Parkinson's Disease Flashcards
What is parkinson’s disease?
Under normal circumstances, dopamine causes the decrease of acetylcholine and GABA. In Parkinson’s ACh and GABA increases because of reduced dopamine.
What are two hallmark features?
Depigmentation of DA-producing neurons. Lewy bodies are present.
What are some non-motor symptoms?
Autonomic and sensory symptoms (pain, sweating, constipation)
Distrubed sleep patterns (daytime somnolence, insomnia, sleep apnea)
Cognitive and Psychiatric changes (slow thought processes, confusion, depression)
What are some examples of motor symptoms?
Akinesia (bradykinesia)
Tremors and rigidity
Gait disturbance
Difficulty with speech and swallowing
What are some drugs that can cause parkinson’s disease?
Typical antipsychotics, lithium, metoclopramide, valproate.
What are some antiparkinsomism drugs?
Levodopa, dopamine agonists, MOAB Inhibitors, COMT Inhibitors, anticholinergics, amantadine
What is special about the absorption of APDs?
Depends on gastric emptying and gastric pH. L-Dopa is taken 30-60 mins before food
What are the effects of dietary proteins and implications of levodopa therapy?
L-DOPA is absorbed by Saturable amino acid transport system. Its transported across the BBB by this transport system. Dietary proteins compete for transport system. Allow gap between L-DOPA dose and eating high protein food.
What are some side effects of L-DOPA?
Nausea and vomiting, dizziness, insomnia, postural hypotension, dyskinesia
What is the dosing for L-DOPA?
Levodopa-300mg/day
Carbidopa-75/day
What are the effects of COMT?
Blocks catechol-o-methyl-transferase which leads to less 3-O-Methyldopa, which leads to more dopamine in the peripheral and the central nervous system.
What are some advantages of dopamine agonists relative to L- Dopa?
No enzymatic conversion is needed. No potentially toxic metabolites, better side effect profile than L-DOPA, may allow for lower L-DOPA doses to be used
