ANSWERS - 2nd Year MBBS Pharmacology (KDT Reference)

ls /home/daytona/workspace/ 2>/dev/null || echo "workspace empty or missing"

mkdir -p /home/daytona/workspace/antiparkinson-flashcards && echo "done"

~/antiparkinson-flashcards/make_flashcards.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm
from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, HRFlowable
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY
from reportlab.platypus import KeepTogether

# ─── Color palette ────────────────────────────────────────────────────────────
DARK_BLUE    = colors.HexColor("#1a237e")
MED_BLUE     = colors.HexColor("#1565c0")
LIGHT_BLUE   = colors.HexColor("#e3f2fd")
ACCENT       = colors.HexColor("#0288d1")
GREEN        = colors.HexColor("#2e7d32")
LIGHT_GREEN  = colors.HexColor("#e8f5e9")
RED          = colors.HexColor("#c62828")
LIGHT_RED    = colors.HexColor("#ffebee")
ORANGE       = colors.HexColor("#e65100")
LIGHT_ORANGE = colors.HexColor("#fff3e0")
PURPLE       = colors.HexColor("#6a1b9a")
LIGHT_PURPLE = colors.HexColor("#f3e5f5")
TEAL         = colors.HexColor("#00695c")
LIGHT_TEAL   = colors.HexColor("#e0f2f1")
GOLD         = colors.HexColor("#f57f17")
LIGHT_GOLD   = colors.HexColor("#fffde7")
WHITE        = colors.white
GRAY_LIGHT   = colors.HexColor("#f5f5f5")
GRAY_MED     = colors.HexColor("#9e9e9e")
DARK_TEXT    = colors.HexColor("#212121")

OUTPUT = "/home/daytona/workspace/antiparkinson-flashcards/Antiparkinson_Drugs_Flashcards.pdf"

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=1.5*cm,
    leftMargin=1.5*cm,
    topMargin=1.5*cm,
    bottomMargin=1.5*cm,
)

W = A4[0] - 3*cm   # usable width

styles = getSampleStyleSheet()

# ─── Custom styles ─────────────────────────────────────────────────────────────
def S(name, **kw):
    return ParagraphStyle(name, **kw)

title_style = S("MainTitle",
    fontSize=22, fontName="Helvetica-Bold", textColor=WHITE,
    alignment=TA_CENTER, spaceAfter=4)

subtitle_style = S("Subtitle",
    fontSize=11, fontName="Helvetica", textColor=colors.HexColor("#bbdefb"),
    alignment=TA_CENTER, spaceAfter=2)

card_title_style = S("CardTitle",
    fontSize=14, fontName="Helvetica-Bold", textColor=WHITE,
    alignment=TA_CENTER, leading=18)

card_subtitle_style = S("CardSub",
    fontSize=9, fontName="Helvetica", textColor=colors.HexColor("#e0e0e0"),
    alignment=TA_CENTER, spaceBefore=2)

section_label = S("SecLabel",
    fontSize=8, fontName="Helvetica-Bold", textColor=WHITE,
    alignment=TA_LEFT, spaceBefore=0, spaceAfter=1)

body_style = S("Body",
    fontSize=9, fontName="Helvetica", textColor=DARK_TEXT,
    leading=13, spaceAfter=2, alignment=TA_LEFT)

bullet_style = S("Bullet",
    fontSize=9, fontName="Helvetica", textColor=DARK_TEXT,
    leading=13, leftIndent=10, spaceAfter=1,
    bulletIndent=2, alignment=TA_LEFT)

bold_bullet = S("BoldBullet",
    fontSize=9, fontName="Helvetica-Bold", textColor=DARK_TEXT,
    leading=13, leftIndent=10, spaceAfter=1)

key_point_style = S("KeyPoint",
    fontSize=9, fontName="Helvetica-BoldOblique", textColor=DARK_BLUE,
    leading=12, alignment=TA_LEFT, spaceBefore=2)

mnemonic_style = S("Mnemonic",
    fontSize=10, fontName="Helvetica-Bold", textColor=PURPLE,
    alignment=TA_CENTER, spaceBefore=4, spaceAfter=4)

