Neurological Flashcards
Parkinson’s Disease
neurodegenerative disorder characterized by progressive motor dysfunction Tremor Rigidity Bradykinesia Disturbance in posture
PD - patho
degeneration of dopaminergic neurons projecting from the substantia nigra to the striatum
deficiency of dopamine
need balance of dopamine (inhibitory) and acetylcholine (stimulatory)
Therapeutic action of Anti-parkinsons drugs
restores balance between dopamine and acetylcholine in the brain
Dopaminergics
increase dopamine levels in the corpus striatum
Anticholinergic Agents
block acetylcholine and inhibits hyperactivity in the brain
Dopamine precursors
cross BBB and then converted into DA
DA2 receptor agonist
Bind DA2 receptors to mimic DA
MO-B inhibitors
increase DA available for release by blocking enzymes that breakdown neurotransmitters
Drugs that promote release of DA
may also prevent reuptake of DA
Drugs that decrease the effect of Ach
mAch receptor antagonist that acts in CNS
Levodopa + Carbidopa (Sinemet)
Increases DA in the striatum reducing motor effects in PA
Levodopa is precursor of dopamine (DA cannot cross the BBB)
Metabolize to DA in brain, increasing DA in synapses in striatum
Carbidopa prevents metabolism of levodopa to DA outside the brain
Sinemet has to be given at a strict time schedule because…
Abrupt withdrawal of levodopa can lead to skeletal muscle rigidity which can interfere with adequate ventilation
Continue levodopa therapy during perioperative period including usual morning dose
Seizures
disturbances of the brains electrical activity that may affect consciousness, motor activity and sensation
Nutritional therapy for seizures
high fat
low carb and protein
Limited water
Controls calories
Ketogenic Diet
Drug Mechanisms of action - Seizures
Increasing stimulation of GABA receptors
Reduce Na influx into neurons
Reduce Ca influx into neurons
Block glutamate receptors
