Drugs For Neurodegenerative Disorders Flashcards
(14 cards)
Neurodegenerative disorders
Irreversible death of neurons resulting in progressive impairment of neuronal function
Parkinson’s Alzheimer’s Huntington Vascular dementia Wilson’s disease Ms Als
ART classification
A kinetic-rigid form: bad prognosis
Tremor dominant; slow progression
Therapy of Parkinson’s
Dopamine side - substitution (levodopa) - MAOIs - dopamine agonists - COMT inhibitors - amantadine Acetylcholine side - centrally acting anticholinergic
Substitution therapy in PD
Levodopa
Good oral absorption
Peak;1-2 h
Plasma half life; 1-3 h
Metabolized by dopa carboxylase in periphery- block with carbidopa or benserazide
Start as late as possible
MAO-b inhibitors in PD
Inhibit dopamine metabolism
Selegiline
Rasagiline
Safinamide
Dopamine agonist in PD
Ergot derivatives;
Bromocryptine
Cabergoline
Non-ergot derivatives Pramipexole Ropinirole Rotigotine Apomorphine
COMT inhibitors in PD
Prolong action of levodopa
Entacapone and opicapone; inhibit peripheral metabolism of levodopa
Tolcapone
Amantadine in PD
Originally; antiviral drug
Uncertain mech
Acetylcholine side in PD
Centrally acting anticholinergic drugs;
- m receptor antagonists
- good CNS penetration
- eg; procyclidine, biperiden, trihexyphenidyl, orphenadrine
Treatment of Alzheimer’s
Acetylcholinesterase inhibitors - rivastigmine - donepezil - galantamine NMDA receptor antagonist - memantine Other - amyloid vaccination - amyloid antibodies
Huntington treatment
Autosomal dominant
GABAergic drugs: baclofen or benzodiazepines
Tetrabenazine
Antipsychotic (haloperidol, tiapride)
Vascular dementia treatment
Acetylcholinesterase inhibitors - rivastigmine - donepezil - galantamine NMDA receptor antagonist - memantine Other - amyloid vaccination - amyloid antibodies
Nootropic agents;
Piracetam
Vinpocetine
Nicergoline
Wilson’s disease treatment
Autosomal recessive
D-penicillamine, trientine (chelators)
Amyotrophic lateral sclerosis treatment
Riluzole
Na+ blocker
Increase survival by 2 months
