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AntiParkinson Drugs
AntiParkinson Drugs
disease
Pathogenesis of Parkinson’s
disease
Parkinson’s disease (PD) is a
progressive disorder of movement
that occurs mainly in the elderly. The
chief symptoms are:
H ypokinesia
R igidity
T remors
10/29/23 3
Parkinson’s Disease
A degenerative and progressive disorder
Associated with neurological consequences of
decreased dopamine levels produced by the
basal ganglia (substantia nigra)
Dopamine is a neurotransmitter found in the
neural synapses in the brain
Normally, neurones from the SN supply
dopamine to the corpus striatum (controls
unconscious muscle control)
Initiates movement, speech and self-expression
Balance, posture, muscle tone and involuntary
movement depends on the roles of dopamine
(inhibitory) and acetylcholine (Ach: excitatory)
Adverse effects:
Mental confusion and hallucinations.
It can occur as can peripheral atropine-
like toxicity (e.g. cycloplegia, urinary
retention, constipation)
Huntington’s Chorea
Inherited autosomal dominant disorder
Error in huntingtin gene
Synthesis of huntingtin protein (repeats of
polyglutamine cause excitotoxicity and
apoptosis in cortex and striatum)
Degeneration of GABAergic neurons in the
striatum
Huntington’s Chorea
Huntington’s Chorea
Dance like movements of limbs
Rhythmic movements of tongue and face
Dementia
Progressive brain degeneration
Huntington’s Chorea
Tx
Chlorpromazine
Haloperidol
Olanzapine
Alzheimer’s disease
Progressive memory loss
Disordered cognitive functions
Reduced verbal fluency
Bedridden as disease progresses
Complications of immobility
Alzheimer’s disease
Amyloid plaque (extracellular deposits of
β-amyloid protein)
Intraneuronal neurofibrillary tangles
(aggregates of highly phosphorylated
neuronal protein)
Loss of cholinergic neurons in brain
(originates from nucleus basalis in
forebrain and project to frontal cortex and
hippocampus)
Alzheimer’s disease Tx
Anticholinesterases Nootropics
Tacrine (hepatotoxic) Piracetam
Donepezil
Rivastigmine Anti-oxidants
Galantamine Vit. A, C,
Zinc, Selenium
Modafinil-
inc alertness & keep awake
Caffeine-
Migraine, allay fatigue, apnoea in premature
infants
MCQs
Q1. In parkinsonism, Carbidopa acts as:
A.Dopamine agonist
B.Dopamine precursor
C.Peripheral decarboxylase inhibitor
D.Dopamine reuptake blocker
Ans- C
Q2. In parkinsonism, Entacapone acts as:
A.Dopamine agonist
B.Dopamine precursor
C.COMT inhibitor
D.Dopamine reuptake blocker
Ans- C
Q 3.Which one of the following clinical
features of parkinsonism is benefited more
by central anticholinergic drugs?
A.Hypokinesia
B.Rigidity
C.Tremors
D.Festinating gait
Ans C
Q 4.Which one of the following clinical
features of parkinsonism is resolved
first by levodopa?
A.Hypokinesia
B.Rigidity
C.Tremors
D.Festinating gait
Ans A and B
Q5. Tolcapone is withdrawn due to
A.Cadiotoxicity
B.Nephrotoxicity
C.Carcinogenecity
D.Hepatotoxicity
Ans D
Thank you
Bibliography
Essentials of Medical Pharmacology -7th edition by KD Tripathi
Goodman & Gilman's the Pharmacological Basis of Therapeutics
12th edition by Laurence Brunton (Editor)
Lippincott's Illustrated Reviews: Pharmacology - 6th edition
by Richard A. Harvey
Basic and Clinical pharmacology 11th edition by Bertram G Katzung
Rang & Dale's Pharmacology -7th edition
by Humphrey P. Rang
Clinical Pharmacology 11th edition By Bennett and Brown, Churchill
Livingstone
Principles of Pharmacology 2nd edition by HL Sharma and KK
Sharma
Review of Pharmacology by Gobind Sparsh
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