BB1a Flashcards
Which PD treatment can be prescribed as a transdermal patch? [1]
State the MoA [1]
b. Rotigotine
Dopamine agonist: directly activates indirect pathway
Which drugs are Madopar are combination of? [2]
levodopa and benserazide.
MoA of benserazide? [1]
peripheral decarboxylase inhibitor
- 95% of neurons in the striatum use which NT? [1]
GABA
The dorsal striatum is comprised of which two structures? [2]
Caudate nucleus and putamen
The dorsal striatum is comprised of which two structures? [2]
b. Caudate nucleus and putamen
Which basal ganglia nuclei are the intrinsic nuclei? [2]
Located between the input and output nuclei in the relay of information
b. Globus pallidus externus
c. Substantia nigra pars compacta
Which basal ganglia structures are the output [2] and input nuclei? [2]
1. Input nuclei:
a. Receive information from different sources (cortical, thalamic and nigral)
b. Caudate nucleus and putamen (aka dorsal striatum)
2. Output nuclei:
a. Send basal ganglia information to the thalamus
b. Globus pallidus internus
c. Substantia nigra pars reticulata
Describe the direct, indirect and hyper-direct pathway :)
Describe the differences between D1 and D2 receptor inputs to the direct and indirect pathways
Describe the pathophysiology of Parkinson’s disease [4]
Describe the link between PD and depression [2]
b. Thought to be due to the reduction in dopamine levels
c. Also due to levodopa wearing off before next dose is due
Selegiline should not be treated alongside which drug class? [1]
SSRIs
Describe why the patient’s symptoms got worse
Describe the symptoms of L-dopa induced dyskinesia [6]
a. Dystonia:
i. This is where excessive muscle contraction leads to abnormal postures or exaggerated movements.
b. Chorea:
i. These are abnormal involuntary movements that can be jerking and random.
c. Athetosis:
i. These are involuntary twisting or writhing movements usually in the fingers, hands or feet.
d. Depression
e. Psychosis
f. Insomnia
Describe MoA of L-Dopa [1]
Which drug class is it commonly combined with? [1] Give two examples [2]
i. Synthetic dopamine
ii. Combined with peripheral decarboxylase inhibitors:
1. Carbidopa
2. Benserazide
Describe the MoA of Rotigotine [1]
How is it prescribed? [1]
What symptom can it specifically treat? [1]
i. Dopamine agonist: directly activates indirect pathway
1. Transdermal patch
2. Treats restless leg syndrome
State the MoA of Selegiline [1]
i. Monoamine Oxidase-B inhibitor
1. Inhibits the breakdown of dopamine secreted by dopaminergic neurons
State the MoA of Selegiline [1]
i. Monoamine Oxidase-B inhibitor
1. Inhibits the breakdown of dopamine secreted by dopaminergic neurons
Describe the advantage of prescribing Selegiline [2]
ii. Used for patients taking Levodopa combinations
iii. Reduces the dose needed for Levodopa combinations to control symptoms and reducing the on/off effect
What drug class is Citalopram from? [1]
i. Selective serotonin reuptake inhibitor:
Describe the MoA of citalopram [3]
- Increases amount of serotonin by reducing the reuptake of serotonin from synaptic cleft into the presynaptic neuron
- Antagonise serotonin transporter (SERT) on presynaptic membrane
- Allows more serotonin to bind to 5HT receptors on post synaptic membrane
State 4 AEs of using citalopram and other SSRIs [4]
- Sexual dysfunction
- Sleep disturbance
- Anxiety
- GI distress
-
Suicide ideation & self harm
a. Review within a week
What drug class is Mirtazapine? [1]
i. Tricyclic antidepressant
Describe the MoA of Mirtazapine [1]
inhibits the central presynaptic alpha-2-adrenergic receptors, which causes an increased release of serotonin and norepinephrine.
