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BB2 > Pharmacology of Movement > Flashcards

Pharmacology of Movement Flashcards

1
Q

What are the genes associated with Parkinson’s?

A
  • SNCA - involves alpha-synuclein protein, Aggregates into clumps (Lewy bodies)
  • LRRK2 - most common genetic contributor to Parkinson’s, kinase, specialised protein type which modifies other proteins
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2
Q

What are the main features of PD?

A
  • resting tremor
  • bradykinesia
  • rigidity
  • frozen facial expression
  • flexed posture
  • altered gai/postural changes
  • difficulty initiating and stopping movement
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3
Q

What are some non-motor features of PD?

A 
Olfactory depression
Depression
Psychotic symptoms
Cognitive dysfunction
Dementia
Sleep disturbance
Autonomic dysfunction
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4
Q

How are dopaminergic neurons degenerated?

A
  • MPTP (methyl-phenyl-tetrahydropyridine) is transformed into metabolite MPP+ which is neurotoxic
  • MPP+ causes dysfunction of complex I of mitochondrial respiratory chain = oxidative stress
  • dopamine easily oxidised -> free radicals produced
  • monoamine oxidase involved
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5
Q

How is dopamine synthesised?

A

L-Tyrosine -> L-Dopa (via tyrosine hydroxylase)

L-Dopa -> Dopamine (via L-aromatic amino acid decarboxylase)

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6
Q

How is dopamine metabolised?

A

Dopamine -> DOPAC (MAO and aldehyde dehydrogenase)

DOPAC -> Homovanillic acid (via COMT)

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7
Q

What are the treatments for Parkinson’s in regards to dopamine?

A

L- dopa direct administration
L-dopa decarboxylase inhibitor
MOA and COMT inhibitors

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8
Q

What are the 3 pathways in which projection neurons can release dopamine?

A

Mesocortical
Nigostriatal
Mesolimbic

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9
Q

What are the dopamine receptors?

A

GPCRs

  • D1 like (D1 and D5)
  • D2 like (D2, D3, D4)
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10
Q

How can L-Dopa treat PD?

A

Directly compensates for decreased dopamine levels

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11
Q

What are some precursors of L-Dopa?

A 
Carbidopa
Benserazide (levodopa)
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12
Q

What are some adverse effects of L-Dopa?

A 
Nausea/vomiting
Postural hypotension
Psychosis
Impulse control disorders
Motor complications - on and off effect, dyskinesia
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13
Q

What are some dopamine agonists?

A

Rotigotine: transdermal patch
Apomorphine: infusion

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14
Q

What are MAOb inhibitors?

A

Stop dopamine breaking down due to oxidatio

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15
Q

What are some examples of MAOb inhibitors?

A

Rasagiline

Selegiline

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16
Q

Why are anticholinergic compounds used?

A

Loss of dopamine = increased activity of cholinergic cells = hyperactivity

17
Q

What are some examples of anticholinergics?

A

Orphenadrine

Procyclidine

18
Q

What is the role of amantadine?

A

Inhibits reuptake of dopamine

Increases release of dopamine

19
Q

What are some examples of COMT inhibitors?

A

Entacapone

Tolcapone

20
Q

What are some other treatment methods to PD?

A
  • human embryonic mesencephalic graft (releases dopamine)
  • surgical approaches (stimulates certain structures/lesions such as the subthalamic nucleus/pallidotomy causes slight damage to globus pallidus)
21
Q

What is the cause of Huntington’s?

A

Changes in gene coding protein huntingtin on chromosome 4

  • abnormal glutamine repeats in sequence
  • gain of function = mutated protein aggregates in cells
  • striatal neuron degeneration and cortical atrophy
22
Q

How does neurodegeneration occur?

A 
Loss of medium size spiny neurons
Intranucleus inclusions of huntingtin
Excitoxicity
Loss of neurotrophic factors
Dysregulation of transcription
Increased oxidative stress
Abnormalities in axonal transport
23
Q

What are the symptoms of Huntington’s?

A 
Choreic movements
Gait abnormalities
Lack of coordination
Cognitive impairment
Psychiatric disturbances
Sleep disturbance
Weight loss
24
Q

What are the 3 methods of treatment for Huntington’s?

A
  • tetrabenazine: reduces chorea, reversible depletion of monoamines like dopamine
  • haloperidol/olanzapine: antipsychotic, higher affinity for serotonin transporters than dopamine
  • imipramine/amitriptyline: TCA depressant, stronger effect on serotonin transporters, nearly no effect on dopamine transporters
25
Q

What is the role of tetrabenazine?

A

Inhibits vesicular amine transporters

26
Q

What is the role of haloperidol/olanzapine?

A

Antidopaminergic/antipsychotic

27
Q

What is the role of imipramine/amitriptyline?

A

Antidepressant

28
Q

What is experimental treatment for Huntington’s?

A

Striatal fetal graft

BB2 (31 decks)

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