# ─── Helper builders ───────────────────────────────────────────────────────────

def make_cover():
    """Title cover block."""
    data = [[Paragraph("ANTIPARKINSON DRUGS", title_style)],
            [Paragraph("Mechanisms • Side Effects • Key Points", subtitle_style)],
            [Paragraph("KDT Pharmacology — 2nd Year MBBS Flashcards", subtitle_style)]]
    t = Table(data, colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), DARK_BLUE),
        ("TOPPADDING",    (0,0), (-1,-1), 14),
        ("BOTTOMPADDING", (0,0), (-1,-1), 14),
        ("LEFTPADDING",   (0,0), (-1,-1), 16),
        ("RIGHTPADDING",  (0,0), (-1,-1), 16),
        ("ROUNDEDCORNERS", (0,0), (-1,-1), [10,10,10,10]),
    ]))
    return t

def header_cell(text, sub, bg_color):
    """Colored header banner for a flashcard."""
    data = [
        [Paragraph(text, card_title_style)],
        [Paragraph(sub, card_subtitle_style)],
    ]
    t = Table(data, colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg_color),
        ("TOPPADDING",    (0,0), (-1,-1), 8),
        ("BOTTOMPADDING", (0,0), (-1,-1), 6),
        ("LEFTPADDING",   (0,0), (-1,-1), 12),
        ("RIGHTPADDING",  (0,0), (-1,-1), 12),
    ]))
    return t

def section_banner(text, bg):
    data = [[Paragraph(text.upper(), section_label)]]
    t = Table(data, colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("TOPPADDING",    (0,0), (-1,-1), 3),
        ("BOTTOMPADDING", (0,0), (-1,-1), 3),
        ("LEFTPADDING",   (0,0), (-1,-1), 8),
    ]))
    return t

def body_box(rows, bg=GRAY_LIGHT):
    """Simple bordered content box."""
    data = [[r] for r in rows]
    t = Table(data, colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("TOPPADDING",    (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 2),
        ("LEFTPADDING",   (0,0), (-1,-1), 10),
        ("RIGHTPADDING",  (0,0), (-1,-1), 10),
        ("BOX", (0,0), (-1,-1), 0.5, colors.HexColor("#bdbdbd")),
    ]))
    return t

def two_col(left_rows, right_rows, left_bg, right_bg, left_label, right_label):
    """Two-column layout: mechanism (left) | side effects (right)."""
    half = (W - 0.3*cm) / 2

    def col_table(label, bg_label, rows, bg_body):
        inner = [[section_banner(label, bg_label)]]
        for r in rows:
            inner.append([r])
        t = Table(inner, colWidths=[half])
        t.setStyle(TableStyle([
            ("BACKGROUND", (0,1), (-1,-1), bg_body),
            ("TOPPADDING",    (0,0), (-1,-1), 3),
            ("BOTTOMPADDING", (0,0), (-1,-1), 2),
            ("LEFTPADDING",   (0,0), (-1,-1), 6),
            ("RIGHTPADDING",  (0,0), (-1,-1), 6),
            ("BOX", (0,0), (-1,-1), 0.5, colors.HexColor("#bdbdbd")),
        ]))
        return t

    lc = col_table(left_label,  left_bg,  left_rows,  LIGHT_BLUE)
    rc = col_table(right_label, right_bg, right_rows, LIGHT_RED)

    outer = Table([[lc, rc]], colWidths=[half, half],
                  spaceBefore=0, spaceAfter=0)
    outer.setStyle(TableStyle([
        ("VALIGN", (0,0), (-1,-1), "TOP"),
        ("LEFTPADDING",  (0,0), (-1,-1), 0),
        ("RIGHTPADDING", (0,0), (-1,-1), 0),
        ("TOPPADDING",   (0,0), (-1,-1), 0),
        ("BOTTOMPADDING",(0,0), (-1,-1), 0),
    ]))
    return outer

def bp(text):
    return Paragraph(f"• {text}", bullet_style)

def bb(text):
    return Paragraph(f"• <b>{text}</b>", bullet_style)

def b(text):
    return Paragraph(text, body_style)

def kp(text):
    return Paragraph(f"⭐ {text}", key_point_style)

def mn(text):
    return Paragraph(text, mnemonic_style)

def card_wrapper(items):
    """Wrap a card so it tries to keep together and adds spacing."""
    return KeepTogether(items + [Spacer(1, 0.35*cm)])

