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BB2 > Pharmacology Of Basal Ganglia > Flashcards

Pharmacology Of Basal Ganglia Flashcards

1
Q

Loss of which cells causes Parkinson’s

A

Dopaminergic cells in substantia nigra

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2
Q

Where do stereotyped patterns of oscillatory synchronisation occur in Parkinson’s

A

Corticobasal ganglia circuits

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3
Q

How does Parkinson’s effect the direct indirect and hyper direct pathways

A

Indirect incr
Direct decr
Hypodirect unknown

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4
Q

What causes Parkinson’s

A

Dopaminergic cell loss in SNc
Lewy bodies

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5
Q

How are Lewy bodies staged in Parkinson’s

A

Braak staging - 1-6

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6
Q

How can dopaminergic cell loss be monitored

A

DaT scan

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7
Q

Parkinson symptoms

A

Main 3 - Resting tremor, bradykinesia, rigidity
Frozen facial expression
Altered gate
Posture changes
Flexed posture
Difficulty initiating and stopping movements
Micrographia

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8
Q

Non motor Parkinson’s features

A

Olfactory dysfunction
Depression
Psychotic symptoms
Cognitive dysfunction
Dementia
Sleep disturbance
Bladder and bowel dysfunction
Speech and language changes

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9
Q

Do non motor symptoms typically start before or after motor symptoms

A

Before - premotor phase

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10
Q

Scoring scale for disability associated w impaired mobility

A

Schwab and England activities of Daily living

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11
Q

Is Parkinson’s sporadic or familial

A

Sporadic
Familial v rare

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12
Q

Abnormalities in which gene cause the rare familial Parkinson’s

A

SNCA

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13
Q

Genes associated with Parkinson’s

A

SNCA
LRRK2
GBA
PARK2
PINK1
PARK7

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14
Q

How can mitochondrial dysfunction cause dopaminergic neurone damage

A

Produce MPP+ which is neurotoxic for dopaminergic neurons

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15
Q

Dopaminergic pathways in CNS

A

Mesocortical
Mesolimbic
Nigrostriatal

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16
Q

How is l dopa converted to dopamine

A

Decarboxylation

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17
Q

2 types of dopamine receptors

A

D1 like
D2 like

18
Q

Which dopamine receptors are excitatory and inhibitory

A

D1 excitatory
D2 inhibitory

19
Q

Parkinson drugs

A

L dopa
Dopaminergic agonist
MOAb inhibitors
COMT inhibitors
Anticholinergic compounds
Amantadine

20
Q

How does L dopa work and why is it given with carbidopa or benserazide

A

Converted to dopamine decreasing dopamine deficit
Given w peripherally acting DOPA decarboxylase inhibitors to prevent nausea and vomiting

21
Q

Why can L dopa cause nausea and vomiting when given without carbidopa or benserazide

A

Converting l dopa to dopamine peripherally activate chemoreceptor trigger zone causing nausea and vomiting

22
Q

Dopaminergic agonist drugs

A

Rotigotine
Apomorphine
Ropinirole
Pramipexole
Bromocriptine
Cabergoline

23
Q

How do MOAb inhibitors work in Parkinson’s

A

Prevent dopamine oxidatiom

24
Q

MOAb inhibitor drugs

A

Rasagiline
Selegiine
Safinamide

25
Q

how do COMT inhibitors work in Parkinson’s

A

Enhance bioavailability and effects of L-dopa

26
Q

COMT inhibitor drugs

A

Entacapone
Tolcapone

27
Q

How do anticholinergics work in Parkinson’s

A

Prevent hyperactivity of cholinergic cells caused by dopamine loss

28
Q

Anticholinergic drugs

A

Orohenadrine
Pro cyclidine
Trihexyphenidyl

29
Q

How does Amantadine work in Parkinson’s

A

Inhibits dopamine reuptake
Increases dopamine release
Weak antagonist of NMDA glutamate receptors

30
Q

Adverse effects of L dopa

A

Nausea and vomiting
Postural hypotension
Psychosis
Impulse control disorders
Day time sleepiness
On off effect
Wearing off
Dyskinesia
Dystonia

31
Q

Non pharmacological treatments Parkinson’s

A

Physiotherapist
Speech and language therapy
Occupational therapy
Monitoring and drug alteration
Deep brain stimulation
Surgery - thalamotomy, pallidotomy

32
Q

Huntingtons inheritance pattern

A

Autosomal dominant

33
Q

What gene mutation causes huntingtons

A

Gene encoding huntingtin protein on Chr 4
Abnormal nbr of CAG repeats - more repeats = earlier onset
Mutated protein aggregates in cells

34
Q

Pathological changes in huntingtons

A

Cortical atrophy
Striatal degeneration
Loss of medium spiny neurones

35
Q

Huntingtons symptoms

A

Choreic movement
Gait abnormalities
Lack of coordination
Cognitive impairment
Psychiatric disturbances
Sleep disturbance
Weight loss

36
Q

How does huntingtons effect direct and indirect pathways

A

Direct incr
Indirect decr

37
Q

Huntington drug types

A

Vesicular amine transporter inhibitor
Antidopaminergics
Antidepressants

38
Q

How do vesicular amine transporter inhibitors work in huntingtons and which drug is used

A

promotes depletion of monoamine neurotransmitters serotonin, norepinephrine, and dopamine from stores
Decreases uptake into synaptic vesicles
Tetrabenazine

39
Q

How do Antidopaminergic drugs work in huntingtons and what are examples

A

Antipsychotics
Haloperidol, olanzapine

40
Q

What drug type are Citalopram fluoxetine and sertraline

A

Antidepressants

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