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M&M Pharma > Treatment Of Neurodegenerative Diseases > Flashcards

Treatment Of Neurodegenerative Diseases Flashcards

1
Q

Examples of neurodegenerative diseases :

A

Parkinson’s disease (PD)

Alzheimer’s disease (AD)

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2
Q

Causes of apoptosis and necrosis in Brain cells :

A

Excitotoxicity
Oxidative stress
Inflammation

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3
Q

Excitotoxicity means :

A

Excessive activation of NMDA receptors by glutamate leading to intracellular calcium overload

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4
Q

Oxidative stress means :

A

Mitochondrial dysfunction
Ageing
Environmental toxins
Genetic abnormalities

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5
Q

Causes of Parkinson’s disease :

A

‏ Stroke
Virus infection
Genetic mutations
MPTP

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6
Q

Drugs that can induce Parkinson’s disease :

A

Reseprine
Metoclopramide (Antiemetic)
Typical Antipsychotics

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7
Q

What is the Pharmacological treatment of Parkinson’s disease :

A

Dopamine precursor
Dopamine agonists
Monoamine oxidase-B inhibitors (MAO-B)
Muscarinic ACh receptor antagonists

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8
Q

What are the surgical treatment of Parkinson’s disease :

A

A- High-frequency deep brain stimulation of the subthalamic nucleus or globus pallidus by an implanted electrode

B- Stem cells implant

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9
Q

Which drug is the first line treatment of motor symptoms in Parkinson’s disease :

A

Levodopa

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10
Q

What’s the name of the substance that convert levodopa into dopamine ?

A

Dopa decarboxylase (DDC)

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11
Q

The absorption of levodopa occurs in ……..

A

Small intestine

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12
Q

Which class of drugs should be combined with levodopa to enhance its effect on central nervous system ?

A

DDC inhibitors / Carbidopa

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13
Q

What are the short-term adverse effects of levodopa ?

A 
Nausea 
Vomiting 
Anorexia 
Postural hypotension 
Schizophrenia like syndrome
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14
Q

What’s the treatment of levodopa GIT adverse affects (Nausea, vomiting, anorexia)

A

Domperidone

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15
Q

Long-term adverse effects of levodopa :

A 
Involuntary movement (Dyskinesia)
Response fluctuation
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16
Q

Drugs and food interactions of levodopa :

A

Pyridoxine (vitamin B6) > enhance the extracerebral metabolism.

MAO-A (event after 2 weeks of its stoppage) > Hypertensive crises.

Iron, some Amino Acids, Antacids and Anticholinergics > Delay the absorption.

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17
Q

Contraindications of levodopa :

A 
Psychotic patients
Angle-closure glucoma
Active peptic ulcer
History of melanoma
Specious undiagnosed skin lesion
18
Q

Examples of dopamine agonists :

A

Rotigotine (patches)

Apomorphine (Subcutaneous)

19
Q

Advantages of dopamine agonists :

A

No need for enzymes like DDCIs
No response fluctuations
No dyskinesia

20
Q

Side effects of dopamine agonists :

A 
Nausea 
Vomiting
Headache
Nasal congestion
Postural hypotension
Hallucinations
Compulsive behavior
Short half life
21
Q

Contradictions of dopamine agonists :

A

Psychotic patients
Myocardial infarction
Active peptic ulceration

22
Q

Which receptor does rotigotine activate :

A

D2 and D3

23
Q

Usage of Apomorphine :

A

Control the “off effect” of levodopa (Rapid onset)

24
Q

Side effects of Apomorphine :

A

Powerful emetic action (must be combined with orally antiemetic)

Mood and behavioural changes

Cardiac dysrhythmias

Hypotension

25
Q

Example of MAO-B inhibitors :

A

Rasagiline

26
Q

Advantages of Rasagiline :

A

Does not convert to amphetamine (no CNS stimulation)

Retard disease progression

27
Q

Mechanism of action of MAO-B inhibitors :

A

Enhance the action of levodopa By preventing dopamine metabolism.

28
Q

Example of muscarinic ACh receptor antagonist :

A

Biperiden

29
Q

Adverse effects of muscarinic ACh receptor antagonist :

A

Dry mouth
Constipation
Impaired vision
Urinary retention

30
Q

What’s the class of amantadine :

A

Anti-viral

31
Q

What’s mechanism action of amantadine regarding Parkinson’s disease :

A

Increases dopamine release
Inhibition of amine uptake
Direct action on dopamine receptors
Block of NMDA receptors

32
Q

Which symptom of Parkinson’s disease does amantadine reduce :

A

Dyskinesia induced by prolonged levodopa treatment

33
Q

Adverse side-effects of amantadine :

A 
CNS stimulation 
Restlessness 
Depression
Irritability
Insomnia 
Agitation
Excitement
Hallucinations
Confusion
34
Q

Contradictions of amantadine :

A

Seizures

Heart failure

35
Q

Treatment for schizophrenia like syndrome in Parkinson’s disease :

A

Clozapine (Atypical antipsychotics )

36
Q

Treatment for depression in Parkinson’s disease :

A

SSRIs

37
Q

Treatment for dementia, cognitive decline and hallucinations in Parkinson’s disease :

A

Rivastigmine (Cholinestrase inhibitor)

38
Q

Treatment for excessive daytime sleepiness in Parkinson’s disease :

A

Modafinil (CNS stimulant)

39
Q

Treatment of postural hypotension in Parkinson’s disease :

A

Increases salt intake
Fludrocortisone (Minralocorticoids)
Midodrine (Alpha 1 agonist)
Desmopressin (ADH Analouge)

40
Q

The treatment of Parkinson’s disease should start ……….

A

Gradually

41
Q

Never stop and antiparkinsonian drug …………….

A

Suddenly

42
Q

Try to ……. the use of Levodopa/Carbidopa for …….

A

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M&M Pharma (4 decks)

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