PARKINSONS/MS/MG Flashcards
What is Parkinsons characterized by?
low dopamine, high acetylcholine
tremor, rigidity, bradykinesia
risk factors for parkinsons
age (70s), men, genetics, anxiety/depression, head trauma, hysterectomy, coffee consumption
pathogenesis of parkinsons
destruction of substatia nigra in basal ganglia, dopamine levels decrease, imbalance between dopamine and ACh, relative excess of ACh, loss of controlled movement and balance
complications of parkinsons
dementia, depression/anxiety, decreased mobility, falls, malnutrition, aspiration, pneumonia, UTIs, skin breakdown, drug-related
levodopa/carbidopa MOA
levodopa - converts to dopamine in the brain and activates dopamine receptors
carbidopa - blocks destruction of levodopa
disadvantages of levodopa/carbidopa
takes several months to see improvement, does not work long term, AVOID PROTEIN
AE of levodopa/carbidopa
N/V, dyskinesias, postural hypotension, dysrhythmias, psychosis, hallucinations, nightmares, paranoia
What is Myasthenia Gravis?
an autoimmune disease characterized by fluctuating weakness of certain muscle groups
risk factors for MG
surgeries, immunizations, illnesses, drugs, age 10-65, women
MG pathogenesis
antibodies attack ACH receptors = decreased ACH receptor sites that prevents ACH from attaching and stimulating muscle contraction
CM of MG
fluctuating weakness, worse at night, ptosis, facial weakness, slurred speech, dysphagia
what is a myasthenic crisis
acute exacerbation of muscle weakness triggered by a stressor
Complication: breathing muscle weakness
neostigmine (prostigmin) class, moa, indication
cholinesterase inhibitor
prevents inactivation of ach
MG
What could a toxicity of neostigmine lead to?
cholinergic crisis
What is a cholinergic crisis?
extreme muscle weakness or paralysis
treatment: mechanical ventilation
What is multiple sclerosis?
a chronic, inflammatory autoimmune disorder
brain, spinal cord, optic nerves
What are the characteristics of MS?
inflammation, demyelination, scar development
What is the cause of MS?
unknown, autoimmune triggered by infection, genetic predisposition
MS risk factors
20-40, women, northern US, caucasian, family hx
pathogenesis of MS
body’s IS attacks myelin sheath
T-cells cross BBB
antigen/antibody initiates inflammatory response
axons are de-myelinated and destroyed
types of progression
benign
relapsing-remitting
primary-progressive
secondary-progressive
progressive-relapsing
symptoms of MS
cognitive slowing, vision problems, depression, pain, incontinence, weakness, ED, gait issues, muscle stiffness, heat sensitivity
