Neurodegenerative Diseases Flashcards
What is the primary neurotransmitter deficiency in Parkinson’s disease? .
Dopamine
What are the main classes of drugs used to treat Parkinson’s disease?
Dopamine precursors
dopamine agonists
What is the role of levodopa in Parkinson’s disease treatment?
Levodopa is a dopamine precursor that crosses the blood-brain barrier and is converted to dopamine in the brain.
Why is carbidopa combined with levodopa?
Carbidopa inhibits peripheral breakdown of levodopa allowing more to reach the brain and reducing peripheral side effects.
What are common side effects of levodopa/carbidopa therapy?
Nausea orthostatic hypotension
Name two dopamine agonists used in Parkinson’s disease.
Pramipexole and ropinirole.
What is the mechanism of action of dopamine agonists like pramipexole and ropinirole?
They directly stimulate dopamine receptors in the brain.
What is the role of MAO-B inhibitors in Parkinson’s disease?
They inhibit the breakdown of dopamine by MAO-B increasing dopamine availability in the brain.
Name two MAO-B inhibitors used in Parkinson’s disease.
Selegiline and rasagiline.
What are common side effects of MAO-B inhibitors?
Insomnia nausea
What is the function of COMT inhibitors in Parkinson’s disease?
They prevent the breakdown of levodopa prolonging its effect.
Name two COMT inhibitors used in Parkinson’s disease.
Entacapone and tolcapone.
Why is tolcapone less commonly used than entacapone?
Tolcapone is associated with a risk of hepatotoxicity.
What are anticholinergic drugs used for in Parkinson’s disease?
They reduce tremors and rigidity by blocking acetylcholine receptors.
Name two anticholinergic drugs used in Parkinson’s disease.
Benztropine and trihexyphenidyl.
What is amantadine’s role in Parkinson’s disease?
Amantadine may help reduce dyskinesias and has mild anti-Parkinsonian effects.
What is the mechanism of action of amantadine?
It increases dopamine release inhibits dopamine reuptake
What is the primary neurotransmitter deficiency in Alzheimer’s disease? .
Acetylcholine
What are acetylcholinesterase inhibitors used for in Alzheimer’s disease?
They increase acetylcholine levels by inhibiting its breakdown which may improve cognition.
Name three acetylcholinesterase inhibitors used in Alzheimer’s disease.
rivastigmine Donepezil
What are common side effects of acetylcholinesterase inhibitors?
Nausea diarrhea
What is the mechanism of action of memantine in Alzheimer’s disease?
Memantine is an NMDA receptor antagonist that reduces excitotoxicity associated with glutamate.
What are common side effects of memantine?
headache Dizziness
What is the primary goal of multiple sclerosis (MS) drug therapy?
To reduce the frequency and severity of relapses and slow disease progression.
What is the mechanism of action of interferon-beta in MS?
Interferon-beta modulates immune response reducing inflammation and immune cell activity in the CNS.
What are common side effects of interferon-beta therapy?
Flu-like symptoms injection site reactions
What is glatiramer acetate and how does it work in MS?
Glatiramer acetate is an immune modulator that mimics myelin
What are monoclonal antibodies used for in MS and name one example.
They target immune cells to reduce disease activity; example: natalizumab.
What is a major risk associated with natalizumab therapy in MS?
Progressive multifocal leukoencephalopathy (PML) a rare but serious brain infection.
What are two oral agents commonly used in MS?
Fingolimod and dimethyl fumarate.
How does fingolimod work in MS?
It traps immune cells in lymph nodes reducing their migration to the CNS.
What are common side effects of fingolimod?
Bradycardia increased risk of infections
What is riluzole and what is its role in ALS?
Riluzole is a glutamate inhibitor used to slow progression in amyotrophic lateral sclerosis (ALS).
What is edaravone and what is its role in ALS?
Edaravone is an antioxidant that may slow disease progression in ALS.
What is the primary cause of Huntington’s disease?
A genetic mutation leading to a CAG trinucleotide repeat expansion in the HTT gene on chromosome 4.
What neurotransmitter imbalance is associated with Huntington’s disease?
Decreased levels of GABA and acetylcholine, with increased dopamine activity.
What are the main drug classes used to manage symptoms of Huntington’s disease?
Dopamine depleters, antipsychotics, and antidepressants.
What is the role of dopamine depleters in Huntington’s disease?
They help reduce chorea by decreasing dopamine levels in the brain.
Name two dopamine-depleting agents used in Huntington’s disease.
Tetrabenazine and deutetrabenazine.
How do tetrabenazine and deutetrabenazine work?
They inhibit VMAT2 (vesicular monoamine transporter 2), reducing dopamine release in the brain.
What are common side effects of tetrabenazine and deutetrabenazine?
Sedation, depression, anxiety, and risk of suicidal ideation.
Why might deutetrabenazine be preferred over tetrabenazine?
Deutetrabenazine has a longer half-life and may cause fewer side effects.
What type of drugs are used for psychiatric symptoms in Huntington’s disease?
Antipsychotics and antidepressants.
What is the role of antipsychotics in Huntington’s disease?
They help manage symptoms like chorea, agitation, and psychosis.
Name two antipsychotics commonly used in Huntington’s disease.
Risperidone and olanzapine.
What are common side effects of antipsychotics in Huntington’s disease?
Weight gain, sedation, metabolic syndrome, and extrapyramidal symptoms.
What is the role of SSRIs in Huntington’s disease treatment?
SSRIs help manage depression and anxiety, which are common in Huntington’s disease.
Name two SSRIs used in Huntington’s disease.
Sertraline and fluoxetine.
What role does physical and occupational therapy play in Huntington’s disease?
They help maintain mobility, manage motor symptoms, and improve quality of life.
What is the genetic basis of Huntington’s disease?
A CAG repeat expansion in the HTT gene, with longer repeats associated with earlier onset.
What experimental approaches are being studied for Huntington’s disease?
Gene silencing, RNA interference, and antisense oligonucleotides targeting the mutant HTT gene.
What is the role of genetic counseling in Huntington’s disease?
To provide information on genetic risks, inheritance patterns, and implications for family planning.
