Drug Treatments of Movement Disorders Flashcards Preview

Yr2 Control - Term 2 and 3 > Drug Treatments of Movement Disorders > Flashcards

Flashcards in Drug Treatments of Movement Disorders Deck (50)
Loading flashcards...
1

What are the main features of neurodegenerative disorders? (3)

-Loss of neurons
-Progressive
-Irreversible (cannot regenerate neurons)

2

When was Parkinson’s first described, and what were the main features?

1817.
-‘shaking palsy
-akinetic-rigid syndrome
-extrapyramidal disorder

3

How does Parkinson’s progress?

Slowly; usually die within 10-15 years.
-death usually due to bronchopneumonia / sepsis

4

What is remission, and how common is it in Parkinson’s?

Disappearance of signs.
-rare, and only lasts for seconds/minutes

5

What are the main symptoms of Parkinson’s? (6)

-Tremor (4-7Hz)
-Rigidity (increased tone)
-Slurred speech
-Akinesia
-Decreased blinking
-Postural changes (stoop, shuffling)

6

What are the unusual ways to describe some of the symptoms of Parkinson’s?

TREMOR – ‘pill rolling’
RIGIDITY - ‘lead piping limbs’
DECREASED BLINKING – ‘serpentine stare’
POSTURAL CHANGES – ‘telegraph pole falls’

7

What is akinesia?

Difficulty initiating voluntary movements.

8

What is the general pathology of Parkinson’s?

-Loss of neruones in substantia nigra
-Lewy body accumulation (eosinophilic proteins in cells)
-Loss of nigro-subtantia inhibitory-excitatory pathway

9

What type of neurones are affected by Parkinson’s?

Dopaminergic neurones.

10

What causes Parkinson’s?

Unknown cause.
-idiopathic

11

What disorders are associated with Parkinson’s? (3)

-Drug-induced (iatrogenic)
-MPTP-induced (amphetamine-related)
-Post-encephalitic

12

What are the 2 pathways affected by Parkinson’s?

Indirect and direct.
-both involve dopamine (D1/D2)

13

What is the direct pathway?

D1-mediated.
-signals from striatum

14

What is the indirect pathway?

D2-mediated.
-signals from striatum

15

What is the abbreviation of dopamine?

DA.

16

What are the general mechanisms of Parkinson’s treatment? (2)

-Increase DA activity
-Decrease Ach activity

17

How is DA activity increased? (4)

-Replace DA
-Decrease DA breakdown
-Increase DA release
-DA agonists

18

What drug is used to replace DA?

L-DOPA.

19

What drugs are used to decrease DA breakdown? (2)

-MAO inhibitors
-COMT inhibitors

20

What drug is used to increase DA release?

Amantidine.

21

What drugs are used as DA agonists? (2)

-Bromocriptine
-Pergolide

22

What class of drugs decrease Ach activity?

Antimuscarinics.
-benzhexol, orphenadrine

23

What is the 1st line treatment for Parkinson’s?

-L-DOPA
-MAO / COMT inhibitors

24

How does L-DOPA increase dopamine levels?

L-DOPA is a precursor for dopamine.
-DOPA decarboxylase converts it

25

How does L-DOPA act?

-L-DOPA crosses the BBB >> neurones.
-converted to DA in neurones and glia

26

What is the main problem with L-DOPA?

Metabolised in the periphery >> only 1% reaches brain.
-90% in intestine

27

What is given with L-DOPA to prevent it being broken down, and how does it work?

Carbidopa.
-inhibits DOPA decarboxylase
-doesn’t pass BBB

28

What are the main side effects of L-DOPA?

-‘On-off’ effect (worsening symptoms)
-Nausea / anorexia
-Dysknesias
-Tachycardia
-Hypotension
-Insomnia

29

What happens to the side effects of L-DOPA with time?

Increased side effects with time.
-partly due to increased dose

30

How do MAO inhibitors reduce DA breakdown?

Mono-amine oxidase (MAO) breaks down DA to homovanillinic acid.
-inhibitors prevent this