Flashcards in Pharm of parkinson 2 Deck (26)
1
Diphenhydramine Class
anticholinergic
2
Diphenhydramine SE
1. swallowing difficulties
2. decreased bowel motility
3. urinary retention
4. sedation
3
Diphenhydramine function
1st class antihistamine
antagonizes H1 and M receptor
4
Rasagiline Class
MAO inhibitor
5
Rasagiline Function
allow reduction in L-DOPA doses in 20-30%
6
Rasagiline SE
worsening of postural hypotension
7
Selegiline class
MAO inhibitor
8
Selegiline function
allow for reduction in L-DOPA doses by 20-30%
9
Selegiline SE
worsening of postural hypotension
10
Tolcapone
class
COMT inhibitor
11
Tolcapone
SE
inhibits liver enzymes and has caused liver toxicity
12
Entacaptone class
COMT inhibitor
13
The substantia nigra pars compacta (SNc) sends dopaminergic axons to:
2 populations of medium spiny neurons in the striatum; those with D1 receptors and those with D2 receptors.
14
Neurons with D1 receptors are excited by_____
dopamine and stimulation results in production of cAMP.
15
Neurons with D2 receptors are inhibited by____.
binding of dopamine
16
D2 R inhibited by dopamine:
1. These neurons project to the globus pallidus external (GPe) segment and are also GABAergic neurons.
2. GABAergic GPe neurons (aka inhibitory) project to the subthalamic nucleus (STN).
3. The STN has glutaminergic neurons that are excitatory and stimulate the GPi.
4. Stimulation of the GPi results in inhibition of the VL thalamus.
17
GABAergic neurons means that they inhibit
GPe neurons from firing
18
Neurons with D1 Receptors are excited by dopamine and stimulation results in_____.
production of cAMP
19
Neurons with D1 Receptors are
1spiny neurons that are GABAeric.
20
GABAeric means that when stimulated by DA, neurons result in
increased inhibition of the globus pallidus internal (GPi) segment
21
The GPi inhibits
ventro-lateral thalamus (VL).
the VL activates the cortex to create the desired movement.
22
In Parkinson’s disease, dopamine is not produced due to ____
death of cells in the substantia nigra.
23
loss of dopamine causes
too much inhibition on both the D1 and D2 arm of the pathway, inhibiting the thalamus’s signaling ability to the cortex.
24
The result of substantia nigra death on the D1 side of the path is that ___
the GPi is not inhibited the way it should be causing unopposed inhibition from the GPi to the VL thalamus.
There is too much inhibition
25
The result of substantia nigra death on the D2 side of the path is____
that the medium spiny neurons of the striatum are NOT inhibited so they fire GABA signs like crazy causing unopposed inhibition of the GPe.
26