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13 Cards in this Set
- Front
- Back
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Pathophysiology
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Loss of SUBSANTIA NIGRA NEURONS
Loss of dopaegernic projections to the striatum |
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Environmental Factors
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Pesticides
Toxins: MPTP Well Water Head Trauma Smoking/coffee=protection |
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Genetic factors
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Genetic component more obvious with early onset cases
Most likely a complex interaction with many other genes |
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Basal Ganglia
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collection of nuclei in forebrain that make connections with motor cortex and the midbrain
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Pathology of Parkinson's
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Loss of neurons in the NIGRO STRIATAL PATHWAY
----Substantia niagra has dopamine containing neurons ----Project to the Basal Ganglia Antipsychotics |
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Pathophysiology
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Loss of neurons in the substantia nigra
Loss of striatal dopamine |
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Pathology of remaining neurons
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--Lewy Bodies
--Mitochondrial Dysfunction |
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Neuropharmalogical Treatment
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1. Increase activity in dopamine synapses
2. suppress activity in structures with heightened activity (symptom oriented!) *Direct DA agonists *ACh antagonists *glutamate antagonists *MAO inhibitors |
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L-DOPA
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DA precursor
Mechanism of action: -converted into DA in the brain -Released by remaining neurons DOPAMINE DOES NOT CROSS THE BBB |
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Problems with L-DOPA treatment
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Converted into DA rapidly in the brain, so high doses are required, and high doses cause nausea
Long terms effects: dyskenesia (involuntary movement) and "on/off periods" |
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Carbidopa
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Delays the conversion of LDOPA
DOES NOT CROSS BBB Lower doses of LDOPA required, because more reaches the brain |
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Other Treatments
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1. MAO-B Inhibitors: boost effects of ldopa, controls metabolism in the brain,
2. COMT inhibitors: prolong symptom relief by postponing metabolism of L-Dopa |
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GDNF
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has been shown to reduce loss of DA neurons in rats
Protect neurons/Regenerate them? |
