Antiparkinsonian Drugs Flashcards
What are the four key characteristics of Parkinson’s?
- Bradykinesia
- Muscular rigidity
- Resting tremor
- Postural instability
What are the proteins that are deposited in Parkinson’s?
Lewy bodies
What is the cause of parkinson’s?
Progressive loss of dopaminergic neurons in the basal ganglia
What happens to Parkinsonian pts without treatment?
rigid, akinetic state, leading to secondary complication like pneumonia or PE
What is the goal of pharmacologic treatment of Parkinson’s?
Improve functionality
Where is the loss of dopaminergic neurons in Parkinson’s greatest? What other brain regions are affected?
Basal ganglia
Brainstem
Hippocampus
Cerebral cortex
What are the 3 main characteristics of Neurodegenerative disorders?
- Progressive and irreversible loss of neurons
- Etiology relates to specific neuronal loss
- Aggregation of misfolded proteins
What is the neuron/neurotransmitter lost in AD?
Ach in hippocampal areas
What is the protein that is accumulate in Parkinson’s? Where?
Alpha-synuclein in intracytoplasmic aggregates
What is the protein that is accumulate in AD? Where?
Extracellular beta-amyloid plaques, and intracellular neurofibrillary tangles
What is the protein that is accumulated in Huntington’s disease?
Intranuclear Huntingtin protein
What age does Parkinson’s usually start?
50 and 60s
What are the non-motor effects of PD?
Cognitive decline
Affective disorder
Sleep disorders
Personality changes
Resting tremor = what dysfunction?
Basal ganglia (PD)
Why is it that cerebellar dysfunction are usually ipsilateral to the lesion?
Crosses twice
What part of the basal ganglia specifically, is affected by PD?
Substantia nigra
What are the components of the motor loop?
Cortex
Striatum
Pallidum
Thalamus
What is the principal input structure of the basal ganglia? Where does this receive input from? What kind of input?
Striatum, receives excitatory input from the cortex
What is the neurotransmitter used in the striatum?
Dopamine
What are the two pathways from the striatum?
Direct pathway = striatum to substantia nigra pars reticularis and GP
Indirect = From the striatum through the GP and subthalamic nucleus (GABA links)
What is the primary defect in PD?
Destruction of the dopaminergic neurons of the substantia nigra pars compacta
What are the neurotransmitters from the cerebral cortex to the striatum?
Glu (+)
What are the neurotransmitters from the striatum to the globus pallidus?
GABA (-)
What is the neurotransmitter from the globus pallidus to the subthalamic nucleus?
GABA (-)
What is the neurotransmitter from the globus pallidus to the substantia nigra?
Glu (+)
What is the neurotransmitter from the substantia nigra to the VA/VL thalamus?
(GABA) (-)
What is the neurotransmitter from the thalamus, back to the cortex?
Glu (+)
Draw out the neurotransmitter/ basal ganglia relationship pathway (pg 4 of the handout).
Draw, and mark the pathway destroyed in PD