Parkinson's Drug Flashcards Preview

Clin med II Patho > Parkinson's Drug > Flashcards

Flashcards in Parkinson's Drug Deck (18):
1

Cardinal signs of Parkinson's disease

Resting tremor
Bradykinesia
Postural instability
Rigidity

2

Etiology of PD

degeneration of dopamine producing neurons in the substantia nigra compacta in the midbrain

imbalance of decrease in dopamine and increase in AcH

others: 5-HT, NE, Glutamate, GABA

3

Levodopa treatment

goal: increase dopamine in the basal ganglia

can't directly administer dopamine due to BBB

precursor L-Dopa adminstered to eventually cross BBB and become dopamine

4

Carbidopa treatment

L-dopa becomes dopamine before reaching the brain

Carbidopa prevents premature conversion of L-dopa into dopamine by inhibiting the dopa decarboxylase enzyme

often used in conjunction with L-dopa

5

Synthesis of Dopamine

tyrosin through tyrosine hydroxylase becomes
dopa through dopa decarboxylase becomes
dopamine

6

L-dopa side effects

GI irritation, hypotension
Dyskinesia, freezing gait
psychotropic effect, others

7

L-dopa fluctuation

End of dosage fluctuation
decrease response due to end of dosing cycle

On-off fluctuation
fluctuation of response during the cycle of dosing

8

L-dopa tolerance

decrease in benefit is seen within 4-5 years due to tolerance

may postpone usage for more severe cases

may want to use immediately if case is progressed already

9

Dopamine agonist

can cross the BBB
longer half life=more stable response to drug
may be used as the initial tx of PD
neuroprotective?

10

Dopamine agonist associated side effects

naseua, vomitting
confusion, hallucination
postural hypotension, increase dyskinesia

11

COMT inhibitors

inhibits the enzyme that degrades dopamine
increases "on" time and decreases fluctuation
often used in conjunction with L-dopa and Carbidopa

12

COMT inhibitors associated side effects

GI irritation diarhhea
OH, increased dyskinesia

13

Anticholinergic agents

decrease AcH influence= decreased rigdity and tremor

limited use of these drugs due to the Anticholinergic package effects

14

MAO-B inhibitors

prolongs the effect of dopamine in the brain

combined with L-dopa= increase effect time

neuroprotective

no associated side effects

15

Amantadine

antiviral (discovered by chance)
NMDA blocker that decreases excitatory Glut activity
decreases chance of dyskinesia

16

Amantadine associated risks

OH, skin discoloration, psychotropic effects

17

Rehab implications

optimal treatment time is 30-60 minutes after administering medication

assess synergistic effect of therapy and meds

18

Future research

tissue transplant
surgery
toxin role?