Pharmacology Of Parkinsons And Alzheimers Drugs

Question 1

What is the neuropathology of Parkinson’s disease?

Answer 1

• Selective degeneration of the substantia negra
• Lewy bodies

Question 2

What movement and cognitive disorders characterise Parkinson’s disease?

Answer 2

• Tremor, rigidity, bradykinesia, akinesia, dyskinesia
• dementia

Question 3

What is the advantage of using L-DOPA (Levodopa) instead of dopamine in the treatment of Parkinson’s?

Answer 3

L-dopa can cross the blood brain barrier, dopamine cannot

Question 4

What are the main causes of Parkinson’s disease?

Answer 4

Idiopathic, familial/generic, drug-induced (Parkinsonism), environmental factors (toxins), viral

Question 5

What drugs can induce Parkinsonism?

Answer 5

Dopamine-blocking drugs:
- Antipsychotics (prochlorperazine, haloperidol…)
- Antiemetics
- Antihistamines
- Methyldopa

Question 6

What is the mechanism of action and clinical benefit of carbidopa/benserazide?

Answer 6

Inhibits DOPA carboxylase, reducing peripheral dopamine production

Reduces dose of L-DOPA required and reduces peripheral side effects

Question 7

What is the pathology of Alzheimer’s disease?

Answer 7

• Selective loss of cholinergic neurones and the loss of choline acetyltransferase (inability to synthesise acetylcholine)
• Aggregates of mis-folded protein (Amyloid plaques: beta-amyloid peptide (A beta plaques)

Question 8

What are the treatment strategies for Alzheimer’s disease?

Answer 8

• Enhance cholinergic transmission
• Inhibit glutamate transmission

Question 9

What is an example of a drug that inhibits glutamate transmission?

Answer 9

Memantine

Question 10

What are examples of cholinesterase inhibitors?

Answer 10

Tacrine, Donepezil, Rivastigmine, Galantamine