Parkinson's disease - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2020-11-14T13:45:01Z

Differential Diagnosis

← Revisión anterior		Revisión del 13:45 14 nov 2020
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Dementia DDX}}		{{Dementia DDX}}
			{{Movement disorder DDX}}

	==Evaluation==		==Evaluation==

ClaireLewis at 04:25, 3 October 2019

2019-10-03T04:25:57Z

← Revisión anterior		Revisión del 04:25 3 oct 2019
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	==Clinical Features==		==Clinical Features==
	===TRAP mnemonic===		===TRAP mnemonic===
	*'''T'''remor (resting)		*[[tremor\|'''T'''remor]] (resting)
	**Initially is unilateral tremor of upper extremity, especially finger and thumb ("pill rolling")		**Initially is unilateral tremor of upper extremity, especially finger and thumb ("pill rolling")
	**Dissipates when intentional movement is performed		**Dissipates when intentional movement is performed
Línea 28:		Línea 28:

	==Management==		==Management==
			''Initiation of or modifications in medications should be made in conjunction with neurologist''
	*Dopamine agonists		*Dopamine agonists
	**[[Levodopa]] and [[carbidopa]] (peripheral decarboxylase inhibitor) = gold standard		**[[Levodopa]] and [[carbidopa]] (peripheral decarboxylase inhibitor) = gold standard
	**[[Pramipexole]] (Mirapex)		**[[Pramipexole]] (Mirapex)
	**Ropinirole (Requip)		**Ropinirole (Requip)
	*~~Anticholenergics~~		*[[Anticholinergics]]
	**[[Benztropine]] - caution in acute psychosis		**[[Benztropine]] - caution in acute psychosis
	*Monoamine oxidase inhibitor - blocks DA reuptake		*Monoamine oxidase inhibitor - blocks DA reuptake
	**Selegiline (Eldepryl)		**Selegiline (Eldepryl)
	**Rasagiline (Azilect)		**Rasagiline (Azilect)
	*Agents for psychotic symptoms, hallucinations		*Agents for [[psychosis\|psychotic symptoms]], [[hallucinations]]
	**Pimavanserin (Nuplazaid) - serotonin inverse agonist (not anti-dopamine), FDA approved in 2016<ref>FDA approves first drug to treat hallucinations and delusions associated with Parkinson’s disease. April 29, 2016. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm498442.htm.</ref>		**Pimavanserin (Nuplazaid) - serotonin inverse agonist (not anti-dopamine), FDA approved in 2016<ref>FDA approves first drug to treat hallucinations and delusions associated with Parkinson’s disease. April 29, 2016. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm498442.htm.</ref>
	**Avoid antidopaminergic drugs if possible (expect worsening motor symptoms), but commonly used agents:		**Avoid antidopaminergic drugs if possible (expect worsening motor symptoms), but commonly used agents:

Rossdonaldson1: /* Management */

2019-05-17T02:41:29Z

Management

← Revisión anterior		Revisión del 02:41 17 may 2019
Línea 29:		Línea 29:
	==Management==		==Management==
	*Dopamine agonists		*Dopamine agonists
	**Levodopa and ~~Carbidopa~~ (peripheral decarboxylase inhibitor) = gold standard		**[[Levodopa]] and [[carbidopa]] (peripheral decarboxylase inhibitor) = gold standard
	**[[Pramipexole]] (Mirapex)~~<br>ropinirole~~ (Requip)		**[[Pramipexole]] (Mirapex)
			**Ropinirole (Requip)
	*Anticholenergics		*Anticholenergics
	**[[Benztropine]] - caution in acute psychosis		**[[Benztropine]] - caution in acute psychosis
Línea 43:		Línea 44:
	**Others:		**Others:
	***Rivastigmine		***Rivastigmine
	***Citalopram in depressed patients		***[[Citalopram]] in depressed patients

	==Disposition==		==Disposition==

Jonwarren: /* Management */

2019-04-25T05:22:22Z

Management

← Revisión anterior		Revisión del 05:22 25 abr 2019
Línea 30:		Línea 30:
	*Dopamine agonists		*Dopamine agonists
	**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard		**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard
	**~~pramipexole~~ (Mirapex)<br>ropinirole (Requip)		**[[Pramipexole]] (Mirapex)<br>ropinirole (Requip)
	*Anticholenergics		*Anticholenergics
	**[[Benztropine]] - caution in acute psychosis		**[[Benztropine]] - caution in acute psychosis