# ═══════════════════════════════════════════════════════════════════════════════
#  FLASHCARD DATA
# ═══════════════════════════════════════════════════════════════════════════════

def card_levodopa():
    mech_rows = [
        b("<b>Drug:</b> Levodopa (L-DOPA)"),
        b("<b>Class:</b> Dopamine Precursor"),
        Spacer(1,3),
        bp("Dopamine CANNOT cross the BBB"),
        bp("Levodopa crosses via Large Neutral Amino Acid Transporter (LNAT)"),
        bp("Inside brain → decarboxylated by AADC (Aromatic L-Amino Acid Decarboxylase) → Dopamine"),
        bp("Dopamine acts on D1 & D2 receptors in striatum → relieves motor symptoms"),
        bp("95–99% converted peripherally → explains side effects"),
        Spacer(1,3),
        b("<b>Route:</b> Levodopa → AADC (brain) → DA → D1/D2 receptors"),
    ]
    se_rows = [
        b("<b>GI (peripheral DA):</b>"),
        bp("Nausea, vomiting (CTZ stimulation)"),
        bp("Anorexia"),
        b("<b>Cardiovascular:</b>"),
        bp("Postural hypotension"),
        bp("Cardiac arrhythmias"),
        b("<b>CNS (long-term):</b>"),
        bp("Dyskinesias (peak dose, most common)"),
        bp("On-Off fluctuations"),
        bp("Wearing-off phenomenon"),
        bp("Psychosis, hallucinations, confusion"),
        bp("Sleep disturbances, vivid dreams"),
        b("<b>Other:</b>"),
        bp("Dark urine/sweat (melanin)"),
        bp("Mydriasis → CI in narrow-angle glaucoma"),
    ]
    return card_wrapper([
        header_cell("LEVODOPA (L-DOPA)", "Dopamine Precursor | Most Effective Antiparkinson Drug", MED_BLUE),
        two_col(mech_rows, se_rows, MED_BLUE, RED, "⚙ Mechanism of Action", "⚠ Side Effects"),
        body_box([
            kp("KDT Key: Only ~1–3% of oral levodopa reaches the brain when given alone"),
            kp("CI: Psychosis, narrow-angle glaucoma, concurrent non-selective MAO inhibitors"),
            kp("NOT given with antipsychotics (D2 blockers — antagonize levodopa)"),
        ], LIGHT_GOLD),
    ])

def card_carbidopa():
    mech_rows = [
        b("<b>Carbidopa:</b> Peripheral DOPA Decarboxylase (DDC) Inhibitor"),
        Spacer(1,3),
        bp("Does NOT cross the BBB (hydrazine group → polar molecule)"),
        bp("Inhibits peripheral decarboxylation of levodopa → peripheral DA NOT formed"),
        bp("More levodopa reaches the brain (~10x more bioavailability)"),
        bp("Carbidopa itself has NO antiparkinson effect"),
        Spacer(1,3),
        b("<b>Ratio:</b> Levodopa : Carbidopa = 4:1 (standard preparation)"),
        b("<b>Benefits of combination:</b>"),
        bp("Levodopa dose reduced by ~75–80%"),
        bp("Faster onset of benefit"),
        bp("Reduced peripheral side effects"),
        bp("No need to restrict dietary protein (protein competes for LNAT)"),
    ]
    se_rows = [
        b("<b>Reduced peripheral side effects:</b>"),
        bp("Less nausea & vomiting"),
        bp("Less postural hypotension"),
        bp("Less cardiac arrhythmias"),
        Spacer(1,3),
        b("<b>Remaining/New effects:</b>"),
        bp("CNS side effects persist (dyskinesias, psychosis, hallucinations — even worse as more levodopa reaches brain)"),
        bp("Involuntary movements appear earlier"),
        Spacer(1,3),
        b("<b>Carbidopa alone:</b>"),
        bp("No major adverse effects"),
        bp("Can precipitate vitamin B6 antagonism (theoretical)"),
    ]
    return card_wrapper([
        header_cell("LEVODOPA + CARBIDOPA", "Peripheral DDC Inhibitor Combination | Syndopa / Sinemet", TEAL),
        two_col(mech_rows, se_rows, TEAL, RED, "⚙ Mechanism & Rationale", "⚠ Side Effects"),
        body_box([
            kp("KDT Key: Carbidopa does NOT cross BBB → selectively inhibits PERIPHERAL DDC only"),
            kp("Entacapone (COMT inhibitor) can be added → triple combo (Stalevo): further increases levodopa availability"),
        ], LIGHT_TEAL),
    ])

