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Flashcards in Dopamine Regulation Deck (36):
1

CNS what does ACh and dopamine do respectively?

ACh - excitatory input
Dopamine - Tonic inhibition

2

Parkinson's is an imbalance between ACh and Dopamine in what two regions?

Corpus striatum
substantia nigra

3

MOtor signs and symptoms of Parkinson's?

tremor
regidity
bradykinesia
festinating gait

4

Facial and speech changes with Parkinson's?

face-impassive/no blinking
speech - monotonous

5

Non-motor signs and symptoms of Parkinson's?

cognition
depression/anxiety
olfactory deficiencies
Bowel and Bladder
fatigue/sleep
pain

6

which nerves degenerate in Parkinson's?

dopaminergic nerves in substantia nigra (presence of Lewy bodies)

7

how much substantia nigra do you need to lose to get symptoms?

~80%

8

Main Management of Parkinson's is?

Drugs: symptomatic relief

9

what Drugs to restore striatum balance?

cholinergic antagonists to allow increase in Dopamine

10

4 way to restore dopamine deficiency:

increase synthesis
increase release
Receptor agonist
Reduce metabolism of D

11

if you ingest pure dopamine:

vomit

12

dopamine crosses BBB?

Nope.

13

L-DOPA in the body, what happens?

90% of it metabolised in periphery

14

How to prevent L-DOPA metabolism in periphery?

combine with inhibitor of peripheral DOPA decarboxylase

15

what do you need in order for L-DOPA to work?

need some functional dopaminergic neurons

16

what happens once you start L-DOPA? why?

increase degen of the neurons possibly due to increased oxidative stress

17

Levodopa ingestion you get what phenomenon?

on-off

18

Levodopa absorption/half-life? continued usage?

1. rapid absorption
2. 1-2hr half-life
3. effectiveness declines with time

19

Levodopa drug interactions? 4 big ones

1. vitamin B6
2. MAOa inhibitors
3. inhaled anaesthetics
4. anticonvulsants/neuroleptics

20

adverse effects of Levodopa?

Anorexia/nausea/vomiting
depression/anxiety
visual/auditory hallucinations

21

what kind of drug preferred in younger patients?

dopamine agonists

22

What to use to decrease dopamine metabolism? 2 of them.

1. MAO(B) inhibitors (Selegiline)
-may reduce free radicals, use early

2. COMT inhibitors

23

What is Amantadine?

type of flu antiviral that enhances dopamine release, less efficacious than L-DOPA

24

When to take muscarinic receptor antagonists to restore dopa-ACh imblance?

adjunct to Levodopa only

25

what are the classic anti-muscarinic side effects?

1. reduced SLUD
2. dry mouth
3. memory impairment

26

Next 5 years for Parkinson's include 3 things

1. adenosine R antagonists
2. glutamate reduction

27

next 5-10 years for parkinson's. 2 things:

1. deep brain stim
2. Optogenetics (modulating genes with light pulses)

28

10-20 years for parkinson's: 2 things.

1. genetics
2. stem cell replacement

29

what fibril is found in Lewy bodies in Parkinson's?

a-synuclein

30

what organelle is implicated in Parkinson's?

Mitochondria damage

31

what two things are protective for Parkinson's?

nicotine and caffeine

32

higher incidence of Parkinson's with exposure to?

pesticides

33

what area is first to be affected by Parkinson's

olfactory
GI

34

largest risk factor for Parkinson's?

age

35

what is MPTP?

inducer of Parkinson's

36

what does MPTP do?

kills dopaminergic cells by killing mitochondria