Flashcards in CNS degenerative disorders Deck (55):
What two components do you see in almost all degenerative disorders?
When do you start to see manifestations of CNS degenerative disorders?
-Later in life
What are eight mechanisms that can cause CNS degenerative disorders?
-Excitatory Amino Acids
What is an excitatory amino acid that can be neurotoxic?
-Glutamate (AMPA, NMDA, Kainate (receptors))
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
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
If you have an AB at the end of a drug what is a likely use of that drug?
-To target the immune system
What is Lewy bodies (aggregate of proteins) part of?
What are the clinical manifestations of Parkinsons disease?
-Forward tilt of body (postural abnormalities)
-Short, shuffling gate
What are some protein aggregations that cause CNS degenerative disorders?
-Lewy bodies (Parkinson's)
T/F Amphetamines increase your chance of getting parkinsons
T/F Lots of salivation can be a sign of parkinsons disease if a person has dysphagia
If a person has parkinson's disease what type of drug are they usually on?
What happens to the salivary secretions to a person with parkinson's disease?
-They go down creating more viscous saliva
What are some of the late symptoms of parkinson's disease?
-Loss of bowel control (constipation)
What is the oral status of a person with Parkinson's disease?
-Avg. 7 root canals
What are synthetic anticholinergic drugs?
What is Phsyotigmine?
What causes parkinson's disease?
Low or falling dopamine levels because dopiminergic neurons in the substantia nigra have died
Does Parkinson's disease begin unilateral or bilateral?
How many people get parkinson's disease?
After the age of 85 what percent of people have Parkinson's?
How many dopamine neurons have to be dead before you see early symptoms of Parkinson's?
How many new cases of Parkinson's are diagnosed in the US per year?
Where is the decreased activity found in a Parkinson's patient?
-Striatum (mostly dopamine cells)
What are environmental causes of Parkinsons?
What are environmental causes of Parkinsons?
What does Dopamine turn into the make it neurotoxic?
-Quinones that turn into Reactive Oxygen Species (ROS)
What genetics can cause Parkinson's disease?
-Alpha Synuclein (a trafficking protein that doesn't work anymore)
When you take away the dopamine what effects go up?
What do you do for treatment of Parkinsons?
-Increase Dopamine side
-Decrease Cholinergic side
Levodopa (L-DOPA) is what?
-A precursor to Dopamine
What does Azilect do?
-Inhibit dopamine breakdown
What does Entacapone do?
-Improve the effect of carbidopa-levodopa
T/F L-DOPA gets metabolized before it gets to the brain
Can Dopamine cross the BBB?
What does carbidopa do?
-Inhibit the metabolism of L-DOPA in the periphery
What two drugs can you use with Carbidopa-Levodopa?
What is Entacapone an inhibitor of?
Can giving L-DOPA increase the degeneration that causes Parkinsons?
-Yes in theory it could but not really hard evidence
What is an anticholinergic drug that is commonly used in Parkinson's pts?
MAO-B inhibitors used for parkinson's disease include what?
COMT inhibitors used for parkinson's disease include what?
What are the dopamine agonists used for Parkinson's disease?
What is the early onset drug used for Parkinson's disease?
What are surgical approaches for Parkinson's?
-Put an electrode into the brain
-Can diminish tremors in younger pts
What drugs given to treat parkinsons disease can cause xerostomia, gingivitis, and glossitis?
What are three drugs given to treat Parkinsons disease that can cause glossitis?
-Carbidopa with Levodopa
-Carbidopa with Levodopa and Entacapone
What drug can cause dark saliva in the treatment of Parkinsons disease?
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
What oral hygiene strategies can you use to treat sialorrhea in parkinson's disease?
-Use anticholinergic medications to address this problem
If a person is using levodopa what oral hygiene strategy should they do?
-Rinse the mouth to prevent discoloration of the teeth
What is selegiline?
What is entacapone?