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PHARMACOLOGY > Alzheimer's Disease > Flashcards

Alzheimer's Disease Flashcards

1
Q

what is Alzheimer’s Disease

A

age related dementia - destroys brain cells -> prgressive decline of mental function

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2
Q

early AZ

A

poor short-term memory recall
language problems
depression

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3
Q

late AZ

A 
long-term memory loss 
difficulty speaking
confusion, disorientation 
anger, sadness, mood swings 
speech impairment 
difficulty swallowing/chewing
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4
Q

what does a PET brain scan show

A

shows Red strong bind - slectively to myloid plaques

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5
Q

what is the major cholinergic output of the CNS

A

basal forebrain

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6
Q

what role does the hippocampus play

A

short term memory

spatial navigation

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7
Q

what brain changes are associated with AZ

A

shrinkage of brain in cellular parts/language memory spaces

increase in ventricle fluid-filled region

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8
Q

what characteristic changes in neural cells are associated with AZ

A

senile plaques = diffuse extracellular deposits of B amyloid (AB) protien

neurofibrillary tangles = fibrous intracellular deposits hyperphosphorylated tau (paired helical filaments)

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9
Q

what is altered in AZ patients

A

cleavage pattern of amyloid precursor protein (APP)

normal cleavage: a + y secretases

abnormal cleavage: B + y secretases

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10
Q

the role of soluble APP

A

sAPP = transcriptional inhibtior of Lipoprotien Receptor 1 (LPR1)

LPR1 facilitates the endocytosis of a cholesterol-protein complex from the blood into neurons

  • a deficit in LPR1 => increased cholesterol catabolism with associated abnormalities in synapse formation
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11
Q

why is soluble AB cytotoxic

A

AB can form ion channels in neuronal cell membranes
=may allow entry of excess Ca into neurons
cell death occurs by apoptosis

soluble peptide - based on the sequence of the pore forming region of the AB channel - blocks ion entry = prevents apoptosis

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12
Q

what do gene alteration increase likeliness of AZ

A

aggregation of AB is favoured by:
1. presence of ApoE4 variant of apolipoprotein E (component of chylomicrons / IDLs)

  1. mutations in the presenilin genes whose products - increase the activity of y-secretase
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13
Q

what is Tau

A

microtubule-associated protien = stabalises microtubules in neuronal processes

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14
Q

how is Tau altered

A

tau becomes hyperphosphorylated = inhibiting binding to microtubules
hyperphosphorylated tau forms insoluble aggregates
= may inhibit vesicular transport
mutations in tau = associated with early-onset AZ-like dementia

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15
Q

why does age = biggest risk factor

A 
lower metabolism
protein/cell repair 
GFs
mitochondrial dysfunction
free radicals
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16
Q

other possible contributing factors to AZ

A 
low education
severe head injury 
CVD
obesity
high blood pressure
high cholesterol
diabetes
17
Q

what is AZ associated with and what is the evidence

A

loss of cholinergic neurons

a decrease in choline acetyltransferase activity of cortex and hippocampus in AZ patients

decreased density of cortical nicotinic cholinergic receptors

18
Q

strategies for treating AZ

A
  1. agents that compensate hypofunction of the cholinergic system
  2. agents that interfere with metabolism of AB peptide
  3. agents that affect the process of formation of neurofibrillary tangles
  4. anti-inflammatory compounds
  5. agents that treat symptoms
19
Q

AChE inhibitors

A
  • GALANTAMINE (allosteric activator of nicotinic R)
  • donepezil
  • metrifonate-prodrug form of physostigmine

used to treat mild/moderate AZ

side effects: enhancement of Parasymp NS:

  • nausea
  • abdominal pain
  • bradycardia
20
Q

selective agonists of muscarinic/nicotinic receptors

A

fewer PNS effects

may lose effectiveness over time due to feedback reduction in receptor conc / reduced receptor response to ACh

21
Q

agents that block excitotoxity

A

NMDA antagonist = block binding of glutamate

MEMANTINE - noncompetitive NMDA antagonist

a temporary improvement in cognitive function with moderate-severe AZ

22
Q

potential treatment

A

Methylthioninium chloride = dissolves tau polymers

stem cell therapy

23
Q

what do ApoE4 proteins do

A

lipoprotein complex - transport cholesterol/lipids through blood

24
Q

what does ApoE2 cause

A

high risk of AZ

PHARMACOLOGY (24 decks)

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