11.2 - Drugs used in neurological conditions Flashcards
What is the pathology behind Parkinsons?
Loss of dopaminergic neurones in substantia nigra. Results in reduced inhibition in neostriatum, allowing increased production of excitatory ACh. Results in abnormal signaling leading to impaired mobitility
What are the symptoms of parkinsons?
TRAP
Tremor, rigidity, akinesia, Postural instability
Mask like face, shuffling gait
What are the non idiopathic causes of parkinsons?
Corticobasal degeneration, drug induced, multiple systems atrophy, wilsons disease
What is wilsons disease? How does it cause damage?
Excess copper accumulation in tissue leading to neurological and hepatic disease
How is Myasthenia gravis treated? what happens in cases of overtreatment?
ACHesterase inhibitors
Overtreatment - cholinergic crisis leads to flaccid paralysis and resp failure
What are the ADRs to AChesterase inhibitiors?
SSLUDGE
Salivation, sweating, lacrimation, urinary incontinence, diarrhoea, GI hypermobility, emesis
What are the 5 drug classes used to treat parkinsons?
SALAD Selegiline (MAO-B inhibitor), amantidine, L-DOPA, Anticholinergics, dopamine receptor agonists
How is L-DOPA used?
Administered with peripheral DOPA decarboxylase inhibitor to prevent dopamine conversion outside brain
What are the ADRs of L-DOPA?
On/off motor, wearing off, dyskinesia, dystonia, long term use shows loss of efficacy
What is the MoA of monoamine oxidase B inhibitors?
Prevents dopamine breakdown
When is monoamine oxidase B inhibitors used?
To enhance effects of L-DOPA
What are the ADRs of dopamine receptor agonist?
sedation, hallucination, confusion, N&V
What is the MoA of COMT inhibitors?
reduce peripheral breakdown of L-DOPA. No use alone
What is the MoA of anticholinergics?
ACh has antagonistic effect to dopamine
What are some ADRs of anticholinergics?
anhydrosis, dry mouth, urinary retention
