Drugs For Neurodegenerative Disorders Flashcards
Neurodegenerative disorders
Irreversible death of neurons resulting in progressive impairment of neuronal function
Parkinson’s Alzheimer’s Huntington Vascular dementia Wilson’s disease Ms Als
ART classification
A kinetic-rigid form: bad prognosis
Tremor dominant; slow progression
Therapy of Parkinson’s
Dopamine side - substitution (levodopa) - MAOIs - dopamine agonists - COMT inhibitors - amantadine Acetylcholine side - centrally acting anticholinergic
Substitution therapy in PD
Levodopa
Good oral absorption
Peak;1-2 h
Plasma half life; 1-3 h
Metabolized by dopa carboxylase in periphery- block with carbidopa or benserazide
Start as late as possible
MAO-b inhibitors in PD
Inhibit dopamine metabolism
Selegiline
Rasagiline
Safinamide
Dopamine agonist in PD
Ergot derivatives;
Bromocryptine
Cabergoline
Non-ergot derivatives Pramipexole Ropinirole Rotigotine Apomorphine
COMT inhibitors in PD
Prolong action of levodopa
Entacapone and opicapone; inhibit peripheral metabolism of levodopa
Tolcapone
Amantadine in PD
Originally; antiviral drug
Uncertain mech
Acetylcholine side in PD
Centrally acting anticholinergic drugs;
- m receptor antagonists
- good CNS penetration
- eg; procyclidine, biperiden, trihexyphenidyl, orphenadrine
Treatment of Alzheimer’s
Acetylcholinesterase inhibitors - rivastigmine - donepezil - galantamine NMDA receptor antagonist - memantine Other - amyloid vaccination - amyloid antibodies
Huntington treatment
Autosomal dominant
GABAergic drugs: baclofen or benzodiazepines
Tetrabenazine
Antipsychotic (haloperidol, tiapride)
Vascular dementia treatment
Acetylcholinesterase inhibitors - rivastigmine - donepezil - galantamine NMDA receptor antagonist - memantine Other - amyloid vaccination - amyloid antibodies
Nootropic agents;
Piracetam
Vinpocetine
Nicergoline
Wilson’s disease treatment
Autosomal recessive
D-penicillamine, trientine (chelators)
Amyotrophic lateral sclerosis treatment
Riluzole
Na+ blocker
Increase survival by 2 months
