Pharmacology Of Basal Ganglia

Question 1

Loss of which cells causes Parkinson’s

Answer 1

Dopaminergic cells in substantia nigra

Question 2

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

Answer 2

Corticobasal ganglia circuits

Question 3

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

Answer 3

Indirect incr
Direct decr
Hypodirect unknown

Question 4

What causes Parkinson’s

Answer 4

Dopaminergic cell loss in SNc
Lewy bodies

Question 5

How are Lewy bodies staged in Parkinson’s

Answer 5

Braak staging - 1-6

Question 6

How can dopaminergic cell loss be monitored

Answer 6

DaT scan

Question 7

Parkinson symptoms

Answer 7

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

Question 8

Non motor Parkinson’s features

Answer 8

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

Question 9

Do non motor symptoms typically start before or after motor symptoms

Answer 9

Before - premotor phase

Question 10

Scoring scale for disability associated w impaired mobility

Answer 10

Schwab and England activities of Daily living

Question 11

Is Parkinson’s sporadic or familial

Answer 11

Sporadic
Familial v rare

Question 12

Abnormalities in which gene cause the rare familial Parkinson’s

Answer 12

SNCA

Question 13

Genes associated with Parkinson’s

Answer 13

SNCA
LRRK2
GBA
PARK2
PINK1
PARK7

Question 14

How can mitochondrial dysfunction cause dopaminergic neurone damage

Answer 14

Produce MPP+ which is neurotoxic for dopaminergic neurons

Question 15

Dopaminergic pathways in CNS

Answer 15

Mesocortical
Mesolimbic
Nigrostriatal

Question 16

How is l dopa converted to dopamine

Answer 16

Decarboxylation

Question 17

2 types of dopamine receptors

Answer 17

D1 like
D2 like

Question 18

Which dopamine receptors are excitatory and inhibitory

Answer 18

D1 excitatory
D2 inhibitory

Question 19

Parkinson drugs

Answer 19

L dopa
Dopaminergic agonist
MOAb inhibitors
COMT inhibitors
Anticholinergic compounds
Amantadine

Question 20

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

Answer 20

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

Question 21

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

Answer 21

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

Question 22

Dopaminergic agonist drugs

Answer 22

Rotigotine
Apomorphine
Ropinirole
Pramipexole
Bromocriptine
Cabergoline

Question 23

How do MOAb inhibitors work in Parkinson’s

Answer 23

Prevent dopamine oxidatiom

Question 24

MOAb inhibitor drugs

Answer 24

Rasagiline
Selegiine
Safinamide

Question 25

how do COMT inhibitors work in Parkinson’s

Answer 25

Enhance bioavailability and effects of L-dopa

Question 26

COMT inhibitor drugs

Answer 26

Entacapone Tolcapone

Question 27

How do anticholinergics work in Parkinson’s

Answer 27

Prevent hyperactivity of cholinergic cells caused by dopamine loss

Question 28

Anticholinergic drugs

Answer 28

Orohenadrine Pro cyclidine Trihexyphenidyl

Question 29

How does Amantadine work in Parkinson’s

Answer 29

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

Question 30

Adverse effects of L dopa

Answer 30

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

Question 31

Non pharmacological treatments Parkinson’s

Answer 31

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

Question 32

Huntingtons inheritance pattern

Answer 32

Autosomal dominant

Question 33

What gene mutation causes huntingtons

Answer 33

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

Question 34

Pathological changes in huntingtons

Answer 34

Cortical atrophy Striatal degeneration Loss of medium spiny neurones

Question 35

Huntingtons symptoms

Answer 35

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

Question 36

How does huntingtons effect direct and indirect pathways

Answer 36

Direct incr Indirect decr

Question 37

Huntington drug types

Answer 37

Vesicular amine transporter inhibitor Antidopaminergics Antidepressants

Question 38

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

Answer 38

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

Question 39

How do Antidopaminergic drugs work in huntingtons and what are examples

Answer 39

Antipsychotics Haloperidol, olanzapine

Question 40

What drug type are Citalopram fluoxetine and sertraline

Answer 40

Antidepressants