Pharmacology of Parkinson's Disease plus CPC w/Patient Flashcards
What is the difference between L-DOPA and carbidopa?
L-DOPA is the precursor to dopamine.
Carbidopa inhibits DOPA decarboxylase in the peripheral tissues (it doesn’t get into the CNS), and thus ensures that L-DOPA doesn’t cause PNS stimulation.
Comtan (entacapone) treats Parkinson’s by ___________.
inhibiting COMT (catecholamine-O-methyl transferase), thereby preventing the degradation of dopamine
Parkinson the doctor called his disorder ___________.
shaking palsy
What are Lewy bodies?
Protein precipitates that resemble nuclei
People develop Parkinson’s when they’ve lost _______ percent of their substantia nigra cells.
50
“The cortex initiates movement, but the subcortical nuclei are necessary for _____________.”
modulating that movement
What percent of people over age 60 have Parkinson’s?
1%
What environmental factors have been shown to increase or decrease the likelihood of developing Parkinson’s?
Increase: well water; pesticides; copper; iron
Decrease: tea; coffee; smoking
Loss of the dopamine-producing neurons of the substantia nigra lead to a deficit of dopamine in the ______________.
caudate and putamen
The enzyme _________ makes dopamine from L-DOPA.
DDC (DOPA decarboxylase)
How does carbidopa work?
It inhibits the peripheral enzyme decarboxylase, which converts L-DOPA to dopamine, so that L-DOPA gets into the CNS. Decarboxylase is not in the CNS and thus a higher percent of the L-DOPA given makes it to the brain.
Amantadine facilitates the _____________.
release of endogenous dopamine (also uncertain role as glutamate antagonist)
Why do you need to give anticholinergics to those with Parkinson’s?
Because dopamine inhibits cholinergic neurons in the CNS. Thus, in its absence, cholinergic neurons fire faster and overstimulate the CNS.
By what end result does dopamine let us move?
It induces the striatum (directly) and globus pallidus (indirectly) to reduce their GABA secretion, thus inhibiting movement
The average age of onset of Parkinson’s is _______.
60
What are the short- and long-term complications of L-DOPA?
Short: nausea, depression, psychosis, and hypotension
Long: dyskinesia
What is the primary purpose of dopamine agonists (such as apomorphine, pramipexole, and ropinirole)?
To blunt the on-off effect of L-DOPA
The annual cost of having Parkinson’s is roughly ________.
$24,000
What areas are stimulated by DPS to alleviate the symptoms of Parkinson’s?
Thalamus
Internal pallidum
Subthalamic nucleus
Some __________ trials have shown that patients no longer need L-DOPA.
fetal dopamine cell transplant
