Pharma 11.2 Neuro Drugs

Question 1

What is the pathology behind Parkinsons?

Answer 1

Loss of dopaminergic neurones in substantia nigra. Results in reduced inhibition in neostriatum, allowing increased production of excitatory ACh. Results in abnormal signaling leading to impaired mobitility

Question 2

What are the symptoms of parkinsons?

Answer 2

TRAP
Tremor, rigidity, akinesia, Postural instability
Mask like face, shuffling gait

Question 3

What are the non idiopathic causes of parkinsons?

Answer 3

Corticobasal degeneration, drug induced, multiple systems atrophy, wilsons disease

Question 4

What is wilsons disease? How does it cause damage?

Answer 4

Excess copper accumulation in tissue leading to neurological and hepatic disease

Question 5

How is Myasthenia gravis treated? what happens in cases of overtreatment?

Answer 5

ACHesterase inhibitors

Overtreatment - cholinergic crisis leads to flaccid paralysis and resp failure

Question 6

What are the ADRs to AChesterase inhibitiors?

Answer 6

SSLUDGE

Salivation, sweating, lacrimation, urinary incontinence, diarrhoea, GI hypermobility, emesis

Question 7

What are the 5 drug classes used to treat parkinsons?

Answer 7

SALAD
Selegiline (MAO-B inhibitor), amantidine, L-DOPA, Anticholinergics, dopamine receptor agonists

Question 8

How is L-DOPA used?

Answer 8

Administered with peripheral DOPA decarboxylase inhibitor to prevent dopamine conversion outside brain

Question 9

What are the ADRs of L-DOPA?

Answer 9

On/off motor, wearing off, dyskinesia, dystonia, long term use shows loss of efficacy

Question 10

What is the MoA of monoamine oxidase B inhibitors?

Answer 10

Prevents dopamine breakdown

Question 11

When is monoamine oxidase B inhibitors used?

Answer 11

To enhance effects of L-DOPA

Question 12

What are the ADRs of dopamine receptor agonist?

Answer 12

sedation, hallucination, confusion, N&V

Question 13

What is the MoA of COMT inhibitors?

Answer 13

reduce peripheral breakdown of L-DOPA. No use alone

Question 14

What is the MoA of anticholinergics?

Answer 14

ACh has antagonistic effect to dopamine

Question 15

What are some ADRs of anticholinergics?

Answer 15

anhydrosis, dry mouth, urinary retention

Question 16

give 3 examples of dpoamine receptor agonists`

Answer 16

apomorphine, bromocriptine, ropinirole

Question 17

Give an example of a COMT inhibitor

Answer 17

entacapone

Question 18

Give 2 examples of antimuscarinics

Answer 18

amantadine and procyclidine