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29 Cards in this Set
- Front
- Back
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What are the 2 major types of symptoms seen in Alzheimer's disease?
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-Short-term memory loss
-Cognitive impairment that is gradual and relentless |
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What are the 2 major pathophysiologic changes seen in Alzheimer's disease?
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-Cortical Atrophy
-Senile plaque formation |
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What type of cortical neurons are disproportionately lost in AD?
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Cholinergic neurons
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Where are the B-amyloid deposits most abundant and what does their abundance correlate with?
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-Most in hippocampus and cortical association areas
-Abundance correlates with disease severity |
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What are the 2 main strategies for treating Alzheimer's?
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1. Increase the amt of ACh in the cerebral cortex
2. Block NMDA receptors to decrease excitotoxicity |
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What is required for actually putting Cholinergic agonists into the brain and why?
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Surgical intracereboventricular administration - because giving it in a less targeted manner would cause many side effects.
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What is a more common method of increasing ACh in the brain for AD patients?
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AChesterase inhibitors
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What is tricky about giving AChesterase inhibitors?
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There is a fine line between therapeutic effects and too many toxic side effects.
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What are the 3 AChesterase inhibitors given to treat AD?
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-Donepezil
-Rivastigmine -Galantamine |
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What drug is used for decreasing excitotoxicity by blocking NMDA receptors in Alzheimer's?
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Memantine
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What efficacy has been seen with Memantine therapy?
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Reduced rate of clinical deterioration
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What are the 2 main symptoms of Huntington's disease?
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-Motor dyscoordination
-Chorea |
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When does cognitive function decline in patient with HD?
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In midlife
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How is Huntington's disease acquired?
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By autosomal dominant inheritance
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How do symptoms of HD compare between homo vs heterozygotes?
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Same - both are affected with equal severity
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What is the cause of symptoms of motor dysregulation and chorea in HD?
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Loss of GABA neurons in the caudate and putamen (striatum)
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What pathway is mostly affected by the GABA-ergic neuronal loss?
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The inhibition pathway is lost so there is increased excitatory drive to the motor cortex.
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Where else does neuron loss occur in the CNS in HD?
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-Cortex
-Thalamus -Hypothalamus So symptoms are widespread |
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What is the genetic defect that causes HD?
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Trinucleotide repeats in the Huntingtin gene
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What is current treatment for HD focused on?
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Treating the symptoms, not the disease.
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What are the 2 types of symptoms that are mainly treated?
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-Depression
-Seizures |
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What is the main type of symptom seen in ALS?
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Rapidly progressive weakness
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What are 3 clinical signs of the rapidly progressive weakness in ALS?
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-Muscle atrophy
-Spasticity -Respiratory compromise |
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What is the pathophysiologic etiology of ALS?
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Loss of both upper and lower motor neurons
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What is the etiology of familial cases of ALS?
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Gain of function mutation in the gene for SOD
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What % of ALS is familial?
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Only 10%
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So what is the best idea for the etiology of the other 90% of ALS?
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Decreased glutamate reuptake resulting in excitotoxicity
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What is the main drug used in ALS treatment and what symptom is it used to decrease?
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Baclofen - to reduce spasticity
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What is Baclofen?
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A GABA-B receptor agonist
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