def card_dopamine_agonists():
    mech_rows = [
        b("<b>Class:</b> Direct Dopamine Receptor Agonists (D2/D3)"),
        Spacer(1,3),
        b("<b>Ergot-derived:</b>"),
        bp("Bromocriptine — D2 agonist"),
        bp("Cabergoline — D2 agonist, very long t½ (~65h)"),
        Spacer(1,3),
        b("<b>Non-ergot (preferred):</b>"),
        bp("Pramipexole — D2 + D3 agonist"),
        bp("Ropinirole — D2 + D3 agonist"),
        bp("Rotigotine — transdermal patch"),
        Spacer(1,3),
        b("<b>Mechanism:</b>"),
        bp("Act DIRECTLY on striatal D2/D3 receptors"),
        bp("Do NOT require conversion — no need for surviving neurons"),
        bp("Longer duration of action than levodopa"),
        bp("Fewer motor fluctuations (on-off, dyskinesias)"),
        b("<b>Use:</b> Early PD (monotherapy) or adjunct to levodopa"),
    ]
    se_rows = [
        b("<b>Common:</b>"),
        bp("Nausea, vomiting"),
        bp("Postural hypotension"),
        bp("Somnolence (sudden 'sleep attacks' — important for driving!)"),
        Spacer(1,3),
        b("<b>CNS:</b>"),
        bp("Hallucinations, psychosis (more than levodopa)"),
        bp("Confusion, delirium (especially in elderly)"),
        Spacer(1,3),
        b("<b>Impulse Control Disorders (ICDs):</b>"),
        bp("Pathological gambling"),
        bp("Hypersexuality"),
        bp("Compulsive eating/shopping"),
        bp("Especially with pramipexole & ropinirole"),
        Spacer(1,3),
        b("<b>Ergot-specific (bromocriptine/cabergoline):</b>"),
        bp("Pulmonary/retroperitoneal fibrosis"),
        bp("Cardiac valvulopathy (rare)"),
        bp("Erythromelalgia"),
    ]
    return card_wrapper([
        header_cell("DOPAMINE AGONISTS", "Bromocriptine • Pramipexole • Ropinirole • Cabergoline", ACCENT),
        two_col(mech_rows, se_rows, ACCENT, RED, "⚙ Mechanism of Action", "⚠ Side Effects"),
        body_box([
            kp("KDT Key: Non-ergot DA agonists (pramipexole, ropinirole) are preferred — less fibrotic complications"),
            kp("Apomorphine (D1+D2 agonist) given SC for acute 'off' episodes — fastest onset"),
            kp("Warn patients about sudden sleep attacks — avoid driving!"),
        ], LIGHT_GOLD),
    ])

