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CNS > P.COLOGY: Parkinson's disease > Flashcards

P.COLOGY: Parkinson's disease Flashcards

1
Q

Define neurodegenerative

A

Death of dopamine-containing cells of the substantia nigra

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2
Q

What is the substantia nigra?

A

Origin of dopaminergic afferents implicated in Parkinson’s disease

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3
Q

Describe the pathophysiology of parkinson’s disease

A
  • Loss of dopamine neurones in s.nigra
  • Loss of noradrenergic + serotonergic neurones
  • Accumulation of protein deposits in s.nigra, locus coeruleus + other regions
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4
Q

What are the genetic causes of parkinson’s?

A

Early onset, late onset + juvenile onset genes

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5
Q

What are the environmental causes of parkinson’s?

A

Ageing

MPTP

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6
Q

What are the motor symptoms of parkinson’s?

A
  • Bradykinesia
  • Resting tremor
  • Rigidity
  • Postural instability
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7
Q

What is the pharmacological management of parkinsons?

A
  • Levodopa
  • Dopamine agonist
  • Monoamine oxidase Type-B inhibitors
  • COMT inhibitors
  • Anticholinergics + glutamate antagonist
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8
Q

What is levodopa therapy?

A

Levodopa + dopa-decarboxylase inhibitor e.g. carbidopa/benserazide)

  • dopa-decarboxylase inhibitor used to prevent levodopa converting to dopamine in the bloodstream, more medication can get to the brain
  • Decrease peripheral side effects e.g. nausea, vomiting, CVS
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9
Q

Example of dopamine agonists

A

Ropinirole

Pramipexole

Rotigotine

  • agonist selective for D2 + D3 post-synaptic receptors
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10
Q

Example of monoamine oxidiase-B inhibitors

A

Selegiline

Rasagidine

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11
Q

Example of catechol-o-methyl transferase (COMT) inhibitors

A

Entacapone

  • prevents dopamine degradation
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12
Q

Why is Amantadine part of the pharmacological management?

A
  • Mild anti-parkinsonism effect
  • MOA = unclear mixed with dopaminergic + anti-glutamatergic actions
  • Side effects = confusion, insomnia etc.
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13
Q

Why is anti-muscarinics part of the pharmacological management of parkinsons?

Give an example.

A

Benzhexol

Inhibit dopamine suppression

  • Compensatory mechanism for decreasing dopamine levels
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14
Q

What is the pharmacological management of non-motor symptoms?

  • GI dysfunction
  • Cognitive dysfunction
  • Mood disorders
A

GI

  • Constipation = macrogol

Cognitive

  • Dementia = choliesterase inhibitors or memantine

Mood disorders

  • Depression = antidepressant
  • Psychosis = antipsychotics (clozapine)
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15
Q

People can develop dyskinesia + motor flunctuations despite optimal levdopa therapy.

What can be offered to treat this?

A
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16
Q

What are the co-morbidities linked with parkinson’s disease?

A
17
Q

What is the surgical management of parkinson’s?

A
18
Q

Dopamine agonist causes Impulsive compulsive behaviour.

How is this exacerbated + treated?

A
19
Q

What is the non-pharmacological management of parkinson’s?

A
20
Q

What are the non-motor symptoms of parkinson’s?

A

CNS (8 decks)

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