neurodegenerative

Question 1

Loss of intrinsic GABAergic neurons of the of the Vladimir Putin(caudate putamen)

Answer 1

Huntington’s disease

Question 2

Excessive cortical activity, chorea, hyperkinesia

Answer 2

Huntington’s disease
chorea-a neurological disorder characterized by jerky involuntary movements affecting especially the shoulders, hips, and face.

Question 3

what are lewy bodies?

Answer 3

abnormal intracellular proteins clump or aggregate
a synuclein ubiquitin
Parkinson’s

Question 4

Progressive degeneration of y-aminobutyric acid (GABA) neurons in the basal ganglia and cortex

Answer 4

Huntington disease

Question 5

And anti viral agent used to treat mild to moderate Parkinson disease, Anti cholinergic properties

Answer 5

Amantadine/Symmetrel

Question 6

loss of intrinsic cortical neurons beginning in the entorhinal cortex that spreads to the whole cortex resulting in a loss of memory and logical thinking

Answer 6

Alzheimer’s disease

Question 7

Potent dopamine D1 and D2 receptor agonist

Answer 7

Apomorphine(apokyn)

Question 8

name two anticholinesterase used to treat Alzheimer’s

Answer 8

donepezil(Aricept)

galantamine (razadyne)

Question 9

With this disease there is a marked decrease in cholinergic neuron activity as a result these patients are very sensitive to central nervous system effects of muscarinic antagonist

Answer 9

Alzheimer’s patients

Question 10

Parkinson’s disease is an issue with the neurotransmitter______ and decreased activation of the _______pathway which results and an increased activation of the_______ pathway. Parkinson’s is a ____kinetic disorder.

Answer 10

Parkinson’s disease there’s an issue with the neurotransmitter dopamine and decreased activation of the direct pathway which results in an increased activation of the indirect pathway. Parkinson’s is a hypokinetic disorder.

Question 11

these drugs are used to treat huntington’s by decreasing dopamine neurotransmission, depletion of dopamine and nerve terminals by inhibition of VMAT

Answer 11

tetra-benazine/ xenazine

deu-tetra-benazine/ austedo

Question 12

side effect of being metabolised to methamphetamine or L amphetamine which may account for the side effect of anxiety and insomnia

Answer 12

Selegine/eldepryl-selective irreversible MAOB inhibitor

Question 13

GABA and decreased indirect pathway, which disease?

Answer 13

Huntington’s

Question 14

Parkinson’s disease also results in some neurodegenerative signs related to autonomic degeneration
4

Answer 14

orthostatic hypotension
Significant autonomic dysfunction-hemodynamic instability
Bowel and bladder and mobility
Incontinence

Question 15

Major side effects similar to carbidopa-levodopa/Sinemet-orthostatic hypotension, nausea vomiting Constipation, psychotic reactions, cardiac dysrhythmias, dyskinesias

Answer 15

Apomorphine(apokyn)

Question 16

What is the longer duration patch form of Ropinirole/requip

Answer 16

Rigatoni

Rotigone/neupro

Question 17

Parkinson’s disease can also include some non motor cognitive and emotional symptoms such as?

Answer 17

fatigue 
loss of interest in religion 
Alexithymia-Loss of one's ability to recognize one's own emotions as well as the emotions of others
dementia 
Depression of mood
Anxiety

Question 18

a key relay station in the initiation and control of coordinated patterns of movement

Answer 18

the basal ganglia/basal nuclei

Question 19

these drugs treat Huntington’s disease by blockade of postsynaptic dopamine

Answer 19

Antipsychotic drugs haloperidol and chlorpromazine

Question 20

b-amyloid, tau protein which disorder

Answer 20

Alzheimer’s

Question 21

Loss of dopamine neurons of the substantia nigra that innervate the basal nuclei (basal ganglia)

Answer 21

Parkinson’s disease

Question 22

side effects include may exacerbate carbidopa-levodopa/Sinemet induced dyskinesias, confusing and hallucinations

Answer 22

Selegine/eldepryl-selective irreversible MAOB inhibitor

Question 23

why are typical antipsychotics not administered to Parkinson disease patients

Answer 23

blocking D2

typical antipsychotics are D2 antagonist

Question 24

What causes the Parkinson psychosis hallucinations and delusions

Answer 24

D2

Question 25

A muscarinic receptor antagonist used to reduce cholinergic dominance in Parkinson's

Answer 25

Benztropine(Cogentin)

Question 26

Parkinson's adjunct therapy that peripherally inhibits COMT-Blocks conversion of L-DOPA to 3-O-methyldopa increasing L-DOPA availability

Answer 26

Entacapone/comtan

Question 27

Acts on dopamine one and two, a rescue medication, short acting, approved for subq doses? this drug must be taken with what? How must the IV infusion be administered?

Answer 27

Apomorphine(apokyn) D1&2 agonist Antiemetic long term in-dwelling venous catheter

Question 28

name a positive allosteric modulator of nicotinic acetylcholine receptors used to treat Alzheimer's

Answer 28

galantamine (razadyne) | anticholinesterase

Question 29

What's some anesthetic implications for Parkinson's disease

Answer 29

Short half life of L-DOPA, frequent doses-may have to administer and long surgeries avoid dopamine antagonists avoid dopamine receptor blockade for PONV prophylaxis

Question 30

What causes the adverse side effects of dopamine?

Answer 30

Dopamine is metabolised in norepinephrine and epinephrine in the CNS and in the periphery. side effects are what you would expect from high catecholamine levels

Question 31

Inhibits the metabolism of L-DOPA in the periphery by action on AADC(aromatic amino acid decarboxylase)

Answer 31

Carbidopa/sinemet

Question 32

dopamine and decreased direct pathway, which disease?