def card_mao_b():
    mech_rows = [
        b("<b>Drugs:</b> Selegiline (Deprenyl), Rasagiline"),
        b("<b>Class:</b> Selective, Irreversible MAO-B Inhibitors"),
        Spacer(1,3),
        b("<b>Mechanism:</b>"),
        bp("MAO-B = monoamine oxidase type B"),
        bp("Responsible for dopamine catabolism in the striatum"),
        bp("Selegiline inhibits MAO-B → reduces DA breakdown → ↑ DA availability"),
        bp("Does NOT inhibit MAO-A at therapeutic doses"),
        bp("NO 'cheese reaction' (tyramine interaction)"),
        Spacer(1,3),
        b("<b>Neuroprotective hypothesis:</b>"),
        bp("Reducing DA oxidation → less free radical production → may slow neurodegeneration (debated)"),
        Spacer(1,3),
        b("<b>Selegiline metabolized to:</b> L-amphetamine & L-methamphetamine (CNS stimulant metabolites)"),
        b("<b>Rasagiline:</b> No amphetamine metabolites; more selective"),
        b("<b>Use:</b> Early monotherapy or adjunct to levodopa for 'wearing off'"),
    ]
    se_rows = [
        b("<b>Common (selegiline):</b>"),
        bp("Insomnia, agitation (amphetamine metabolites)"),
        bp("Nausea"),
        bp("Dizziness"),
        Spacer(1,3),
        b("<b>Interactions (IMPORTANT):</b>"),
        bp("With pethidine/meperidine → serotonin syndrome (FATAL — contraindicated)"),
        bp("With SSRIs/TCAs → serotonin syndrome risk"),
        bp("With sympathomimetics → hypertensive crisis"),
        Spacer(1,3),
        b("<b>At high doses:</b>"),
        bp("Loses MAO-B selectivity → MAO-A inhibited → cheese reaction possible"),
        Spacer(1,3),
        b("<b>Rasagiline side effects:</b>"),
        bp("Headache, arthralgia"),
        bp("Fewer CNS stimulant effects than selegiline"),
    ]
    return card_wrapper([
        header_cell("MAO-B INHIBITORS", "Selegiline (Deprenyl) • Rasagiline", PURPLE),
        two_col(mech_rows, se_rows, PURPLE, RED, "⚙ Mechanism of Action", "⚠ Side Effects"),
        body_box([
            kp("KDT Key: Selegiline is selective MAO-B inhibitor → NO cheese reaction at therapeutic doses"),
            kp("CRITICAL CI: Never combine with pethidine → fatal serotonin syndrome"),
            kp("Rasagiline is 5–10x more potent than selegiline, no amphetamine metabolites"),
        ], LIGHT_PURPLE),
    ])

def card_comt():
    mech_rows = [
        b("<b>Drugs:</b> Entacapone, Tolcapone, Opicapone"),
        b("<b>Class:</b> COMT (Catechol-O-Methyl Transferase) Inhibitors"),
        Spacer(1,3),
        b("<b>Mechanism:</b>"),
        bp("COMT metabolizes levodopa → 3-O-methyldopa (3-OMD, inactive) in the periphery"),
        bp("3-OMD competes with levodopa for LNAT → reduces brain entry"),
        bp("COMT inhibitors block this step → more levodopa available → prolonged plasma half-life"),
        bp("Entacapone: peripheral COMT inhibitor only (does NOT cross BBB)"),
        bp("Tolcapone: inhibits both peripheral AND central COMT (more effective but hepatotoxic)"),
        Spacer(1,3),
        b("<b>Always used WITH levodopa</b> (not effective alone)"),
        b("<b>Stalevo:</b> Levodopa + Carbidopa + Entacapone — triple combination"),
        b("<b>Use:</b> Adjunct to levodopa to reduce 'wearing off' fluctuations"),
    ]
    se_rows = [
        b("<b>Common (entacapone):</b>"),
        bp("Diarrhea (most common reason for stopping entacapone)"),
        bp("Nausea, abdominal pain"),
        bp("Orange-brown discoloration of urine (harmless)"),
        bp("Dyskinesias (as more levodopa reaches brain — reduce levodopa dose)"),
        bp("Hallucinations"),
        Spacer(1,3),
        b("<b>Tolcapone (additional):</b>"),
        bp("HEPATOTOXICITY — potentially fatal (rare)"),
        bp("Requires LFT monitoring every 2 weeks"),
        bp("Reserved for patients not responding to entacapone"),
        Spacer(1,3),
        b("<b>Opicapone:</b>"),
        bp("Once-daily peripheral COMT inhibitor"),
        bp("Newer; better tolerability profile"),
    ]
    return card_wrapper([
        header_cell("COMT INHIBITORS", "Entacapone • Tolcapone • Opicapone", GREEN),
        two_col(mech_rows, se_rows, GREEN, RED, "⚙ Mechanism of Action", "⚠ Side Effects"),
        body_box([
            kp("KDT Key: Entacapone — peripheral COMT only (safer); Tolcapone — central + peripheral (hepatotoxic)"),
            kp("Orange urine with entacapone — warn patients (harmless but alarming)"),
            kp("Diarrhea is the main reason for discontinuing entacapone"),
        ], LIGHT_GREEN),
    ])

