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Parkinson's Disease - Coggle Diagram

- - - - Head injury: Traumatic brain injury has been associated with an increased risk of developing PD.
      - Area of Resistance: There are differences in the geographic distribution of PD. This could be due to the differences in environmental factors and genetic risk factors.
      - Exposure to Metals: Occupational exposures to various metals have been related to the development of PD.
      - Solvents and Polychlorinated Biphenyls (PCBs): Trichloroethylene (TCE) is a solvent used in many industries. It the most common organic contaminant in groundwater. Exposure to TCE is associated with PD among workers whose factory jobs have caused long-term exposure. PCBs have been found in high concentration in the brains of people who had PD.
      - Pesticides and Herbicides: These have been shown to have a strong link with PD. One herbicide, paraquat, has been linked to PD and is a common herbicide used in the U.S. However, this herbicide is banned in 32 other countries.
- - - - Carbidopa/Levodopa (Sinemet) remains the most effective therapy and is available in many different strengths and formulas. It can also be used with other classes of medications including Dopamine Agonists, COMT Inhibitors, MAO Inhibitors, and Anticholinergic agents.
      - Carbidopa/Levodopa are a combination of medications given to the patient. Carbidopa is added to levodopa which prevents levodopa from being converted into dopamine in the bloodstream. This allows more of the medication to get to the brain where it can help increase the dopamine levels.
      - Carbidopa/Levodopa works best when taken on an empty stomach because it does NOT absorb well with protein. However, If the patient is experiencing GI side effect, it can be taken with food.
        Adverse Effects: Confusion, involuntary movements, GI distress, hypotension, and cardiac dysrhythmias.
        As Parkinson's disease progresses, patient's nerve terminals start to lose function which inhibits the effect of Levodopa. Levodopa usually only works for about 5-10 years before it leaves the patient severely debilitated.
    - - Ergot Derivitaves: Bromocriptine (Parlodel) This drug activates presynaptic dopamine receptors to stimulate the production of more dopamine. Patients with peripheral vascular disease are cautioned when using this drug.
        Adverse Reactions: GI upset, dyskinesia, sleep disturbances
        Drug interactions: Erythromycin and adrenergic drugs
      - Nonergot Derlvatives: Pramipexole (Mirapex) This drug works by acting as a dopamine agonist to directly stimulate nerves in the brain that lacking in dopamine stimulation with the effects of Parkinson's.
        This drug has more specific antiparkinson effects with fewer adverse effects. Having fewer adverse effects is very beneficial for patients. In addition, this drug may delay the need for the use of Levodopa.