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Pharmacology 2100 > Parkinsons > Flashcards

Flashcards in Parkinsons Deck (39):
1

what age does parkinsons usually show symptoms

60

2

signs of parkinsons

rhythmic tremor-rolling a pill motion
leaning forward and backward
muscle rigidity- jerky
difficulty rising from sitting
shrinking of writing
loss of spontaneous movements
bradykinesia- slow movement

3

how is movement controlled

signlas form motor cortex to spinal cord go to muscles

4

corticospinal tracts

from motor cortex to spinal cord
makes up the pyramids in the medulla

5

extra pyramidal system

basal ganglia signals to the cortex
controls movement without corticospinal nerves

6

voluntary motor pathways

upper and lower motoneurons
corticospinal pathway
piramidal tracts

7

involuntary motor pathways

extrapiramidal system
basal ganglia
reticular and vestibular system

8

what is parkinsons caused by

loss of neurons in substantia nigra and thus loss of dopamine innervation of striatum

9

when do symptoms appear

when 70% of nigrostriatal neurons are lost

10

what happens to gaba neurons normally

inhibited by dopamine and sitmulated by acetylcholine

11

what happens to gaba in parkinsons

dopaminergic neurons die so excess acetylcholine (stimulatory)

12

what happens to gaba in huntingtons

gaba and some acetylcholine neurons die

13

etiology of parkinsons

metabolism of dopamine by MAO B
environmental toxin
dopamine itslef an axidant
genetic pathway

14

what do COMT and DDC do

convert l-dopa before it can cross the BBB

15

di receptor dopamine subfamily

Gs adn increase camp

16

d2 dopamine subfamily

Gi and decrease camp

17

striatum dopamine receptors

smooth muscle in periphery

18

dopamine agonists

pramipexole
ropinirole

19

first line therapy for parkinsons

levadopa

20

how does l-dopa distribute in the body

rapidly absorbed from SI by amino acid transport system
crosses the BBB
peak concentraiton an hour after ingestion with 1-3 hour half life

21

bioavailability issues with ldopa

metabolized in the intestine, blood, and periphery
only 1% actually enters the brain

22

therapeautic effects of ldope

reduces rigidity and bradykinesia
improves motor function and speech
return of facial expression

23

side effects of ldopa

anorexia
hypotension adn cardiac arrhythmias
dyskinesias (involuntary movements)
on-off effect becuase wears off
behavoiural changes
insomnia confusion
schizophrenia like behaviour

24

why is carbidopa used in adjuncts with ldopa

inhibits dopa decarboxylase so less ldopa converted outside the BBB thus reducing the amount required and the adverse effects

25

what does entacapone do

reversible inhibtors of peripheral COMT used in later stages
can enhance some adverse effects of ldopa such as dyskinesias

26

what do ropinirole and pramipexole do

agonists of d2 and d3 receptors in and outside of corpus striatum that improves depressive symptoms

27

side effects of dopamine agonists

action of d2 receptors outside of corpus striatum causes dyskinesia
activates other D receptors suppressing prolactin secretion, suppressing growth hormone release
hypotension
visual and auditory hallucinations

28

examples of muscarinic antagonists

trihexyphenidyl
benzatropine mesylate

29

who are the muscarinc antagonists used in

young patients wiht tremor to inhibit striatal cholinergic activity
not in the elderly

30

muscarinic antagonist side effects

dry mouth
blurred vision
urinary retention
constipation
mental confusion
delusions
drowsy
hallucination
glaucoma

31

what does MAO A do

metabolizes NE and serotonin

32

what does MOA B do

metabolizes dopamine

33

what does selegiline do

selectively inhibits MOAB to enhance ldopa effects and manage on off effect

34

side effects of selegiline

insomnia
cognitive problems
dont use with MAOI

35

why is rasagiline better than selegiline

less production of amphetamine like byproducts
better bioavailability
useful for depressed of poor cognitive function patients

36

what does amantadine do

increase dopamine release in the CNS

37

how is amantadine excreted

kidney takes 12-14hr

38

side effects of amantadine

similar to ldopa
livedo reticularis-redblue netliek mottling of skin of the extremities with long term use due to vasoconstriction

39

some non pharm therapies

surgery
deep brain stimulation
glial cell line derived neurotrophic factor
stem cells replace dopaminergic neurons