def card_amantadine():
    mech_rows = [
        b("<b>Drug:</b> Amantadine"),
        b("<b>Class:</b> Antiviral / NMDA Receptor Antagonist"),
        Spacer(1,3),
        b("<b>Mechanisms (multiple):</b>"),
        bp("1. Increases dopamine RELEASE from surviving neurons"),
        bp("2. Inhibits dopamine RE-UPTAKE"),
        bp("3. Blocks NMDA glutamate receptors → reduces excitotoxicity"),
        bp("4. Mild anticholinergic activity"),
        Spacer(1,3),
        b("<b>Unique use:</b>"),
        bp("Drug of choice for LEVODOPA-INDUCED DYSKINESIAS"),
        bp("Used as monotherapy in early mild PD"),
        bp("Adjunct in moderate-severe PD"),
        Spacer(1,3),
        b("<b>Originally developed as:</b> Antiviral (influenza A)"),
        b("<b>Renally excreted:</b> Reduce dose in renal impairment"),
    ]
    se_rows = [
        b("<b>Common:</b>"),
        bp("Livedo reticularis (mottled purplish skin discoloration — characteristic)"),
        bp("Ankle edema"),
        bp("Insomnia, dizziness"),
        Spacer(1,3),
        b("<b>CNS:</b>"),
        bp("Hallucinations, confusion (especially elderly)"),
        bp("Nightmares"),
        bp("Ataxia"),
        Spacer(1,3),
        b("<b>Anticholinergic effects:</b>"),
        bp("Dry mouth, blurred vision"),
        bp("Urinary retention"),
        Spacer(1,3),
        b("<b>Cardiovascular:</b>"),
        bp("Peripheral edema"),
        bp("Orthostatic hypotension"),
        Spacer(1,3),
        b("<b>Withdrawal:</b>"),
        bp("Abrupt withdrawal → neuroleptic malignant syndrome-like state"),
    ]
    return card_wrapper([
        header_cell("AMANTADINE", "NMDA Antagonist • DA Releaser | Drug of Choice for Levodopa-Induced Dyskinesias", ORANGE),
        two_col(mech_rows, se_rows, ORANGE, RED, "⚙ Mechanism of Action", "⚠ Side Effects"),
        body_box([
            kp("KDT Key: Livedo reticularis = characteristic skin finding with amantadine"),
            kp("DOC for levodopa-induced dyskinesias (NMDA receptor mechanism)"),
            kp("Originally an antiviral — repurposed for PD"),
        ], LIGHT_ORANGE),
    ])

def card_anticholinergics():
    mech_rows = [
        b("<b>Drugs:</b> Trihexyphenidyl (Benzhexol), Biperiden,"),
        b("Procyclidine, Orphenadrine"),
        b("<b>Class:</b> Central Anticholinergic / Antimuscarinic Drugs"),
        Spacer(1,3),
        b("<b>Rationale (KDT):</b>"),
        bp("In PD: DA deficiency → relative excess of ACh activity in striatum"),
        bp("Anticholinergics block muscarinic (M1) receptors in striatum"),
        bp("Restore DA/ACh balance → reduce tremor and rigidity"),
        Spacer(1,3),
        b("<b>Receptor:</b> M1 muscarinic receptor blockade (central)"),
        Spacer(1,3),
        b("<b>Trihexyphenidyl:</b> Most commonly used"),
        b("<b>Best for:</b> Tremor > Rigidity"),
        b("<b>NOT effective for:</b> Bradykinesia (least effective for this)"),
        Spacer(1,3),
        b("<b>Uses:</b>"),
        bp("Drug-induced parkinsonism (antipsychotic-induced EPS) — DOC"),
        bp("Tremor-predominant PD (especially young patients)"),
        bp("Adjunct when levodopa is inadequate for tremor"),
    ]
    se_rows = [
        b("<b>Peripheral antimuscarinic:</b>"),
        bp("Dry mouth (xerostomia)"),
        bp("Blurred vision (cycloplegia)"),
        bp("Urinary retention (CI in BPH)"),
        bp("Constipation"),
        bp("Tachycardia"),
        bp("Mydriasis (CI in narrow-angle glaucoma)"),
        Spacer(1,3),
        b("<b>Central (CNS):</b>"),
        bp("Memory impairment, confusion"),
        bp("Cognitive decline (especially elderly)"),
        bp("Hallucinations, delirium"),
        bp("Sedation, drowsiness"),
        Spacer(1,3),
        b("<b>Contraindications:</b>"),
        bp("Elderly (cognitive impairment)"),
        bp("Benign prostatic hyperplasia"),
        bp("Narrow-angle glaucoma"),
        bp("Dementia (Alzheimer's)"),
    ]
    return card_wrapper([
        header_cell("ANTICHOLINERGIC DRUGS", "Trihexyphenidyl (Benzhexol) • Biperiden • Procyclidine", colors.HexColor("#bf360c")),
        two_col(mech_rows, se_rows, colors.HexColor("#bf360c"), RED, "⚙ Mechanism of Action", "⚠ Side Effects"),
        body_box([
            kp("KDT Key: Best for TREMOR; least effective for BRADYKINESIA"),
            kp("DOC for drug-induced (antipsychotic-induced) parkinsonism"),
            kp("AVOID in elderly — high risk of cognitive impairment & hallucinations"),
        ], LIGHT_RED),
    ])

