parkinsons

Question 1

what are the signs and symptoms of parkinson’s

TRAP

Answer 1

T - tremor
R - rigidity
A - amnesia and brady
P - postural instability

Question 2

what are the characteristic problems of parkinson’s

Answer 2

-refer to slides -

Question 3

what occurs in parkinson’s in the direct pathway of movement

Answer 3

the cortex sends excitatory glutaminergic neurone (they produce glutamate which is an excitatory neurone in the CNS)to stimulate the stratum

the substantia niagra region of the brain also stimulates the stratum, and does so by using dopamine at the D2 receptors

to increase the activity of the stratum which then leads to reader motor output by the muscles

however in parkinson’s

there is a decrease in the dopamine in the substantia niagra which then reduces the motor output

and also leads to the formation of lewy bodies - these are abnormal protein clumps inside the neurones, they contain aggregates of alpha synuclein protein, contributing to the cell dysfunction and eventual death.

Question 4

pharmacology of parkinson’s

Answer 4

• levadopa- FIRST LINE
  this is a precursor to dopamine , it is able to pass the blood brain barrier unlike dopamine- however there is an enzyme which breaks down levadopa before it gets past the blood brain barrier so an additional education will also be prescribed (bradykinesia and rigidity respond the best to this but is the least affective against postural instability)

DECARBOXYLASE INHIBITORS - these will be iven in combination, these will inhibit the enzyme allowing it pass the bbb

COMT inhibitors - COMT can also break down levadopa once it passes the bbb so these can also be prescribed

dopamine agonist- these will bind to d2 receptors and act as dopamine to elicit the response

MOA antagonists - they inhibit the moa enzyme stopping it from breaking down any dopamine that is being produced

… these do n to address the dopamine raid symptoms