Pharmacology Winter Test 1 L8 Parkinsons And Alzheimers

Front 1

What is parkinsons?

Back 1

this is degeneration of dopamine pathways from substantia nigra along the nigrostriatal pathway

Front 2

How much brain is lost before symptoms occur?

Back 2

about 70% of the striatal DA is lost

Front 3

What are the primary symptoms of parkinsons?

Back 3

stiffness, tremor
bradykinesia
difficult balance
difficult walking

Front 4

What is the pathophysiology of parkinsons disease?

Back 4

degeneration of DA neurons in pars compacta of substantia nigra. This leads to overactivity in the *indirect pathway*. leading to increased glutamate to subthalamic nucleus (an inhibitory guy)-> more GABA to thalamus itself

Front 5

How do DA neurons affect the striatum output?

Back 5

DA inhibits GABA output from stiratum

Front 6

how do AcH neurons affect Striatum output?

Back 6

Ach increases the GABA output from striatum

Front 7

How does L-Dopa work?

Back 7

this is the precursor to DA, it is used to increase DA levels in the brain (to inhibit GABA output from striatum)

Front 8

How much L-Dopa is given?

Back 8

this requires a large dose of L dopa, because it is metabolized in thegut by COMT

Front 9

What does Dopa/Carbidopa (Sinemet) do?

Back 9

Carbidopa is a dopa decarboxylase inhibitor that doesnt enter the brain- so this allows more L dopa to enter the brain

Front 10

Does sinemet alter the course of parkinsons disease?

Back 10

no it does not, it only reduces symptoms for a couple years before it loses effect

Front 11

What is Sinemet best at treating in parkinsons?

Back 11

bradykinesia

Front 12

What are the GI effects of Sinemet?

Back 12

these will be nausea and vomiting, but side effects are low compared to L dopa alone

Front 13

What are the Cardiovascular side effects of Sinemet?

Back 13

possible arrythmias

hypertension

Front 14

What are the movement side effects of Sinemet?

Back 14

you get dyskinesias over time

Front 15

What are the behavior side effects of Sinemet?

Back 15

depression
psychosis- treated with atypical antipsychotics

Front 16

What is the On-Off phenomenon of L-Dopa?

Back 16

this is alternating periods of akinesia (off) followed by improved mobility with dyskineas (on periods)

Front 17

How is L-Dopa discontinued?

Back 17

this is done gradually

may cause akenesia or neuroleptic malignant syndrome

Front 18

What is the memonic for neuroleptic malignant syndrome?

Back 18

F- fever
E- encephalopathy
V- vitals unstable
E- elevated CPK enzyme
R- rigid muscles

Front 19

How do MAOI's affect L-Dopa?

Back 19

these can produce hypertensive crisis together

Front 20

How does Vitamin B6 (pyridoxine) affect L dopa?

Back 20

this increases the peripheral metabolism of L dopa

Front 21

What are the Contraindications of L-Dopa?

Back 21

Psychosis*
closed-angle glaucoma
cardiac disease
peptic ulcer
malignant melanoma

Front 22

What type of drug is Selegiline (Deprenyl)?

Back 22

this as an MAOI against MAO-B

Front 23

Where is MAO-B located?

Back 23

in the striatum

Front 24

How does Selegiline (Deprenyl) work?

Back 24

this reduces metabolism of DA by inhibiting MAO-B in the striatum

Front 25

How does Selegiline (deprenyl) affect free radicals?

Back 25

this decreases them, because MAO-B creates them when breaking down DA

Front 26

What do you NOT combine with Selegiline (deprenyl)?

Back 26

Meperidine (demerol)

Front 27

What does Tolcapone (Tasmar) do?

Back 27

this is a COMT inhibitor

Front 28

What is the prototype for dopamine receptor agonists?

Back 28

Bromocriptine

Front 29

How does Bromocriptine (parlodel) effect change over time?

Back 29

its effectiveness does not change over the course of parkinsons

Front 30

How does Bromocriptine (parlodel) affect prolactin levels?

Back 30

this decreases the release of prolactin

Front 31

What are the GI effects of Bromocriptine (parlodel)?

Back 31

anorexia, nausea, vomiting

Front 32

What are the cardiovascular effects of Bromocriptine (parlodel)?

Back 32

postural hypotension

cardic arryhtmias

Front 33

can Bromocriptine (parlodel) cause dyskinesia?

Back 33

yes it can

Front 34

What drug causes Erythromelaglia?

Back 34

Bromocriptine (parlodel).

this is red, tender, swollen feet due to vasospasm

Front 35

What kind of drug is Pramipexole (mirapex)

Back 35

this is a dopamine receptor agonist like Bromocriptine (parlodel)

Front 36

What does Pramipexole (Mirapex) treat?

Back 36

this treats parkinsons disease

Front 37

What does Ropinirole (requip) treat?

Back 37

this treats parkinsons disease

Front 38

What does Apomorphine (Apokyn) treat?

Back 38

this treats off-period akinesia in parkinsons treatments

Front 39

How is Apomorphine (apokyn) given?

Back 39

this is a subcue injection

Front 40

What is amantadine (symmetrel) used to treat?

Back 40

this is an antiviral drug thats being used to treat parkinsons! neat!

Front 41

What are the side effects of Amantadine (symmetrel)?

Back 41

toxic psychosis
convulsions
spotting of skin
edema

Front 42

What kind of drug is Benztorpine (Cogentin)

Back 42

this is an anticholinergic drug

Front 43

What kind of drug is Biperiden (akineton)

Back 43

this is an anticholinergic drug

Front 44

How does Benztropine (Cogentin) affect parkinsons symptoms?

Back 44

this relieves rigidity, tremor, and drooling

does NOT help bradykinesia

Front 45

What two drugs treating huntingtons disease?

Back 45

Tetrabenazine, and reserpine

Front 46

What is the best drug for Tourettes syndrome?

Back 46

Haloperidol

Front 47

What are the risk factors for Alzheimers?

Back 47

Being old
family history
being a woman
low education

Front 48

What is the hallmark destruction of the brain in Alzheimers disease?

Back 48

degeneration of cholinergic neurons in the nucleus basalis of Meynert, which projects to the cerebral cortex and hippocampus

Front 49

What NT does Alzheimers effect?**

Back 49

ACh is reduced by up to 90%

Front 50

What type of drugs treat alzheimers?

Back 50

cholinesterase inhibitors

Front 51

What kind of drug is Tacrine (Cognex)

Back 51

this is a cholinestease inhibitor used in alzheimers

Front 52

What kind of drug is Rivastigmine (exelon)

Back 52

this is a cholinesterase inhibitor

Front 53

What is the major adverse effect of Tacrine (Cognex)

Back 53

this causes liver toxicity in up to HALF of people

Front 54

How does memantine (Ebixa) work?

Back 54

this is an antagonist of NMDA receptors

blocks sustained activation of NMDA receptors by glutamate

Front 55

What does memantine (ebixa) treat?

Back 55

this treats severe Alzheimers disease

Front 56

What are the side effects of Mamantine (Ebixa)

Back 56

this enhances the side effects of L-dopa

agitation
urinary incontinence/ infection
insomnia
diarrhea