Answer 32

Parkinson's

Question 33

Noncompetitive glutamate NMDA receptor antagonists used to treat Alzheimer's

Answer 33

Memantine/namzaric

Question 34

The treatment strategy of which disease is to decrease dopamine neurotransmission? what mechanism of the disease causes this to be a solution?

Answer 34

Huntington disease because there is a destruction of the GABA neurons in the basal ganglia and cortex/indirect pathway, the dopamine mediated direct pathway is overactive.

Question 35

an inverse agonist at serotonin 5 HT-2A receptors-

Answer 35

pimavanserin(nuplazid) pimps might work out of vans too the one that's similar to LSD far out man hippies live in vans like Brennan

Question 36

Dead and dying nerve cells contain neurofibrillary tangles which are made up of twisted strands of tau protein

Answer 36

Alzheimer's Tau protein stabilize microtubules, Microtubules provide platforms for intracellular transport Toxic b amyloid oligomers Impair basic neuronal processes and activate immune system causing inflammation

Question 37

What might interact with carbidopa-levodopa/sinemet reducing its efficacy?

Answer 37

Pyridoxine(vitamin B6) accelerate systemic metabolism of levodopa by enhancing the effectiveness of decarboxylase thereby decreasing availability of the amino acid to the brain

Question 38

Name of dopamine receptor agonist primarily at D2, adjunct Parkinson therapy

Answer 38

Ropinirole/requip

Question 39

To prevent a life threatening hypertensive crisis and hyperpyrexia, non selective Mao inhibitors should be discontinued how many days before carbidopa-levodopa/Sinemet is administered

Answer 39

14 days

Question 40

Parkinson's is a profound loss of dopaminergic neurons where?

Answer 40

substantia nigra

Question 41

a synuclein ubiquitin which disorder

Answer 41

Parkinson's disease

Question 42

Used for management of drug induced parkinsonism and schizophrenic patients treated with antipsychotics(potent D2 receptor antagonist), Preferred treatment of neuroleptic induced extrapyramidal syndrome

Answer 42

Benztropine(Cogentin) Used for management of drug induced parkinsonism and schizophrenic patients treated with antipsychotics(potent D2 receptor antagonist), Preferred treatment of neuroleptic induced extrapyramidal syndrome

Question 43

the basal ganglia consist of three structures

Answer 43

Caudate nucleus Putamen Globus pallidus

Question 44

Describe some of the characteristic motor symptoms of Parkinson's disease

Answer 44

resting tremor(most obvious early symptom) rigidity and stiffness stooped posture shuffling gait poor righting reflex-balance Bradykinesia-slowness of movement, difficulty walking Difficulty speaking and swallowing Difficulty writing (tiny, crowded handwriting) mask like face in advanced stages of Parkinson's disease patients become virtually immobile

Question 45

What are two common characteristics of neurodegenerative disorders?

Answer 45

accumulation abnormal protein | progressive and irreversible loss of neurons in the brain

Question 46

Within the basal nuclei Which pathway facilitates movement and which pathway inhibits movement?

Answer 46

Direct pathway facilitates movement | Indirect pathway inhibits movement

Question 47

what part of the brain does Alzheimer's begin in?

Answer 47

entorhinal cortex

Question 48

Adverse side effects include cardiac arrhythmias and transit tachycardia, nausea and vomiting, and orthostatic hypotension. what is the nausea and vomiting caused by?

Answer 48

L-Dopa | dopamine D receptors on the chemo trigger zone

Question 49

carbidopa-levodopa/sinemet is contraindicated in combination with which drugs? two different classes

Answer 49

dopamine receptor antagonist-typical antipsychotic drug chlorpromazine, Thorazine haloperidol, Haldol flupenthixol, fluanxol Non selective irreversible Mao inhibitors Phenelizine/nardil Ipronizad(marsilid, iprazid, ipronid

Question 50

Huntington protein which disorder

Answer 50

Huntington’s disease

Question 51

This disease has a loss of dopaminergic input/inhibition, which leads to acetylcholine mediated excitation of inhibitory GABA neurons. GABA has done let loose like it's spring break in Myrtle Beach 1995.

Answer 51

Parkinson disease

Question 52

dopamine precursor that crosses the blood brain barrier by active transport to stimulate dopamine synthesis

Answer 52

levodopa(l-dopa)

Question 53

What treatment strategy/drug would block dopamine degradation in the brain?

Answer 53

Selegine/eldepryl-selective irreversible MAOB inhibitor

Question 54

Administration of this drug has the benefits of a lower dose of L-DOPA being administered, more L-DOPA reaches the brain, reduction in peripheral side effects, resulting in less peripheral conversion of L-DOPA to dopamine and norepinephrine

Answer 54

carbidopa-levodopa/sinemet

Question 55

The disease process progresses to include lateral temporal and parietal lobes and when severe associated with loss of neurons throughout the cortex including frontal and occipital lobe, severe cortical atropy in later stages

Answer 55

Alzheimer's

Question 56

Usually develops in the mid 30s to 40s, early symptoms include mental decline, problems with mood and cognition, general lack of coordination and an unsteady gait. as the disease advances coordinated movements become difficult, uncoordinated involuntary jerking or twitching movements known as chorea, further mental decline into dementia

Answer 56

Huntington's disease

Question 57

Reduced cortical stimulation hypokinetic disorder

Answer 57

Parkinson's