Parkinsons Flashcards
dopamine
carbidopa
L-DOPA
selegiline
PD symptoms
tremor
rigidity
akinesia (slow movement)
postural instability
PD is characterized by ___
loss of dopamine neurons in substantia nigra
studies suggest that 50% of ______ or 70-80% of ____ in striatum are lost before patients present with motor symptoms
dopamine neurons
nerve terminals
PD can be characterized by presence of what ?
Lewey bodies
what is a Lewey body
spherical protein deposit that is enriched with protein alpha synuclein
where are Lewey bodies found
substantia nigra, cortex
stages of Braak and what is it
Braak is measure of spreading aloha synuclein
1. brainstem
2. raphe
3. substantia nigra
4.meocortex/thalamus
5. neocortex/prefrontal cortex
6. entire neocortex
basal ganglia includes what
striatum and globus pallidus
striatum includes what
caudate nucleus and putamen
signaling from the substantia nigra to ______ receptors in the striatum favors ____
D1 and D2 receptors
thalamocortical signaling
(this is disrupted in PD)
antimuscarinic used in PD
benztropine
loss of dopamine results in ____ activity the cholinergic pathway
excess
why is there a bioavailability difference in L-DOPA and dopamine
L-DOPA can cross BBB
dopamine positive at pH 7
L-DOPA side effects
nausea, hypertension, psychosis
how can we lower a dose of L-DOPA?
add carbidopa which is peripherally acting DDC inhibitor
carbidopa MOA
inhibits Dopa decarboxylase in periphery, does not penetrate BBB
we can eliminate on/off ausciltations with L-DOPA therapy how
continuous administration of L-DOPA with infusion
if we cant convert L-DOPA to dopamine what can we use?
dopamine agonists - postsynaptic dopamine receptors are still present in striatum
what is apomorphine
D1/D2 dopamine agonist