Pharm of parkinson 2

Question 1

Diphenhydramine Class

Answer 1

anticholinergic

Question 2

Diphenhydramine SE

Answer 2

1. swallowing difficulties
2. decreased bowel motility
3. urinary retention
4. sedation

Question 3

Diphenhydramine function

Answer 3

1st class antihistamine

antagonizes H1 and M receptor

Question 4

Rasagiline Class

Answer 4

MAO inhibitor

Question 5

Rasagiline Function

Answer 5

allow reduction in L-DOPA doses in 20-30%

Question 6

Rasagiline SE

Answer 6

worsening of postural hypotension

Question 7

Selegiline class

Answer 7

MAO inhibitor

Question 8

Selegiline function

Answer 8

allow for reduction in L-DOPA doses by 20-30%

Question 9

Selegiline SE

Answer 9

worsening of postural hypotension

Question 10

Tolcapone

class

Answer 10

COMT inhibitor

Question 11

Tolcapone

SE

Answer 11

inhibits liver enzymes and has caused liver toxicity

Question 12

Entacaptone class

Answer 12

COMT inhibitor

Question 13

The substantia nigra pars compacta (SNc) sends dopaminergic axons to:

Answer 13

2 populations of medium spiny neurons in the striatum; those with D1 receptors and those with D2 receptors.

Question 14

Neurons with D1 receptors are excited by_____

Answer 14

dopamine and stimulation results in production of cAMP.

Question 15

Neurons with D2 receptors are inhibited by____.

Answer 15

binding of dopamine

Question 16

D2 R inhibited by dopamine:

Answer 16

1. These neurons project to the globus pallidus external (GPe) segment and are also GABAergic neurons.
2. GABAergic GPe neurons (aka inhibitory) project to the subthalamic nucleus (STN).
3. The STN has glutaminergic neurons that are excitatory and stimulate the GPi.
4. Stimulation of the GPi results in inhibition of the VL thalamus.

Question 17

GABAergic neurons means that they inhibit

Answer 17

GPe neurons from firing

Question 18

Neurons with D1 Receptors are excited by dopamine and stimulation results in_____.

Answer 18

production of cAMP

Question 19

Neurons with D1 Receptors are

Answer 19

1spiny neurons that are GABAeric.

Question 20

GABAeric means that when stimulated by DA, neurons result in

Answer 20

increased inhibition of the globus pallidus internal (GPi) segment

Question 21

The GPi inhibits

Answer 21

ventro-lateral thalamus (VL).

the VL activates the cortex to create the desired movement.

Question 22

In Parkinson’s disease, dopamine is not produced due to ____

Answer 22

death of cells in the substantia nigra.

Question 23

loss of dopamine causes

Answer 23

too much inhibition on both the D1 and D2 arm of the pathway, inhibiting the thalamus’s signaling ability to the cortex.

Question 24

The result of substantia nigra death on the D1 side of the path is that ___

Answer 24

the GPi is not inhibited the way it should be causing unopposed inhibition from the GPi to the VL thalamus.

There is too much inhibition

Question 25

The result of substantia nigra death on the D2 side of the path is____

Answer 25

that the medium spiny neurons of the striatum are NOT inhibited so they fire GABA signs like crazy causing unopposed inhibition of the GPe.

Question 26

This unopposed inhibition in parkinsons means the

Answer 26

1. GPe can’t fire its own GABA neurons
2. so the STN is highly active
3. The result of a highly active glutaminergic STN is excitation of the GPi.
4. the GPi inhibits the VL thalamus, once again causing too much inhibition of the system.