parkinson drugs Flashcards
most important parkinson’s drug
l-dopa
what is special about l-dopa
it can cross the bbb, but unfortunately is degraded. often administered with carbi-dopa, which prevents degradation
what happens when people stop taking l-dopa
really poorly off, and the brain is “out of balance”.
easy way to determine is someone has parkinson’s
given them l-dopa and see if they improve
is the onset of parkinson’s unilateral or bilateral?
unilateral
how much dopamine do we make per day
around a gram a day, thus patients usually require some fraction of these drugs.
l-dopa side effects?
think schizophrenia. hallucinations delusions
comtan
dopamine esterase inhibitor, allows l-dopa to remain active longer
main problem in parkinsons
initiating movement.
typical symptoms
rigidity, issues initiating movement, pill rolling tremor - notable, the cognitive functions are intact
where do dopaminergic SN projections go?
caudate and putamen
how does dopamine initiate movement?
dopamine overrules the inhibitory signal coming from the globus palidus, which allows the initiation of movement
dopa-1
stimulates gaba neuron in striatum, leads to gaba inhibition in gp-internal
dopa-2
inhibits gaba neuron in straiatum, which leads through gaba inhibition in gp-external, and finally gaba inhibition in gp-internal;
who gets parkinsons?
people over 60
1/100 incidence in people over 60
young folks usually have genetic defects
people who drink coffee and smoke have a lower risk
