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;
21 Cards in this Set
- Front
- Back
|
Cardinal features of Parkinson's disease
|
tremor at rest; cogwheel rigidity; bradykinesia; postural instability
|
|
|
Pathway to make epinephrine
|
Tyrosine-->L-Dopa-->Dopamine-->NE-->Epi; L-Dopa can also be converted to 3-o-methyldopa via COMT.
|
|
|
Non-motor problems of Parkinson's
|
Sleep disturbances, olfactory difficulties, autonomic, anxiety
|
|
|
Underlaying NT cause of Parkinson's
|
Loss of dopaminergic neurons in the pars compacta of the substantia nigra, with a relative excess of cholinergic activity. Therapy is directed at replacing the dopamine or suppressing the acetylcholine.
|
|
|
Main systemic effects of dopamine
|
renal vasodilation, cardiac stimulation, increased BP
|
|
|
The activation of which receptors is primarily responsible for improving motor control in Parkinson's patients?
|
D2
|
|
|
Fate of L-Dopa in the periphery
|
Converted to dopamine via AADC, or converted to 3-o-methyldopa via COMT. Can also cross the BBB into the CNS.
|
|
|
Fate of L-Dopa in the CNS
|
Converted to dopamine, which can then be converted to breakdown products by MAOB.
|
|
|
Carbidopa
|
Inhibits AADC to prevent the conversion of L-Dopa to Dopamine in the periphery.
|
|
|
Sinemet
|
Combination of L-dopa and carbidopa
|
|
|
Sinemet is contraindicated in what?
|
Acute angle glaucoma
|
|
|
How and why do you administer COMT inhibitors?
|
Prevent the conversion of L-Dopa-->3-o-methyldopa in the periphery. Can never be given as a monotherapy; you need to give it with Sinemet so there is some L-Dopa initially.
|
|
|
Dopamine agonists, ergot alkaloids
|
Bromocriptine. D2 agonists. Used to decrease prolactin levels in patients with pituitary adenomas.
|
|
|
Which are used to Parkinson's, ergot or non-ergot alkaloids? And why?
|
Non-ergot; ergot alkaloids can cause fibrotic complications.
|
|
|
Which medication is administered subcutaneously and used for acute freezing attacks of Parkinson's?
|
Apomorphine (non-ergot alkaloid)
|
|
|
MAO-B inhibitors
|
Decreases central conversion of dopamine to breakdown products (DOPAC and hydrogen peroxide); reduces the formation of free radicals.
|
|
|
What are MAO-B inhibitors metabolized to?
|
Amphetamine and methamphetamine (so don't give it at night)
|
|
|
Selegiline
|
MAO-B inhibitor
|
|
|
Tx for mild symptoms
|
Amantidine, MAO-B inhibitor, dopamine agonist
|
|
|
Tx for tremors
|
Anticholinergics
|
|
|
Tx for severe Parkinson's
|
L-dopa, dopamine agonist, COMT inhibitor
|
