Treatment of Neurodegenrative diseases Flashcards
بسم الله الرحمن الرحيم
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Dementia means ?
Cognitive impairment including memory IN fully cosciouness person
Casues of dementia
Primary Alzhemir
Seondary:
Vacular = storke + infarction
Toxins
Tumor
infections
parkinson
pathopysiology of alzhemir
Extracullular accumulation of B-amyloid plaques
Intracellular accumulation of Tau protein
causing neuronal degenration especially the cholinergics
2 current therapies of Al-zhemir
Cholinimimetics
NMDA Receptor antagonist
Cholinestrase inhibitors ex
Donepazil oral
Rivastigmine oral and Transdermal patch
The only medication approved for Parkinson dementia ?
Rivastigmine
Mention adverse effects of Cholinesterase inhibitors
GIT : NVDA
Bradycardia
Muscle cramps
tremors
Drugn interactions involving CYP450 Except rivastigmine
Adventages of Rivastigmine ?
No drug interaction
Transdemal patch
used in Alzhemir dmentia the only drug !
Mematnie mechnaims describe
its is NMDA Receptor antagnist Preventing ca entering in huge amount preventing Apoptosis of neurons
Adverses of Memantine
Confusion Dizness headache constipation
Constipation
Depression and psychosis of alzemir treat ?>
Depression SSRI AND TCA
PSYCHOSIS AOR
Ariprazole
Olanzopine
Respridone
Autoimmnue inflammatory demyelinating disease of CNS
Multipe sclerosis
Chronic relapsing progressive disease
Mangemetn oF MS
Treatment of Acute episode
Disease modifying drugs
symptomatic treatment
Methylprednisolone dose and form in MS
For acute exacerbations release
1g/d IV for 5 days followd by tepered oral predinsone
Corticosteroids catabolic side effects
Catabolic :
Carbohydrate : hyperglycemia
Fat:lipolysis and fat distribuation
Protein = muscle wasting + Retardation of growth + osteoprosis
may cause pshcosis and depression
Corticosteriods cause edema and HTN why?
Due to salt and water retention
Mention 3 side effects of Coricosteorids
Peptic ulcer
increase infections
Decreased wound healing + Hirsutism
Disease modyfing drugs in MS
-INTF NATALI CHEMO
-1-Interferon B SC IM
-2-Figolimod Oral
-3-Natalizumab IV infusion
-4-Chemotheraputic agents as
cyclophospamide and azathioprine
Fisrt line in modifying MS and its adverse effects
Interferon beta
Flu like symptoms
Depression
Reaction at site of injetion
AST and ALT ELEVATION
First ORAL DMDS is ?
Fingilomod
Lymphocyte sequestation done by?
Fingilimod
S1P1 attachement
First dose bradycardia in DMDs by?>
Finglimoid
Macular edema increased in DM in DMDs by?
Fingiliomd
Finglimod adverses ?
Fist dose bradycardia
Increased Risk of infection
macualr edema
Monoclonal antibody attaching to alpa 1 beta 4 integrin for no attahcment OF t cells to VCAM1 for no passing thorigh BBB TO CENTRAL NEURONS
NATALI
NATALIZIUMAB
K channel blocker improving walking FDA has given it approval as a symptomatic treatment in MS ?
Dal Fampridine
Fatigue = ?
muscle spasticiy= ?
Tremors
Neuralgia
modafinil
diazepam
inderal
carabamazpine antitiptyline
Amyotrophic lateal scelrosis ALS
by genetic and ENVIRONMENTAL : Metals
pesticides
EMF
dEGENRATION Of lateral coritcospinal upper motor also lower motor ccures in ?
ALS
Theroetical pathophysiology of ALS ?
iNCREASED glutamate on NAMDA increasing intracellular calcium causing apoptisis
Delaying need for ventilarot for 3months IN ALS ?
Rilozoule
Delaying need for ventilarot for 3months IN ALS ?
Riluzole
Rilzuole action ?
Blocking Na Channels preventing glutamate relase to NMDA ? Preventing Ca entery
Rilzuole action ?
Blocking Na Channels preventing glutamate relase to NMDA ? Preventing Ca entery
so it is NMDA indirect antagonist right ?!
الحمدلله رب العالمين
