regulating dopamine levels Flashcards

1
Q

the cause of AD is thought to be the degeneration of […] neurons in the […] portion of the extrapyramidal motor system.

this causes reduced dopamine levels.

A

dopaminergic
substantia nigra

reduced dopamine levels.

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2
Q

the substantia nigra is thought to be the focal point of dopaminergic neuron degeneration in AD because…..

A

producing dopamine requires production of free radicals.
dopaminergic neurons are highly concentrated in the substantia nigra—>high rate of ROS production.

may be concomitant with a mutation in PARKIN receptor of the mitochondria that impedes the metabolism of ROS products.

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3
Q

the focus of AD treatment is […] rather than curative. The objective being to restore dopaminergic/cholinergic balance in the striatum (basal ganglia).

A

palliative.

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4
Q

why cant you give patient pure dopamine to tx AD?

A

dopamine does not cross the BBB.

it is also an emetic, and oral ingestion would cause severe vomiting.

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5
Q

L-DOPA is made from […], before being converted to dopamine by […].

Dopamine can be converted to […] by Dopamine Beta-Hydroxylase.

A

tyrosine
DOPA decarboxylase.

noradrenaline

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6
Q

dopamine is broken down and metabolized by [….].

A

MAO (monoamine oxidase) and COMT (catecholo-methyl transferase)

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7
Q

[..and …] are drugs given to patients with parkisons disease in conjuction with levodopa to inhibit peripheral metabolism of levodopa into dopamine, and increase amount of levodopa that crosses the BBB.

A

carbidopa and benserazide

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8
Q

L-DOPA is an [….]. More than 90% is converted by […] into dopamine and noradrenaline in the periphery.
Only 10% of dose reaches the CNS.

A

amino acid isomer.

DDC (dopamine decarboxylase)

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9
Q

dopamine can cause [….] of symptoms in many patients, and thus its effectiveness declines over time with the continued degeneration of dopaminergic neurons.

A

acceleration

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10
Q

[……] are dopamine agonists that may be preferred in [….] patients, since it can be used as monotherapy and

A

bromocriptine and cabergoline

younger

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11
Q

entacapone is a dominergic drug that acts by inhibiting {….] metabolism of L-DOPA to 3-O-methyldopa.

A

COMT

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12
Q

selegiline is a dominergic drug that acts by inhibiting {….] metabolism/deactivation of dopamine.

—>these are advantageous to [….] inhibitors because there are fewer hypertensive crises.

Early use may decrease progression of AD because […..] production is decreased.

A

MAO(B)

MAO(A)

free radical

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13
Q

[…] is a dopaminergic agent (originally an antiviral for influenza) that enhances dopamine release, but less effective than L-DOPA and more rapid tolerance.

A

amantadine

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14
Q

muscarinic receptor antagonists can be used as an adjunct to L-DOPA with the objective of titrating the [….] effect of L-DOPA. However, these have the classic anti-muscarinic side effects of: [….]

A

anticholinergic

Reduced SLUD = salivation, lacrimation, urination, defecation

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