Neurodegenerative diseases Masserano

Question 1

Lewy bodies

Answer 1

Normal brain protein is misfolded and forms aggregates that are associated with cell death and Parkinsons

Question 2

Levodopa MOA

Answer 2

increase dopamine in the remaining nigrostriatal neurons in the caudate nucleus

Question 3

Peripheral dopamine toxicity

Answer 3

Orthostatic hypotension
Cardiac stimulation leading to tachy
Vomiting

Question 4

Central toxicities of levodopa

Answer 4

Dyskinesis: involuntary movements
Behavioral: hallucinations and confusion
“On-off” syndrome: rapid loss of therapeutic effect and fluctuations between drug working and not

Question 5

Dopamine D2 agonists

Pramipexole

Answer 5

Up-regulation of DA-2 receptors in striatum due to low levels of dopamine released.

Question 6

Amantadine

Answer 6

Releases dopamine from nerve terminals.

Question 7

Selegline

Answer 7

Irreversible inhibitor of MAO-B that is used for Parkinsons

Question 8

Tolcapone and Entacapone

Answer 8

COMT inhibitors
COMT suppress the metabolism of levodopa
Only used as adjunct therapy to levodopa

Question 9

Trihecyphenidyl and Benztropine

Answer 9

Anticholinergics that overcome the cholinergic overactivity in the caudate due to imbalance of lack of dopamine
Used for treatment of mild to early parkinsons but use limited due to side effects

Question 10

Genetic associations with Alzheimer disease

Answer 10

APOE3- most common in general pop.
APOE4- common in affected people
APOE2- Neuroprotective: reduces probability

Question 11

Alzheimer diseaseand acetylcholinesteras inhibitors

Answer 11

Link between loss of cholinergic meurons and cholinergic transmission within the cortex = memory loss

Question 12

Three AChE inhibitors approved by FDA for Alzheimers

Answer 12

Donepezil (Aricept)
Galantamine (Razadyne)
Rivastigmine (Exelon)

Question 13

Memantine (Namenda)

Answer 13

Prevents the rate of memory loss by inhibiting the NMDA receptor.
For moderate to severe Alzheimer’s