def card_summary():
    """Summary comparison table card."""
    col_w = [W*0.22, W*0.28, W*0.27, W*0.23]
    header_row = [
        Paragraph("<b>Drug</b>", S("th", fontSize=8, fontName="Helvetica-Bold", textColor=WHITE, alignment=TA_CENTER)),
        Paragraph("<b>Mechanism</b>", S("th", fontSize=8, fontName="Helvetica-Bold", textColor=WHITE, alignment=TA_CENTER)),
        Paragraph("<b>Key Side Effect</b>", S("th", fontSize=8, fontName="Helvetica-Bold", textColor=WHITE, alignment=TA_CENTER)),
        Paragraph("<b>Key Point</b>", S("th", fontSize=8, fontName="Helvetica-Bold", textColor=WHITE, alignment=TA_CENTER)),
    ]
    def row(d, m, s, k, bg=WHITE):
        cs = S("tc", fontSize=7.5, fontName="Helvetica", textColor=DARK_TEXT, leading=11, alignment=TA_LEFT)
        return [Paragraph(d,cs), Paragraph(m,cs), Paragraph(s,cs), Paragraph(k,cs)]

    data = [
        header_row,
        row("Levodopa", "Dopamine precursor\n→ crosses BBB\n→ DA in striatum",
            "Dyskinesias\nOn-off\nPsychosis", "Most effective\ndrug"),
        row("+ Carbidopa", "Peripheral DDC\ninhibitor\n(does NOT cross BBB)",
            "↑ CNS side effects\n(more levodopa\nto brain)", "Reduces dose\n& peripheralSE"),
        row("DA Agonists\n(Pramipexole,\nRopinirole)", "Direct D2/D3\nreceptor agonist\n(no conversion needed)",
            "Hallucinations\nImpulse control\ndisorders", "Non-ergot\npreferred"),
        row("Selegiline\n(MAO-B inh.)", "Irreversible\nselective\nMAO-B inhibitor",
            "Insomnia\nFatal interaction\nwith pethidine", "No cheese\nreaction at\ntherapeutic dose"),
        row("Entacapone\n(COMT inh.)", "Peripheral COMT\ninhibitor\n↑ levodopa t½",
            "Diarrhea\nOrange urine\nDyskinesias", "Always given\nwith levodopa"),
        row("Amantadine", "NMDA antagonist\n+ DA release\n+ reuptake block",
            "Livedo reticularis\nAnkle edema\nHallucinations", "DOC for\nlevodopa-induced\ndyskinesias"),
        row("Trihexyphenidyl\n(Anticholinergic)", "M1 muscarinic\nreceptor blockade\nin striatum",
            "Dry mouth\nUrinary retention\nCognitive decline", "DOC for\ndrug-induced\nParkinsonism"),
    ]

