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16 Cards in this Set
- Front
- Back
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Balance hypothesis
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Dopamine and Cholinergic output needs to balance each other out. When one is out of sync, raising or lowering itself or the other is a possible treatment.
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What drugs can cause parkinsonism
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Haloperidol, Phenothiazine
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MPTP
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Drug that mimics parkinsons for research. Metabolized by MAO-B to MPT+ which kills substantia nigra cells.
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What is the highly reseached method we think is responsible for parkinsons
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Free radical production during dopamine metabolism.
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L-DOPA
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Precursor for Dopamine. We already know this. Crosses BBB. Rapidly absorbed from GI. It has to compete with other aromatics for transport so give on empty stomach. 1-3% get in brain. Could get overproduction of catecholamines. Hypertension. Possible interactions, who cares.
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Carbidopa
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Given as sinemet which is L-DOPA and carbidopa mixture. Blocks peripheral conversion of L-DOPA to Dopamine.
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Amantidine
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Usually antiviral but it also stabilizes dopamine in synapse. Less effective than levodopa but often given with to keep levodopa level high.
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Trihexyphenidyl
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Muscarinic blockade restores imbalance of neurotransmitter activity. Toxicity can look like atropine. This reduces acetylcholine effect.
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Bromocriptine and pergolide
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Dopamine agonists and ergot alkaloids. Additive effects with levodopa.
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Pramipexole and Ropinarole
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Newer dopamine agonists. Modify effectiveness of dopamine. Weird side effect is compulsive gambling or restless leg syndrome.
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Apomorphine
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Dopamine agonist. Used for rescue of akinesia in off periods of dopamine response. Can get nausea.
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Seligilene
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Inhibits MAO-B.
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COMT pathway.
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Turned on by carbidopa. Homeostatic response. Metabolizes Levodopa to 3-O-methyldopa which inhibits transport of DOPA across gut and BBB.
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Entacapone and Tolcapone
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Inhibits COMT. Enhances uptake of levodopa, increases availability of levodopa.
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Huntington Disease
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Triplet expansion in IT15 gene. Dominant inheritance. Selective striatal loss in caudate nucleus. Pattern of loss is from tail of caudate and going mediodorsal to ventrolateral. Striatal GABA lost. Exacerbated by anticholinergics.
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Tetrabenazine
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Treat Huntington's. Reserpine might also be useful.
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