CNS degenerative disorders Flashcards Preview

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Flashcards in CNS degenerative disorders Deck (55):
1

What two components do you see in almost all degenerative disorders?

-Cognitive
-Movement

2

When do you start to see manifestations of CNS degenerative disorders?

-Later in life

3

What are eight mechanisms that can cause CNS degenerative disorders?

-Hypoxia
-Excitatory Amino Acids
-Ion fluxes
-Free radicals
-Immune responses
-Infections
-Apoptosis
-Protein aggregation

4

What is an excitatory amino acid that can be neurotoxic?

-Glutamate (AMPA, NMDA, Kainate (receptors))

5

What ion fluxes can cause CNS degenerative disorders?

-Ca++ (if you get high concentrations in places they shouldn't be it can really foul up a cell) #1
-Manganese
-Magnesium

6

What free radical elements can cause CNS degenerative disorders?

-Catecholamines (can make free radicals via the hydroxy groups) (Dopamine is a free radical culprit)
-Glutamate can generate nitric oxide

7

If you have an AB at the end of a drug what is a likely use of that drug?

-To target the immune system

8

What is Lewy bodies (aggregate of proteins) part of?

-Parkinsons disease

9

What are the clinical manifestations of Parkinsons disease?

-Tremor
-Rigidity
-Bradykinesia
-Forward tilt of body (postural abnormalities)
-Short, shuffling gate

10

What are some protein aggregations that cause CNS degenerative disorders?

-Lewy bodies (Parkinson's)
-Beta-amyloid (Alzheimer's)

11

T/F Amphetamines increase your chance of getting parkinsons

True

12

T/F Lots of salivation can be a sign of parkinsons disease if a person has dysphagia

True

13

If a person has parkinson's disease what type of drug are they usually on?

-Anti-cholinergic drugs

14

What happens to the salivary secretions to a person with parkinson's disease?

-They go down creating more viscous saliva

15

What are some of the late symptoms of parkinson's disease?

-Depression
-Immobile
-Loss of bowel control (constipation)

16

What is the oral status of a person with Parkinson's disease?

-Avg. 7 root canals

17

What are synthetic anticholinergic drugs?

-Glycopyrrolate
-Benzotropine mesylate
-Propantheline bromide
-Trihyxphenidyl HCl

18

What is Phsyotigmine?

-Acetylcholinesterase inhibitor

19

What causes parkinson's disease?

Low or falling dopamine levels because dopiminergic neurons in the substantia nigra have died

20

Does Parkinson's disease begin unilateral or bilateral?

-usually unilateral

21

How many people get parkinson's disease?

1/200

22

After the age of 85 what percent of people have Parkinson's?

-25%

23

How many dopamine neurons have to be dead before you see early symptoms of Parkinson's?

-70%

24

How many new cases of Parkinson's are diagnosed in the US per year?

-60,000

25

Where is the decreased activity found in a Parkinson's patient?

-Striatum (mostly dopamine cells)

26

What are environmental causes of Parkinsons?

-Magnesium
-Mercury
-Pesticides
-Trauma
-Dopamine itself

27

What are environmental causes of Parkinsons?

-Magnesium
-Mercury
-Pesticides
-Trauma
-Dopamine itself

28

What does Dopamine turn into the make it neurotoxic?

-Quinones that turn into Reactive Oxygen Species (ROS)

29

What genetics can cause Parkinson's disease?

-Alpha Synuclein (a trafficking protein that doesn't work anymore)
-Larkin

30

When you take away the dopamine what effects go up?

-Cholingergic effects

31

What do you do for treatment of Parkinsons?

-Increase Dopamine side
-Decrease Cholinergic side

32

Levodopa (L-DOPA) is what?

-A precursor to Dopamine

33

What does Azilect do?

-Inhibit dopamine breakdown

34

What does Entacapone do?

-Improve the effect of carbidopa-levodopa

35

T/F L-DOPA gets metabolized before it gets to the brain

True

36

Can Dopamine cross the BBB?

-No

37

What does carbidopa do?

-Inhibit the metabolism of L-DOPA in the periphery

38

What two drugs can you use with Carbidopa-Levodopa?

-Azilect
-Entacapone

39

What is Entacapone an inhibitor of?

-COMT

40

Can giving L-DOPA increase the degeneration that causes Parkinsons?

-Yes in theory it could but not really hard evidence

41

What is an anticholinergic drug that is commonly used in Parkinson's pts?

-Trihexylphenidyl
-Benztropine

42

MAO-B inhibitors used for parkinson's disease include what?

-Rasagline (Azilect)
-Selegiline (Eldepryl)

43

COMT inhibitors used for parkinson's disease include what?

-Tolcapone
-Entacapone

44

What are the dopamine agonists used for Parkinson's disease?

-Pramipexole
-Ropinirole
-Rotigotine
-Apomorphine
-Cromocriptine

45

What is the early onset drug used for Parkinson's disease?

-Pramipexole

46

What are surgical approaches for Parkinson's?

-Put an electrode into the brain
-Can diminish tremors in younger pts

47

What drugs given to treat parkinsons disease can cause xerostomia, gingivitis, and glossitis?

-Ropinirole

48

What are three drugs given to treat Parkinsons disease that can cause glossitis?

-Carbidopa with Levodopa
-Carbidopa with Levodopa and Entacapone
-Ropinirole

49

What drug can cause dark saliva in the treatment of Parkinsons disease?

-L-DOPA

50

What oral hygiene strategies can you use for xerostomia in parkinsons disease?

-Frequent sips of water may assist with this problem in addition to avoiding dehydration
-Avoid alcohol and smokine

51

What oral hygiene strategies can you use to treat sialorrhea in parkinson's disease?

-Use anticholinergic medications to address this problem

52

If a person is using levodopa what oral hygiene strategy should they do?

-Rinse the mouth to prevent discoloration of the teeth

53

What is selegiline?

-MAO inhibitor

54

What is entacapone?

-COMT inhibitor

55

What is Pramipexole?

-D2 agonist

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