Drugs For Parkinson's Disease
History of Parkinson's Disease
Dr. Parkinson characterized the disease:
Epidemiology
Presence of persistent cholinergic output in the basal ganglia in the absence of dopaminergic influences
Environmental Toxins - Possible Causes?
N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) - A Toxic Chemical Causing Parkinsonism - Is Refractory To Treatment
Parkinsonian Drugs
Anticholinergic Drugs
Mainline Medications Until The Early 1960's
Useful In Patients Who Cannot Tolerate Levodopa
Mechanism Of Action
Adverse Side Effects Of Anticholinergics
Dry Mouth (Xerostomia)
Dopaminergic Drugs
The Problem With Levodopa
Herein lies the problem ….. Dopamine cannot cross the blood-brain barrier. So, it is useless to the Parkinson’s patient if it never gets into the brain !!
So….. the key is to keep levadopa as levadopa until it reaches the blood-brain barrier.
You have to combine levadopa with a dopa decarboxylase inhibitor to insure that levadopa gets to and can cross over the blood-brain barrier.
Carbidopa is the name of the dopa decarboxylase inhibitor that is combined with levadopa which enables levadopa to get to and cross over the blood-brain barrier
At the blood-brain barrier, carbidopa is cleaved from levadopa.
In the brain, levadopa is converted to dopamine where it exerts its inhibitory effects and calms the tremors, and other symptoms of Parkinson’s Disease
Medical Uses
To Decrease Tremor, Rigidity, Bradykinesia
Adverse Side Effects
Tics
Behavioral Changes
Dopamine-Like Drugs
Amantadine Mechanism Of Action
These Medications Are Ergot Alkaloids & Belong To The Same Family As LSD
These Medications Are Used To Decrease The Untoward Side Effects Seen In Patients Using Levodopa - i.e. Involuntary Movements
Ergolines : Adverse Side Effects
Selegiline Mechanism Of Action
This Medication Is More Effective When Given To New Parkinson's Patients
Selegiline allows the patient to:
Selegiline : Adverse Reactions
Clinical Considerations
Maintain Joint Range Of Motion During A Drug Holiday
Maintain As Much Cardiovascular Fitness As Possible During The Drug Holiday
Email: David.Arnall@NAU.EDU , DAArnall@AOL.COM
Home Page: http://jan.ucc.nau.edu/~daa/pt675/
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