Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
28 Cards in this Set
- Front
- Back
|
What transmitters are released via volume transmission?
|
Dopamine and catecholamines, Vt is associated with the raising of extracellular levels
|
|
|
By what mechanism are Glutamate and Gaba released?
|
Within the synapse (classical neurotransmission)
|
|
|
What is the source of dopaminergic input to the basal ganglia?
|
Nirgal-striatal pathway. Cell bodis in the substantia nigra project through the medial forebrain bundle (MFB) to the basal ganglia
|
|
|
What is the basal ganglia comprised of?
|
1. The striatum which consists of the caudate and the putamen
2. The internal/external Globus Pallidus |
|
|
What neural pathway is responsible for motor movements?
|
Pyramidal/corticospinal tract
|
|
|
What is the extrapyramidal system?
|
Pathway including basal ganglia, recticular formation, vestibular nuclei and red nucleis responsible for starting and stopping movement and maintenance of tone and posture
|
|
|
What are pathways important in modification/correction of motor movement?
|
1. Extrapyramidal system
2. Cerebellar output- coordinates msls of skilled movement |
|
|
What compensatory mechanisms occur in Parkinsons?
|
1. Increased synthesis of DA
2. Increased synaptic release of DA 3. Upregulation of DA receptors when lesion is > then 90% |
|
|
What is Sinemet?
|
Treatment for Parkinsons. L-Dopa and carbidopa (peripheral aromatic amino acid decarboxylase Inhibitor that cannot cross BBB)
|
|
|
Discuss side effects of L-dopa.
|
1. anorexia, nausea and vomitting
2. Also some tacchycardia, hypertension |
|
|
What are some dietary considerations neccessary for utilization of L-dopa?
|
1. Foods high in protein may interfere with L-Dopa absorption
2. Take 30 min before eating |
|
|
What are problems associated with L-dopa/sinemet use?
|
1. Short half-life
2. Cab cause hypertensive crisis if given to patient on MAO or MAO-I 3. On-off phenomenon after 5 years 4. Peak dose dyskinesia |
|
|
Discuss the use of Bromocriptine and Pergolide.
|
Ergot derivatives and Dopamine agonists typically used in conjunction with L-Dopa to decrease dosage and concomitatnt bouts of dyskinesia. Bromo-D2/D1 ag/antagonist and Pergolide is a DI and D2 agonist.
|
|
|
What is the advantage to using Bromocriptine and Pergolide to L-dopa?
|
No dependence on dying neurons, bypass presynaptic part to directly excite D2...etc. Disadvantage is that there is no regulation of release.
|
|
|
Discuss the action and cliniclal utility of Ropinirole and Paramipexole.
|
Newer D3>D2 dopamine agonists useful as monodrug therapy.
used to reduce off time when used with L-dopa |
|
|
Discuss the utility of apomorphine.
|
An emetic inhalant....cannot be taken orally
2. Rapid onste and short duration for emergency use in "off" pahse situations. |
|
|
Discuss the clinical utility of COMT-Inhibitors.
|
Used to block metabolism of L-dopa in the periphery by Catechol-O-Methyl Transferase after Aromatic Amino Acid Decarboxylase is blocked by Carbidopa in Sinemet. Allows decrease in dosage and side efx
|
|
|
Name two COMT-Inhibitors?
|
Tolcapone....off the market and enacapone which turns urine bright orange.
|
|
|
Characterize the utilization and classification of Amantidine.
|
Amantidine is an antivral agens which enhances DA releause and inhibits its uptake...useful as a first line therapy
|
|
|
For what type of patient are anticholinergics typically used?
|
Young patients...they have too many side efx
|
|
|
What is the recommendation for treatment of Parkinsons?
|
1. Initiate with amantadine, ropinirole or pramipexole
2. Low does L-dopa 3. Combine with COMT or DA agonists |
|
|
What is the treatment for tremor?
|
1. Beta-blockers- propanolol, indorol
2. Anticonvulsants- gabapentin, topiramate 3. Benzodiazepines- Alprazolam |
|
|
Characterize Huntingtons DZ.
|
Imbalance between Ach, GABA, and dopamine secondary to destruction of Gabaergic/cholinergic neurons in the striatum resulting in slightly increased to normal dopamine...chorea and dementia
SSRI for depression- fluoxetine |
|
|
How is Wilsons Dz treated?
|
Pencillamine- copper chelating agent or ZInc acetate- interferes with copper absorption
|
|
|
True/False. Chorea responds to anticholinergics.
|
False. But other hyperkinetic disorders do.
|
|
|
Give an example of a dopamine depleting drug.
|
Reserprine or tetrabenazine
|
|
|
What is the characteristic treatment for TIC?
|
Haloperidol, DA receptor blocker (neuroleptic) can cause tardive dyskinesia
|
|
|
For what dz are their good pharmalogical treatments? Poor?
|
Good!
1. Wilson 2. Parkisnons 3. Focal dystonia Bad. 1. Huntington 2. Tremor |
