Parkinson's Flashcards
Pathway of developing Parkinson’s
Destruction of dopamine cells in pars compact of substantia nigra and loss of NT dopamine in caudate/putamen
Critical drug for treating Parkinson’s
L-DOPA with carbidopa to prevent its breakdown in stomach
cause of Parkinson’s
cause unknown, but some genetic forms have been discovered (13 genetic loci)
AD from of Parkinson
mutation in alpha-synuclein; this protein normally in Lewy bodies in patients without mutation
carbidopa
peripheral decarboxylase inhibitor (intestines/peripheral organs) so that L-DOPA not degraded so much in intestines; does not cross BBB
L-DOPA
oral; crosses BBB, acts
Dopamine receptor agonists
stimulate DA receptors directly in caudate/putamen
- most drugs work at D2 receptor; not substitute for Sinemet ) L-DOPA + carbidiopa)
- Bromocriptine, Pergolide, Pramipexole, Ropinirole, Cabergoline (d2 agonist with very long half life of about 65 hours)
drugs facilitate release of endogenous dopamine
amantadine –can also work as glutamate receptor antagonist
Anticholinergic drugs
- sometimes for initial therapy of tremor
- balance overactivity of cholinergic interneurons in the caudate/putamen caused by lack of DA
- these block muscarinic receptors
- Side effects: problem with swallowing, bowel function, and bladder control
- Examples – trihexyphenidyl, benzotropine, diphenhydramine (Benadryl)
most important part of striatum in controlling motor activity
putamen
