Drugs and Other Treatments for Parkinson's Disease Flashcards
What are aims of the two types of treatment for Parkinson’s Disease?
Reduce the cholinergic transmission (muscarinic antagonists). Increase dopaminergic transmission (dopamine agonist etc).
What is the role of amantadine (antiviral drug) in treating Parkinson’s Disease?
It increases dopamine production.
State 2 dopamine agonists which treat Parkinson’s Disease.
Bromocriptine. Pramipexole. Ropinirole.
State a COMT inhibitor.
Entacapone. Tolcapone.
What enzyme converts L-Dopa into Dopamine?
Dopa decarboxylase.
L-dopa is often converted into dopamine in the intestinal wall, rather than post the blood-brain barrier. What is given in conjunction with L-Dopa to stop this happening?
Dopa decarboxylase (DDC) inhibitor e.g Carbidopa, benserazide.
State 2 of the benefits of L-DOPA.
Improves rigidity, bradykinesia, facial expression, speech and handwriting (80% patients).
Which receptors are associated with direct (D1R stim), and which ones are associated with indirect (D2R)?
Direct - D1R stim. Indirect - D2R stim.
State 2 side effects of L-Dopa.
Nausea. Postural hypotension. Psychological (hallucinations, confusion, insomnia, nightmares).
State 2 chronic side effects of L-dopa.
Motor fluctuations (‘on-off’ effect and wearing effect) e.g. might freeze. Levodopa-induced dyskinesia e.g. hyperkinetic, involuntary movements.
What patch is used to maintain dopamine levels?
Rotigotine patch.
Name 2 MAO-B inhibitors.
Selegiline. Rasagiline.
State 2 surgical approaches to Parkinson’s Disease.
Neuroablative Surgery (lesion is made in the basal ganglia to restore normal thalamocortical loop). Deep brain stimulation (Direct neural stimulation of basal subthalamic nuclei to ‘switch off’ or ‘normalise firing’ - increase basal ganglia output, reduce motor symptoms).
State 3 non-motor symptoms.
Depression. Anxiety. Cognition deterioration. Insomnia. Restless legs. REM sleep behaviour disorder. Pain.
State a drug used to treat depression.
Bupropion. Setraline (SSRI)