ClaireLewis: /* Management */

2016-09-25T17:02:27Z

Management

← Revisión anterior		Revisión del 17:02 25 sep 2016
Línea 32:		Línea 32:
	**pramipexole (Mirapex)<br>ropinirole (Requip)		**pramipexole (Mirapex)<br>ropinirole (Requip)
	*Anticholenergics		*Anticholenergics
	**Benztropine - caution in acute psychosis		**[[Benztropine]] - caution in acute psychosis
	*Monoamine oxidase inhibitor - blocks DA reuptake		*Monoamine oxidase inhibitor - blocks DA reuptake
	**Selegiline (Eldepryl)		**Selegiline (Eldepryl)
Línea 39:		Línea 39:
	**Pimavanserin (Nuplazaid) - serotonin inverse agonist (not anti-dopamine), FDA approved in 2016<ref>FDA approves first drug to treat hallucinations and delusions associated with Parkinson’s disease. April 29, 2016. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm498442.htm.</ref>		**Pimavanserin (Nuplazaid) - serotonin inverse agonist (not anti-dopamine), FDA approved in 2016<ref>FDA approves first drug to treat hallucinations and delusions associated with Parkinson’s disease. April 29, 2016. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm498442.htm.</ref>
	**Avoid antidopaminergic drugs if possible (expect worsening motor symptoms), but commonly used agents:		**Avoid antidopaminergic drugs if possible (expect worsening motor symptoms), but commonly used agents:
	***Olanzapine		***[[Olanzapine]]
	***Quetiapine		***[[Quetiapine]]
	**Others:		**Others:
	***Rivastigmine		***Rivastigmine

Rossdonaldson1: Text replacement - " esp " to " especially "

2016-07-30T23:50:41Z

Text replacement - " esp " to " especially "

← Revisión anterior		Revisión del 23:50 30 jul 2016
Línea 12:		Línea 12:
	===TRAP mnemonic===		===TRAP mnemonic===
	*'''T'''remor (resting)		*'''T'''remor (resting)
	**Initially is unilateral tremor of upper extremity, ~~esp~~ finger and thumb ("pill rolling")		**Initially is unilateral tremor of upper extremity, especially finger and thumb ("pill rolling")
	**Dissipates when intentional movement is performed		**Dissipates when intentional movement is performed
	*'''R'''igidity (cogwheel)		*'''R'''igidity (cogwheel)

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-24T13:31:59Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 13:31 24 jul 2016
Línea 24:		Línea 24:
	{{Dementia DDX}}		{{Dementia DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Consider [[mini mental status exam]]		*Consider [[mini mental status exam]]

Neil.m.young: Text replacement - "==Treatment==" to "==Management=="

2016-07-08T08:05:07Z

Text replacement - "==Treatment==" to "==Management=="

← Revisión anterior		Revisión del 08:05 8 jul 2016
Línea 27:		Línea 27:
	*Consider [[mini mental status exam]]		*Consider [[mini mental status exam]]

	==~~Treatment~~==		==Management==
	*Dopamine agonists		*Dopamine agonists
	**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard		**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard

Neil.m.young: Text replacement - " ==" to "=="

2016-07-06T13:26:26Z

Text replacement - " ==" to "=="

← Revisión anterior		Revisión del 13:26 6 jul 2016
Línea 21:		Línea 21:
	**Impaired ability to turn or change direction while walking		**Impaired ability to turn or change direction while walking

	==Differential Diagnosis ==		==Differential Diagnosis==
	{{Dementia DDX}}		{{Dementia DDX}}

Línea 27:		Línea 27:
	*Consider [[mini mental status exam]]		*Consider [[mini mental status exam]]

	==Treatment ==		==Treatment==
	*Dopamine agonists		*Dopamine agonists
	**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard		**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard

Neil.m.young: Text replacement - "== " to "=="

2016-07-06T10:22:19Z

Text replacement - "== " to "=="

← Revisión anterior		Revisión del 10:22 6 jul 2016
Línea 21:		Línea 21:
	**Impaired ability to turn or change direction while walking		**Impaired ability to turn or change direction while walking

	== Differential Diagnosis ==		==Differential Diagnosis ==
	{{Dementia DDX}}		{{Dementia DDX}}

Línea 27:		Línea 27:
	*Consider [[mini mental status exam]]		*Consider [[mini mental status exam]]

	== Treatment ==		==Treatment ==
	*Dopamine agonists		*Dopamine agonists
	**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard		**Levodopa and Carbidopa (peripheral decarboxylase inhibitor) = gold standard