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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

This unopposed inhibition in parkinsons means the

1. GPe can’t fire its own GABA neurons
2. so the STN is highly active
3. The result of a highly active glutaminergic STN is excitation of the GPi.
4. the GPi inhibits the VL thalamus, once again causing too much inhibition of the system.