Parkinson Flashcards
which dopamine neurons innervate most of the corpus striatum
substantia nigra
where do substantia nigra neurons synapse onto in the corpus striatum
GABA
what is the problem that causes Parkinson’s disase
the substantia nigra dopaminergic nerves are dead/ nonfunctioning
what is the problem in huntington’s disease
the GABA neurons in corpus striatum are dead/ non functioning
how does the normal circuittry work in dopaminergic neurons leaving the substantia nigra
inhibit the inhibition
what is the frequency of the tremor in parkinsons
4-6 Hz
how do D1 receptors act
induce adenyl cyclase activity
are D1 pre or post synaptic
presynaptic
how do D2 receptors function and where are they
inhibit adenyl cyclase activity
post synaptic on striatal GABA cells
presynaptic on basal ganglia inputs to substantial nigra
which D receptor aqctions are most useful for parkinson’s treatment
D2
what is the structure of Levodopa and how does this structure make it an effective drug
has a carboxylase group
penetrates BBB
where is Levodopa absorbed
small intestine
what is coadministered with levodopa in order to increase levodopa absorption into CNS
peripheral DOPA decarboxylase inihibotr
what is the structural analog of DOPA that inihibts DDC
carbidopa
what is the primary therapy for parkinsons
enhance dopamine levels in straitum
levodopa and dopamine agonists
what is the secondary therapy for parkinsons
enhance DOPA entry into brain
carbidopa
what is the name given to carbidopa + l-dopa
sinemet
what is the initial sinemet ratio
25/100 c/l
what are the adverse effects of levodopa
anorexia, nausea etc all GI
CARDIO bc catecholamine
dyskinesias
behavioural
what are the dopamine agonists used for the treatment of Parkinson’s & what kind of agonists are they
bromocriptine (D2) and pergolide (D1&D2)
are the mental health symptoms worse or better with dopamine agonists compared to levodopa
worse
what are the non-ergot dopamine agonists
pramipexole and ropinirole
what is the MAO inhibitor used for parkinsons
selegine and rasagiline
who should avoid taking selegine
people taking tricyclic antidepressants SSRIs or meperidine