    t = Table(data, colWidths=col_w, repeatRows=1)
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,0), DARK_BLUE),
        ("ROWBACKGROUNDS",(0,1), (-1,-1), [WHITE, GRAY_LIGHT]),
        ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#9e9e9e")),
        ("VALIGN",        (0,0), (-1,-1), "TOP"),
        ("TOPPADDING",    (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING",   (0,0), (-1,-1), 5),
        ("RIGHTPADDING",  (0,0), (-1,-1), 5),
    ]))

    title_t = Table([[Paragraph("QUICK COMPARISON TABLE — All Antiparkinson Drugs", card_title_style)]],
                    colWidths=[W])
    title_t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), DARK_BLUE),
        ("TOPPADDING",    (0,0), (-1,-1), 8),
        ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ]))
    return KeepTogether([title_t, t, Spacer(1, 0.35*cm)])

def card_pd_overview():
    """Pathophysiology overview card."""
    items = [
        b("<b>Parkinson's Disease Pathophysiology:</b>"),
        bp("Degeneration of dopaminergic neurons in <b>Substantia Nigra pars compacta (SNpc)</b>"),
        bp("Loss of nigrostriatal tract → ↓ Dopamine in striatum"),
        bp("Relative excess of <b>Acetylcholine (ACh)</b> activity → motor symptoms"),
        bp("Cardinal features: <b>TRAP</b> — Tremor (resting), Rigidity (cogwheel), Akinesia/Bradykinesia, Postural instability"),
        Spacer(1,4),
        b("<b>Treatment Goal:</b> Restore DA/ACh balance in striatum"),
        Spacer(1,4),
        b("<b>Classification of Antiparkinson Drugs (KDT):</b>"),
        b("<b>A. Dopaminergic (↑ DA):</b>"),
        bp("1. DA Precursor: Levodopa (± Carbidopa, Benserazide)"),
        bp("2. DA Agonists: Bromocriptine, Pramipexole, Ropinirole, Cabergoline, Apomorphine"),
        bp("3. MAO-B Inhibitors: Selegiline, Rasagiline"),
        bp("4. COMT Inhibitors: Entacapone, Tolcapone, Opicapone"),
        bp("5. DA Releaser + NMDA antagonist: Amantadine"),
        b("<b>B. Anticholinergic (↓ ACh):</b>"),
        bp("Trihexyphenidyl (Benzhexol), Biperiden, Procyclidine, Orphenadrine"),
    ]
    title_t = Table([[Paragraph("PARKINSON'S DISEASE — OVERVIEW & DRUG CLASSIFICATION", card_title_style)]],
                    colWidths=[W])
    title_t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), colors.HexColor("#004d40")),
        ("TOPPADDING",    (0,0), (-1,-1), 8),
        ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ]))
    return KeepTogether([title_t, body_box(items, LIGHT_TEAL),
                         body_box([mn("Mnemonic: TRAP = Tremor • Rigidity • Akinesia • Postural instability")], LIGHT_GOLD),
                         Spacer(1, 0.35*cm)])

# ═══════════════════════════════════════════════════════════════════════════════
#  BUILD DOCUMENT
# ═══════════════════════════════════════════════════════════════════════════════

story = []

# Cover
story.append(make_cover())
story.append(Spacer(1, 0.4*cm))

# Overview
story.append(card_pd_overview())

# Individual drug cards
story.append(card_levodopa())
story.append(card_carbidopa())
story.append(card_dopamine_agonists())
story.append(card_mao_b())
story.append(card_comt())
story.append(card_amantadine())
story.append(card_anticholinergics())

# Summary table
story.append(card_summary())

# Footer note
story.append(body_box([
    Paragraph("Reference: KD Tripathi — Essentials of Medical Pharmacology, 8th Ed. | Chapter 32: Drugs for Parkinsonism",
              S("ref", fontSize=8, fontName="Helvetica-Oblique", textColor=GRAY_MED, alignment=TA_CENTER))
], WHITE))

doc.build(story)
print(f"PDF created: {OUTPUT}")

cd /home/daytona/workspace/antiparkinson-flashcards && python make_flashcards.py…

ls -lh /home/daytona/workspace/antiparkinson-flashcards/Antiparkinson_Drugs_Flas…