Parkinson Flashcards

1
Q

which dopamine neurons innervate most of the corpus striatum

A

substantia nigra

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2
Q

where do substantia nigra neurons synapse onto in the corpus striatum

A

GABA

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3
Q

what is the problem that causes Parkinson’s disase

A

the substantia nigra dopaminergic nerves are dead/ nonfunctioning

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4
Q

what is the problem in huntington’s disease

A

the GABA neurons in corpus striatum are dead/ non functioning

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5
Q

how does the normal circuittry work in dopaminergic neurons leaving the substantia nigra

A

inhibit the inhibition

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6
Q

what is the frequency of the tremor in parkinsons

A

4-6 Hz

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7
Q

how do D1 receptors act

A

induce adenyl cyclase activity

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8
Q

are D1 pre or post synaptic

A

presynaptic

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9
Q

how do D2 receptors function and where are they

A

inhibit adenyl cyclase activity
post synaptic on striatal GABA cells
presynaptic on basal ganglia inputs to substantial nigra

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10
Q

which D receptor aqctions are most useful for parkinson’s treatment

A

D2

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11
Q

what is the structure of Levodopa and how does this structure make it an effective drug

A

has a carboxylase group
penetrates BBB

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12
Q

where is Levodopa absorbed

A

small intestine

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13
Q

what is coadministered with levodopa in order to increase levodopa absorption into CNS

A

peripheral DOPA decarboxylase inihibotr

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14
Q

what is the structural analog of DOPA that inihibts DDC

A

carbidopa

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15
Q

what is the primary therapy for parkinsons

A

enhance dopamine levels in straitum
levodopa and dopamine agonists

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16
Q

what is the secondary therapy for parkinsons

A

enhance DOPA entry into brain
carbidopa

17
Q

what is the name given to carbidopa + l-dopa

A

sinemet

18
Q

what is the initial sinemet ratio

A

25/100 c/l

19
Q

what are the adverse effects of levodopa

A

anorexia, nausea etc all GI
CARDIO bc catecholamine
dyskinesias
behavioural

20
Q

what are the dopamine agonists used for the treatment of Parkinson’s & what kind of agonists are they

A

bromocriptine (D2) and pergolide (D1&D2)

21
Q

are the mental health symptoms worse or better with dopamine agonists compared to levodopa

A

worse

22
Q

what are the non-ergot dopamine agonists

A

pramipexole and ropinirole

23
Q

what is the MAO inhibitor used for parkinsons

A

selegine and rasagiline

24
Q

who should avoid taking selegine

A

people taking tricyclic antidepressants SSRIs or meperidine

25
Q

what is COMT and how can it be used therapeuticsally

A

catechol-o-methyl trasnferase
can be inhibited

26
Q

what are the COMT inhibitors of interest

A

TOLCAPONE and entacapone

27
Q

how does tolcapone vs entacapone act differenyl

A

tolcapone = centrally and peripherally
entacapone = only peripherally

28
Q

how does amantadine work for parkinsons

A

NMDA antagonist

29
Q

what anticholinergic are used for treatment of parkinsons

A

biperiden ophrenadine trihexylphenidyl