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65 Cards in this Set
- Front
- Back
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classic trad of pd
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resting tremor
rigidity bradykinesia |
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apart from age what's the strongest predictor of pd
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family hx
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pd is a neurodenetive disorder of hte exrapyramidal dopaminergic --- ----- pathway
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nigrostriatal
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which da neurons are presevered in PD and which die
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preserved: ventral tegmentum
die: substantia nigra |
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t/f
in pd there's an increase in da in the nigrostriatum |
f
decrease |
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when is pd clinically apparent
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after 80% of da die
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mutation in this gene might lead to pd
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alpha-synuclein
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possible environmental factors of pd
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manganese
herbicides/pesticides ani-da antipsychotic durgs recreational drugs: MPTP |
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normal agin endogenous neurotoxins associated w/ pd
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auto-oxidation of dopamine (quinones)
mao catalyzed oxidation of neurotransmission |
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quinone can generate --- ---- radicals and by --- the species in the neuro and cause them to die
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cytotoxic hydroxy
alkylating |
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mao-catalyzed oxidation of catecholamine nt generates --- ----
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hydrogen peroxide
this can form a cytotoxic hydroxy radical |
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--- products of DA metabolism accelerate progressive degeneration of A9 nigral neurons in normal aging and parkinson's disease
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oxidized
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oxidative metabolism of ---- contributes to neuronal cell injury and ---- via oxidative damage resulting from formatio of such reactive oxygen free radical and quinoid species
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catecholamines
death |
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---- is a by-product from reverse ester of the narcotic analgesic meperidine
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MPTP
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MPTP is a ----
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pyridine
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mptp is a substrate for --- ---
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MPTP
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designer drug . . .switch atoms around
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mppp
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neurotoxin from mptp
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MPP+
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what can inhibitthe converstion of mptp to mpdp+ by mao-b
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pargyline
deprenyl |
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what will inhibit the conversion of mpp+ uptake into the catecholamine neurons
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mazindol
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--- is an antipsychotic drug w/ mpp like metabolite that cuases parkinsonian like se
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haldolperidol
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the neurotoxin causes by haldol
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HPP+
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HPP+ can cuause what eps
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tardive dyskinesia
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why's it possible that herbicides can cause pd
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cuase they (paraquat) look like MPP+
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initial lesion has to be ---
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specific
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pharmotx for pd is ----
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symptomatic
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pharmocotx for pd involves the
augmentation of the synthesis of brain ---- stimulatio of da release from --- sites ---- stimulation of da receptors decreasing ----- of da at presynatpic sites decreasing dopamine ------ |
dopamine
presynaptic direct re-uptake catabolism |
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ex of a reuptake blocker
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cocaine
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decrease da catabolism by inhibiting ---
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mao
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------ increases life expectancy among patients w/ pd and survival is significantly reduced if there is a delay in initiation of ---- tx
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levadopa
levadopa |
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t/f
levadopa can cause ------ |
neurotoxicity
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what can prevent the absorption of levadopa
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B6
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levadopa can cause ---- upset w/ n/v due by stimulation by da of ----
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gastric
CTZ |
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levadopa causes direct ----- irritation
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gi
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motor complications of levadopa
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greater severity of parkinsonian symptoms
abnormal involuntary movements neurotoxicity don't know if due to disease or the med |
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psy disturbances due to levadopa
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visual hallucinaitons
mania hypersexuality paranoid psychosis |
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what can increase the proportion of levadopa that crosses the bbb
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inhibition of peripheral decarboxylase activity
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peripheral decarboxylase inhibitor
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carbidopa
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how does carbidopa x bbb
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via transporters
due to polarity |
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motor complications of levadopa
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greater severity of parkinsonian symptoms
abnormal involuntary movements neurotoxicity don't know if due to disease or the med |
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psy disturbances due to levadopa
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visual hallucinaitons
mania hypersexuality paranoid psychosis |
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what can increase the proportion of levadopa that crosses the bbb
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inhibition of peripheral decarboxylase activity
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peripheral decarboxylase inhibitor
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carbidopa
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how does carbidopa x bbb
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via transporters
due to polarity |
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decrease da in the periphery will decrease ---- such as htn
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se
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direct da receptor agonist
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bromocriptine
ropinirole pramipexole |
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what does bromocriptine activate
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D1
D2 decrease PD s/s |
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ropinirole used for
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RLS
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t/f
pramipexole aromatic |
f
but still used |
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what will the direct dopamine receptor agonist bind to
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D1
D2/3/4 5HT alpha |
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maoi
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selegiline
rasagiline |
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selegiline's metabolite
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amphetamine
so releases NE and DA increase bp and pyschostimulant effects |
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does rasaglinie have amphetamine metabolite
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no
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what does comt inhibitor inhibit
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dopa and da
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comt inhibitor always given w/
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l dopa
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se of comt inhibit
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diarrhea
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comt inhbitors
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tolcapone
entacapone |
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tolcapone causes
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liver toxicity
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t 1/2 of tolcapone
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8-12 hrs
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entacapone mainly given block to block --- of da
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methylation
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where does entacapone mainly used
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in periphery
given to scare; not better efficacy |
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da releasers
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amantadine
memantine |
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amantadine is an anti---
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viral
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how does amantadine prevent excitotoxicity
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by inhibiting glutamic acid receptor antagonist
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t/f
memantine is hydrophilic |
f
lipophilic |
