Unit 7: OVERVIEW (Parkinson's, Dementia, Anesthetics) Flashcards
CAUSE of Parkinson’s Disease
depletion of dopamine-containing neurons in substantial migrants –> loss of normal inhibition
DRUG CLASSES used to treat Parkinson’s Disease
Dopamine Agonists
COMT Inhibitors
MAO-B Inhibitors
Anticholinergics
5 Dopamine Agonists used to treat PARKINSON’S DISEASE
bromocriptine pramipexole ropinirole rotigotine apomorphine
Why is LEVODOPA given in treatment of Parkinson’s?
Dopamine does not cross BBB
L-dopa DOES cross BBB
L-dopa is a precursor to dopamine
Why is CARBIDOPA given in treatment of Parkinson’s?
Reduces amount of L-dopa by 75% because it reduces metabolism of L-dopa –> increases amount of L-dopa that reaches the brain
Major drug used to treat Parkinson’s Disease
Carbidopa/Levodopa
2 COMT Inhibitors used to treat Parkinson’s Disease
entacapone
tolcapone
Why are the COMT Inhibitors used to treat Parkinson’s Disease?
they increase the HALF LIFE if LEVODOPA (COMT metabolizes Levodopa)
Name 3 enzymes that metabolize Levodopa
MAO-A
MAO-B
COMT
Name 2 MAO-B Inhibitors used to treat Parkinson’s Disease
selegiline
rasagiline
What needs to be avoided, and why, in Parkinson’s Disease?
for patients on MAO-B Inhibitors, avoid
TYRAMINE-CONTAINING FOODS
because MAO breaks down tyramine in the body
TOO MUCH TYRAMINE can cause a hypertensive emergency
Name 2 anticholinergics used to treat Parkinson’s Disease
benztropine
trihexyphenidyl
Why are anticholinergics used to treat Parkinson’s Disease?
they block muscarinic receptors and therefore decrease excitatory actions of cholinergic neurons
they treat tremors or drooling in early disease stages
Why is Amantadine used to treat Parkinson’s Disease?
treats dystonias
inhibits dopamine reuptake
may improve bradykinesia, rigidity, tremors
NEUROTRANSMITTER: acetylcholine
EXCITATORY or INHIBITORY?
mostly excitatory
NEUROTRANSMITTER: dopamine
FUNCTION?
EXCITATORY or INHIBITORY?
feeling of pleasure
usually inhibitory
NEUROTRANSMITTER: norepinephrine
EXCITATORY or INHIBITORY?
neurotransmitter and hormone
usually excitatory
can be inhibitory
NEUROTRANSMITTER: serotonin
FUNCTION?
mood, appetite, senses, pain
NEUROTRANSMITTER: GABA
FUNCTIONAL AREA?
EXCITATORY or INHIBITORY?
major inhibitory brain neurotransmitter
Cause of Dementia
decreased neuron activity of glutamate, dopamine, norepinephrine, serotonin, somatostatin
Goal in Dementia treatment
increase acetylcholine by inhibiting breakdown
Drug Classes used to Treat Dementia
cholinesterase inhibitors
NMDA receptor antagonists
4 cholinesterase inhibitors used to treat dementia
donepizil
galantamine
rivastigmine
tacrine
1 NMDA Antagonist used to treat Dementia
memantine
Why are NMDA antagonists used in Dementia treatment?
NMDA receptors receive glutamate
binding the receptor increases available glutamate
NEUROTRANSMITTER: glutamate
FUNCTION?
learning and memory
Define anesthetic
drugs used to reduce/eliminate pain and depress nerve function in the CNS
Name 2 inhaled anesthetics
nitrous oxide
halothane
Name 2 IV anesthetics
etomidate
ketamine
Major adverse effect of IV anesthetics
malignant hyperthermia
Treatment for malignant hyperthermia
dantrolene
Most commonly used anesthetic
lidocaine
3 topical anesthetics
lidocaine
bipivucaine
lidocaine + epinephrine
For whom must you use caution when using lidocaine + epinephrine
PVD
fingers/nose
due to vasoconstriction
