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Flashcards in Alzheimers Deck (17)
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1

Main risk factor for alzheimers

Age

2

Clinical symptoms of alzheimers

Memory loss
Poor judgement
Personality changes
Confusion

3

Theory behind pathophysiology of alzheimers

Amyloid hypothesis

4

Physiological processing of amyloid precursor

Amyloid precursor protein cleaved by alpha secretase releasing prducts- one of which is digested by gamma secretase

5

Enzymes involved in processing of amyloid

Alpha and gamma secretase

6

Pathophysiological processing of amyloid protein in alzheimers patients

Instead the precursor protein is cleaved by beta secretase releasing a different fragment. When this is cleaved by gamma secretase it releases amyloid beta protein and forms toxic aggregates

7

Where do beta amyloid protein aggregate

On cell membrane of neurones leading to immune response which destroys neurones

8

Secondary hypothesis to pathophysiology of alzheimers

Tau hypothesis

9

What are tau proteins

Soluble proteins found in axons that are important for stability and assembly of microtubules

10

Pathophysiology of tau hypothesis

Hyperphosphorylated tau is insoluble- tau self-aggregates to form neurofibrillary tangles that are neurotoxic. As there are less tau proteins this results in microtubule instability

11

Alternative less recognised hypothesis for alzheimers disease

Inflammatory hypothesis- people who have taken NSAIDS are less likely to get alzheimers

12

Pathophysiology of inflammatory hypothesis

Increased activity of microglial cells leads to release of inflammatory mediators and cytotoxic proteins. Get increased phagocytosis and so less neuronal protection

13

What drugs are given as alzheimers pharmacotherapy

Reversible cholinesterase inhbitors
Non-competitive NMDA receptor blocker

14

Names of reversible anticholinesterases

Donepezil- very long plasma half life
Rivastigmine
Galantamine- can act as nicotic AcH agonist

15

What is different about rivastigmine as anticholinesterase inhibitor for alzheimers

Inhibits butyryl cholinesterase too

16

Problems with anticholinesterase treatments

Only works for 2 years treating the symptoms

17

What is memantamine

Use dependent non-competitive NMDA receptor blocker (glutamine)
Only licensed for severe alzheimers