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Leucine-rich repeat kinase 2, contributes to Lewy bodies, autosomal dominant |
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a-synuclein, contributes to lewy body formation. Autosomal dominant |
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autosomal resessive gene implicated in Parkinson's disease |
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a nuerotoxin discovered in 1980s, can contribute to Parkinsons by selectively inducing damage in DA neurons. This MPTP is converted to MPP+ by MAOB in CNS which is a high affinity substrate for DA reuptake transporters. |
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Pesticides and herbicides, can contribute to parkinsons |
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Loss of dopaminergic nuerons in the substantia nigra pars compacta Appearance of intracellular inclusion bodies known as lewy bodies |
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Precursor for dopamine, about 1-3 hour half life, peak plasma concentration in half to 2 hours. Renal excretion is about 90% after an original dose in 48 hours. |
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Carbidopa, Levidopa, Sinemt |
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Carbidopa prevents L dopa from being converted to DA in the bloodstreem. Inhibits peripheral DDC so more LDopa can get to the brain. Has symptoms and awkward off times |
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Dyskenesia's still present. Behavioral changes, cardiovascular disease. Also have negative drug interactions, such as being a Dopamine receptor antagonist, MAO inhibitors antagonism. Also on/off periods. |
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Carbidopa prevents L dopa from being converted to DA in the bloodstreem. Inhibits peripheral DDC so more LDopa can get to the brain. Reduces off time, better than sinemet |
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Carbidopa, Levidopa, Entacapone Stalevo |
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Entacapone is a COMT inhibitor, Carbi is a DDecarbox inhibitor, Even more LDopa get into system. Stalevo is for advanced PD |
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A subcutaneous injection that is a DA agonist. can be used as a rescue agent |
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Oral, minimize off effect, can be used 2-6 times a day, affinity for d3 over d2. DA agonist |
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oral, minimize on/off effect taking 2-6 times a day. preferntial for d2/d3. DA agonists |
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Transdermal system, affinity D3> d1/d2> d4/d5. Also used for restless leg syndrome. DA agonist |
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DA agonist, Ergoline class, taken 3x a day, and has affinity for D2 and 5Ht. |
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DA agonist, Ergoline class, witdrawn 2007. 3x a day, affinity for D1 and 2, and 5Ht |
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Trihexyphenidyl, Benztropine mesylate(coquentin) |
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Anticholinergic for musc receptor, restore balance between Ach and DA. Taken 2x a day. Atropine like symptoms |
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Oral MAO-B inhibitor, blocks breakdown of DA in striatum. Converted into an amphetamine like by product which is why side effect. |
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Oral MAO-B inhibit, taken once. Block breadown of DA in striatum |
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MaoB blocker, oral. useful for NMS, taken once a day |
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COMT inhibitor, taken 2-3 times a day, provide average of 1.7-2.9 on time for L dopa. |
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Another type of med, increases DA release from store, keeps it in synapse. Weak antagonism of glutamate. |
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Nueroprotection, electron acceptor, potent antioxidant, slow decline on motor scales |
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nueroprotection, promitochondria effects, may reduce accumulation of asynucli and lipid oxidation with CoQ10 |
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