Question 1

Neuroleptic drug-induced Parkinsonian symptoms are often treated with:&#10;A) an antimuscarinic agent.&#10;B) a serotonin receptor agonist.&#10;C) an antiemetic agent.&#10;D) an increase in neuroleptic dose.

Accepted Answer

Neuroleptic drug-induced Parkinsonian symptoms result from dopamine depletion caused by dopamine receptor blockade. Antimuscarinic agents, such as benztropine or trihexyphenidyl, target the cholinergic system and can improve the symptoms by rebalancing the dopamine-acetylcholine ratio in the brain. Serotonin receptor agonists and antiemetic agents are not typically used to treat Parkinsonian symptoms. Increasing the neuroleptic dose would worsen the symptoms by further depleting dopamine levels.

Question 2

Mr Penson was being treated with drugs for Parkinson's disease and noted an increase in his libido.What drug may have caused this?&#10;A) The dopamine precursor, levodopa&#10;B) The antimuscarinic, benzhexol&#10;C) Amantadine&#10;D) The MAO-B inhibitor, selegiline

Accepted Answer

Levodopa is converted into dopamine in the brain, which is associated with reward and pleasure. Increased libido can be a possible side effect of levodopa treatment, possibly due to its effect on dopamine in the brain. The other drugs listed are not typically associated with increased libido as a side effect.

Question 3

Excessive glutamine repeats in the protein coded by the HTT gene is associated with:&#10;A) motor neurone disease.&#10;B) multiple sclerosis.&#10;C) Huntington's disease.&#10;D) Alzheimer's disease.

Accepted Answer

Excessive glutamine repeats in the protein coded by the HTT gene is associated with Huntington's disease. Parkinson's disease is associated with the death of dopamine-producing neurons in the substantia nigra region of the brain. Multiple sclerosis is a demyelinating disease that affects the central nervous system. Alzheimer's disease is characterized by the accumulation of beta-amyloid protein and tau protein in the brain, leading to neurodegeneration.

Question 4

Which of the following is not an appropriate clinical management activity in relation to tetrabenazine therapy for Huntington's disease?&#10;A) The client should avoid drinking alcohol with tetrabenazine.&#10;B) Therapy is stopped if dysphagia or choking occurs.&#10;C) If depression occurs, the dose of tetrabenazine is reduced or treatment is stopped.&#10;D) The dose of tetrabenazine is reduced gradually over two days to prevent rebound involuntary movements.

Accepted Answer

Tetrabenazine requires a gradual dose reduction over a longer period than just two days to prevent rebound involuntary movements or worsening of symptoms. A sudden stop or too rapid decrease in dose can lead to complications, hence the recommendation is for a more extended tapering period than just two days.

Question 5

Alzheimer's disease is characterised by the lack of which neurotransmitter in the higher centres of the brain?&#10;A) Noradrenaline&#10;B) Acetylcholine&#10;C) Dopamine&#10;D) Serotonin

Accepted Answer

Acetylcholine is the neurotransmitter that is lacking in the higher centres of the brain in Alzheimer's disease. This deficiency is caused by the degeneration of the cholinergic neurons in the basal forebrain.

Question 6

Which one of the following drugs is NOT used in the management of multiple sclerosis to modify the immune response?&#10;A) Baclofen&#10;B) Glatiramer&#10;C) Prednisone&#10;D) Interferon ?

Accepted Answer

Baclofen is a muscle relaxant used to treat spasticity in multiple sclerosis, but it does not modify the immune response. The other options (B, C, D) are all drugs used in the management of multiple sclerosis to modify the immune response.

Question 7

What is the rationale for giving levodopa and carbidopa as combination therapy for Parkinson's disease?&#10;A) Levodopa increases the therapeutic effect of carbidopa.&#10;B) Carbidopa inhibits the breakdown of levodopa, increasing distribution to the central nervous system.&#10;C) Both preparations are required to increase the availability of dopamine in the peripheries.&#10;D) Levodopa increases the half-life of carbidopa.

Accepted Answer

Carbidopa inhibits the breakdown of levodopa by peripheral aromatic L-amino acid decarboxylase, increasing the amount of levodopa that reaches the brain, where it is converted to dopamine, the missing neurotransmitter in Parkinson's disease. This combination therapy reduces levodopa's side effects and improves its clinical effectiveness.

Question 8

To ensure a uniform concentration of levodopa,the dose should be taken:&#10;A) with milk.&#10;B) before exercise.&#10;C) immediately before breakfast and one hour after the evening meal.&#10;D) at the same time each day and in a consistent manner in relation to food.

Accepted Answer

Taking levodopa at the same time each day and in a consistent manner in relation to food helps to ensure a steady concentration of the drug in the body, which can improve its effectiveness in treating symptoms of Parkinson's disease. Additionally, taking levodopa with food, particularly with high-protein foods, can decrease its absorption, leading to fluctuations in drug concentration and potential worsening of symptoms. Therefore, it is recommended to take levodopa on an empty stomach or with a light meal to optimize its absorption and therapeutic benefits.

Question 9

Parkinson's disease is a defect in the function of which transmitter system in the basal ganglia?&#10;A) Noradrenaline&#10;B) Acetylcholine&#10;C) Dopamine&#10;D) Serotonin

Accepted Answer

Parkinson's disease is a neurodegenerative disorder that affects the dopaminergic system in the basal ganglia, leading to motor deficits such as tremors, rigidity, and bradykinesia. The loss of dopamine-producing neurons in the substantia nigra is a hallmark characteristic of the disease.

Question 10

How does donepezil work to improve the symptoms associated with Alzheimer's disease?&#10;A) It induces sedation that reduces agitation in sufferers and allows recovery time for the brain, which in turn improves memory.&#10;B) It stimulates the release of the neurotransmitter acetylcholine into synapses.&#10;C) It blocks the release of the neurotransmitter dopamine to improve the balance between dopamine and acetylcholine.&#10;D) It blocks the enzyme that degrades acetylcholine, which increases the availability and prolongs the action of the neurotransmitter.

Accepted Answer

Donepezil blocks the enzyme acetylcholinesterase, which degrades acetylcholine, leading to increased availability and prolonged action of the neurotransmitter. This helps to improve cognitive function and memory in people with Alzheimer's disease.

Deck 36: Medicines Used in Neurodegenerative Disorders