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Human disease and therapeutics 2020 > CNS degenerative disorders > Flashcards

CNS degenerative disorders Flashcards

1
Q

What two components do you see in almost all degenerative disorders?

A
  • Cognitive

- Movement

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2
Q

When do you start to see manifestations of CNS degenerative disorders?

A

-Later in life

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3
Q

What are eight mechanisms that can cause CNS degenerative disorders?

A
  • Hypoxia
  • Excitatory Amino Acids
  • Ion fluxes
  • Free radicals
  • Immune responses
  • Infections
  • Apoptosis
  • Protein aggregation
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4
Q

What is an excitatory amino acid that can be neurotoxic?

A

-Glutamate (AMPA, NMDA, Kainate (receptors))

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5
Q

What ion fluxes can cause CNS degenerative disorders?

A
  • Ca++ (if you get high concentrations in places they shouldn’t be it can really foul up a cell) #1
  • Manganese
  • Magnesium
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6
Q

What free radical elements can cause CNS degenerative disorders?

A
  • Catecholamines (can make free radicals via the hydroxy groups) (Dopamine is a free radical culprit)
  • Glutamate can generate nitric oxide
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7
Q

If you have an AB at the end of a drug what is a likely use of that drug?

A

-To target the immune system

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8
Q

What is Lewy bodies (aggregate of proteins) part of?

A

-Parkinsons disease

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9
Q

What are the clinical manifestations of Parkinsons disease?

A
  • Tremor
  • Rigidity
  • Bradykinesia
  • Forward tilt of body (postural abnormalities)
  • Short, shuffling gate
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10
Q

What are some protein aggregations that cause CNS degenerative disorders?

A
  • Lewy bodies (Parkinson’s)

- Beta-amyloid (Alzheimer’s)

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11
Q

T/F Amphetamines increase your chance of getting parkinsons

A

True

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12
Q

T/F Lots of salivation can be a sign of parkinsons disease if a person has dysphagia

A

True

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13
Q

If a person has parkinson’s disease what type of drug are they usually on?

A

-Anti-cholinergic drugs

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14
Q

What happens to the salivary secretions to a person with parkinson’s disease?

A

-They go down creating more viscous saliva

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15
Q

What are some of the late symptoms of parkinson’s disease?

A
  • Depression
  • Immobile
  • Loss of bowel control (constipation)
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16
Q

What is the oral status of a person with Parkinson’s disease?

A

-Avg. 7 root canals

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17
Q

What are synthetic anticholinergic drugs?

A
  • Glycopyrrolate
  • Benzotropine mesylate
  • Propantheline bromide
  • Trihyxphenidyl HCl
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18
Q

What is Phsyotigmine?

A

-Acetylcholinesterase inhibitor

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19
Q

What causes parkinson’s disease?

A

Low or falling dopamine levels because dopiminergic neurons in the substantia nigra have died

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20
Q

Does Parkinson’s disease begin unilateral or bilateral?

A

-usually unilateral

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21
Q

How many people get parkinson’s disease?

A

1/200

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22
Q

After the age of 85 what percent of people have Parkinson’s?

A

-25%

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23
Q

How many dopamine neurons have to be dead before you see early symptoms of Parkinson’s?

24
Q

How many new cases of Parkinson’s are diagnosed in the US per year?

25
Where is the decreased activity found in a Parkinson's patient?
-Striatum (mostly dopamine cells)
26
What are environmental causes of Parkinsons?
- Magnesium - Mercury - Pesticides - Trauma - Dopamine itself
27
What are environmental causes of Parkinsons?
- Magnesium - Mercury - Pesticides - Trauma - Dopamine itself
28
What does Dopamine turn into the make it neurotoxic?
-Quinones that turn into Reactive Oxygen Species (ROS)
29
What genetics can cause Parkinson's disease?
- Alpha Synuclein (a trafficking protein that doesn't work anymore) - Larkin
30
When you take away the dopamine what effects go up?
-Cholingergic effects
31
What do you do for treatment of Parkinsons?
- Increase Dopamine side | - Decrease Cholinergic side
32
Levodopa (L-DOPA) is what?
-A precursor to Dopamine
33
What does Azilect do?
-Inhibit dopamine breakdown
34
What does Entacapone do?
-Improve the effect of carbidopa-levodopa
35
T/F L-DOPA gets metabolized before it gets to the brain
True
36
Can Dopamine cross the BBB?
-No
37
What does carbidopa do?
-Inhibit the metabolism of L-DOPA in the periphery
38
What two drugs can you use with Carbidopa-Levodopa?
- Azilect | - Entacapone
39
What is Entacapone an inhibitor of?
-COMT
40
Can giving L-DOPA increase the degeneration that causes Parkinsons?
-Yes in theory it could but not really hard evidence
41
What is an anticholinergic drug that is commonly used in Parkinson's pts?
- Trihexylphenidyl | - Benztropine
42
MAO-B inhibitors used for parkinson's disease include what?
- Rasagline (Azilect) | - Selegiline (Eldepryl)
43
COMT inhibitors used for parkinson's disease include what?
- Tolcapone | - Entacapone
44
What are the dopamine agonists used for Parkinson's disease?
- Pramipexole - Ropinirole - Rotigotine - Apomorphine - Cromocriptine
45
What is the early onset drug used for Parkinson's disease?
-Pramipexole
46
What are surgical approaches for Parkinson's?
- Put an electrode into the brain | - Can diminish tremors in younger pts
47
What drugs given to treat parkinsons disease can cause xerostomia, gingivitis, and glossitis?
-Ropinirole
48
What are three drugs given to treat Parkinsons disease that can cause glossitis?
- Carbidopa with Levodopa - Carbidopa with Levodopa and Entacapone - Ropinirole
49
What drug can cause dark saliva in the treatment of Parkinsons disease?
-L-DOPA
50
What oral hygiene strategies can you use for xerostomia in parkinsons disease?
- Frequent sips of water may assist with this problem in addition to avoiding dehydration - Avoid alcohol and smokine
51
What oral hygiene strategies can you use to treat sialorrhea in parkinson's disease?
-Use anticholinergic medications to address this problem
52
If a person is using levodopa what oral hygiene strategy should they do?
-Rinse the mouth to prevent discoloration of the teeth
53
What is selegiline?
-MAO inhibitor
54
What is entacapone?
-COMT inhibitor
55
What is Pramipexole?
-D2 agonist

Human disease and therapeutics 2020 (60 decks)

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