Parkinson's disease Flashcards
Parkinson disease
Define:
long-term degenerative disorder of the central nervous system that mainly affects the motor system.
- referred to as synucleinopathy due to an abnormal accumulation of the protein alpha-synuclein in the brain
- The classification distinguishes* it from Alzheimer’s disease (brain accumulates a different protein *“tau protein”)
Parkinson’s Disease
Pathophysiology:
degeneration of dopaminergic neurons in substantia nigra (part of basal ganglia)
–> lack of modulation of movement signal from pyramidal tract
A disease associated with problem of Dopaminergic neuron of Substantia Nigra, part of basal ganglion, which modulates the movement out of Pyramidal tract by the influence of Dopamine on direct and indirect signal pathway
What is found inside nerve cells of most PD pt’s?
most PD pts have Lewy bodies – abnormal protein aggregates inside nerve cells
Parkinson’s Disease
symptoms:
mask-like face, resting tremor, rigidity, difficulty initiating movement, bradykinesia, akinesia,
postural instability, shuffling gait, psychiatric problems (dementia, depression, sleep disturbances) *there is NO motor weakness
PD -autonomic symptoms:
autonomic symptoms:
- orthostatic hypotension,*
- heat intolerance,*
- sphincter dysfunction,*
- erectile dysfunction*
PD
Treatment is to facilitate:
Facilitate the Dopamine signal transmission or decrease the tremor by anti-cholinergics:
- Levodopa – dopamine that crosses BBB
- Carbidopa – inhibits peripheral metabolism of levodopa
- Entacapone, Tolcapone – COMT inhibitor
- Seligiline – MAO-B inhibitor
- Amantadine
- dopamine receptor agonists (Bromocriptine, Pergolide)
PD
Increase the central Dopamine level
Meds:
Levodopa
Carbidopa
Tolcapone / Entarcapone
Amantadine
Selegiline
PD
Direct dopamine receptor agonist
Meds:
Bromocroptin
Pergolide
Pramiepxole
Apomorphine
PD- to Decrease tremor
Anticholinergic –Meds
Trihexphenidyl
Benztropine
