together?
Answer: Increased toxicity or altered drug levels may occur.
Explanation: Both medications affect hepatic enzymes, leading to unpredictable serum concentrations and increased CNS side
effects.
9. What is first-line therapy for migraines and headaches?
Answer: NSAIDs and acetaminophen for mild-to-moderate migraines; triptans for moderate-to-severe migraines.
Explanation: Initial therapy depends on symptom severity and patient response.
