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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?

A

-70%

24
Q

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

A

-60,000

25
Q

Where is the decreased activity found in a Parkinson’s patient?

A

-Striatum (mostly dopamine cells)

26
Q

What are environmental causes of Parkinsons?

A
  • Magnesium
  • Mercury
  • Pesticides
  • Trauma
  • Dopamine itself
27
Q

What are environmental causes of Parkinsons?

A
  • Magnesium
  • Mercury
  • Pesticides
  • Trauma
  • Dopamine itself
28
Q

What does Dopamine turn into the make it neurotoxic?

A

-Quinones that turn into Reactive Oxygen Species (ROS)

29
Q

What genetics can cause Parkinson’s disease?

A
  • Alpha Synuclein (a trafficking protein that doesn’t work anymore)
  • Larkin
30
Q

When you take away the dopamine what effects go up?

A

-Cholingergic effects

31
Q

What do you do for treatment of Parkinsons?

A
  • Increase Dopamine side

- Decrease Cholinergic side

32
Q

Levodopa (L-DOPA) is what?

A

-A precursor to Dopamine

33
Q

What does Azilect do?

A

-Inhibit dopamine breakdown

34
Q

What does Entacapone do?

A

-Improve the effect of carbidopa-levodopa

35
Q

T/F L-DOPA gets metabolized before it gets to the brain

A

True

36
Q

Can Dopamine cross the BBB?

A

-No

37
Q

What does carbidopa do?

A

-Inhibit the metabolism of L-DOPA in the periphery

38
Q

What two drugs can you use with Carbidopa-Levodopa?

A
  • Azilect

- Entacapone

39
Q

What is Entacapone an inhibitor of?

A

-COMT

40
Q

Can giving L-DOPA increase the degeneration that causes Parkinsons?

A

-Yes in theory it could but not really hard evidence

41
Q

What is an anticholinergic drug that is commonly used in Parkinson’s pts?

A
  • Trihexylphenidyl

- Benztropine

42
Q

MAO-B inhibitors used for parkinson’s disease include what?

A
  • Rasagline (Azilect)

- Selegiline (Eldepryl)

43
Q

COMT inhibitors used for parkinson’s disease include what?

A
  • Tolcapone

- Entacapone

44
Q

What are the dopamine agonists used for Parkinson’s disease?

A
  • Pramipexole
  • Ropinirole
  • Rotigotine
  • Apomorphine
  • Cromocriptine
45
Q

What is the early onset drug used for Parkinson’s disease?

A

-Pramipexole

46
Q

What are surgical approaches for Parkinson’s?

A
  • Put an electrode into the brain

- Can diminish tremors in younger pts

47
Q

What drugs given to treat parkinsons disease can cause xerostomia, gingivitis, and glossitis?

A

-Ropinirole

48
Q

What are three drugs given to treat Parkinsons disease that can cause glossitis?

A
  • Carbidopa with Levodopa
  • Carbidopa with Levodopa and Entacapone
  • Ropinirole
49
Q

What drug can cause dark saliva in the treatment of Parkinsons disease?

A

-L-DOPA

50
Q

What oral hygiene strategies can you use for xerostomia in parkinsons disease?

A
  • Frequent sips of water may assist with this problem in addition to avoiding dehydration
  • Avoid alcohol and smokine
51
Q

What oral hygiene strategies can you use to treat sialorrhea in parkinson’s disease?

A

-Use anticholinergic medications to address this problem

52
Q

If a person is using levodopa what oral hygiene strategy should they do?

A

-Rinse the mouth to prevent discoloration of the teeth

53
Q

What is selegiline?

A

-MAO inhibitor

54
Q

What is entacapone?

A

-COMT inhibitor

55
Q

What is Pramipexole?

A

-D2 agonist

Human disease and therapeutics 2020 (60 decks)

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