pharmacology: parkinson disease Flashcards Preview

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Flashcards in pharmacology: parkinson disease Deck (20):
1

nigrostriatal tract

caudate and putamen
DA agonists = initiation of movement

2

mesolimbic-mesocortical tracts

amygdala and hippocampus
DA agonists = reinforcement "good feelings"

3

tuberoinfundibular

endocrine (hypothalamus to pituitary)
DA agonists = decreased prolactin

4

chemoreceptor trigger zone (CTZ)

vomiting (DA agonists)

5

D1 receptors

Gs couples (increased cAMP)

6

D2A receptor

Gi coupled (decreased cAMP) - nigrostriatal (movement initiation)

7

D2C receptor

Gi coupled (decreased cAMP) - mesolimic (mood)

8

what are the dopaminergic neural pathways?

nigrostriatal tract, mesolimibic-mesocortical tracts, tuberinfundibular, chemoreceptor trigger zone

9

parkinson disease pathology

degeneration of nigrostriatal dopamine tracts with imbalance between dopamine (decreased) and ACh (increased)

DA and Ach both work on GABA-ergic neuron - Ach will stimulate GABA neuron causing inhibition and DA will inhibit the GABA neuron causing excitatory

10

what are the drugs used in parkinsons

levodopa, cabidopa, talcapone, entacapone, selegiline, bromocriptine, pramipexole, ropinirole, benztropine, trihexyphenidyl, diphenhydramine, amantadine

11

levodopa mechanism and side effects

a prodrug converted to dopamine by aromatic amino acid decarboxylase (AAAD)
side effects: dyskinesias, psychosis, hypotension (D1 receptor agonist), vomiting

12

carbidopa mechanism and use

peripheral inhibitor of AAD (noncompetitive, decrease vmax AAD) - prevents levodopa from being converted to dopamine in periphery - dopamine cannot cross BBB

13

talcapone and entacapone mechanism and use

COMT inhibitors - COMT converts L-dopa to 3-O-methyldopa (partial agonist at dopamine receptors and competes with Ldopa) - works in both brain and periphery

14

side effects tolcapone

hepatotoxic

15

selegiline mechanism

MAO B selective inhibitor (prevents breakdown of dopamine to metabolites) - initial treatment and adjunct to levodopa

16

selegiline side effects

dyskinesia, psychosis, insomnia - metabolized to amphetamine

17

bromocriptine mechanism, use and side effect

mechanism: dopamine receptor agonist
use: hyperprolactinemia and acromegaly
side effects: dyskinesias and psychosis

18

benztropine, trihyexyphenidyl, diphenhydramine mechanims and actions

muscarinic blockers - decrease ACh function
decrease tremor and rigidity but have little effects on bradykinesia

19

amantadine

antiviral - blocks muscarinic receptors and increases dopamine release

20

amantadine side effects

atropine like and livedo reticularis (skin and vessels dilate - rash with blue ness)