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pharmacology 8
| Term | Definition |
|---|---|
| Acetylcholinesterase | Enzyme that degrades the neurotransmitter acetylcholine |
| ApoE4 allele | Defective form of apolipoprotein E that is associated with Alzheimer disease Fifteen percent of persons with this being defective will develop Alzheimer’s disease. |
| Bradykinesia | Slowness in initiating and carrying out voluntary movements |
| Cognitive functions | The ability to take in information via the senses, process the details, commit the information to memory, and recall it when necessary. |
| Dementia | Condition associated with a loss of memory and cognition |
| Neurodegeneration | Destruction of nerve cells |
| Neuroprotective | Protects nerve cells from damage |
| Plaques | fill the spaces between neurons in the brain and interfere with the transmission of signals between the neurons |
| Pseudoparkinsonism | Drug-induced condition that resembles Parkinson disease |
| Tangles | Twisted fibers made up of clumps of a protein called tau that interfere with nerve signal transmission |
| a neurodegenerative disease that causes: Memory loss Behavioral changes Immobility | Alzheimer’s disease |
| what part of the brain is damaged my Alzheimer's | - hippocampus (part of brain involved in memory) - The cerebral cortex shrinks in size |
| what nerves cells die due to Alzheimer's | cholinergic nerve cells |
| plaques and tangles | The accumulation of these produces inflammation, which further damages neurons in Alzheimer's |
| Cerebrovascular disease High blood pressure Diabetes Sleep apnea Parkinson disease | comorbid diseases with Alzheimer's |
| neurotransmitters involved in Alzheimer's | Acetylcholine (ACh) Glutamate Dopamine Norepinephrine Serotonin |
| Excess activity of the _____ receptor is linked to Alzheimer’s disease and is believed to contribute to the process of neurodegeneration | N-methyl-D-aspartate (NMDA) receptor ( a glutamate receptor) |
| ACh levels | cholinergic pathways are involved in memory and cognition - reduced due to Neurodegeneration causes by Alzheimer's |
| Glutamate binding | involved in memory formation and learning - reduced due to Neurodegeneration causes by Alzheimer's |
| Drugs used to treat Alzheimer’s disease either: | Increase ACh levels at the synapse Block glutamate activity Cholinesterase inhibitor drugs prevent the breakdown of acetylcholine |
| Acetylcholinesterase Inhibitors | prescribed for mild to moderate Alzheimer's -increase levels of ACh |
| NMDA Antagonist | Prescribed for moderate to severe Alzheimer's Memantine (Namenda) blocks the actions of glutamate at NMDA receptor sites. |
| Donepezil | -an acetylcholinesterase inhibitor -manage symptoms of mild, moderate, and severe Alzheimer's disease -Highly protein bound and metabolized by CYP 450 isoenzymes -Subject to drug interactions with drugs that are similarly protein bound |
| Rivastigmine | treat mild to moderate dementia associated with Alzheimer's disease and Parkinson's disease Readily crosses the blood–brain barrier Cholinesterase inhibition of up to 10 hours premixed solution must be consumed within 4 hours of mixing. |
| Memantine | used to treat the symptoms of moderate to severe Alzheimer's disease Blocks glutamate |
| Donepezil adverse reactions | Abdominal pain and cramping Dizziness Diarrhea Nausea Increased urination |
| Rivastigmine adverse reactions | Abdominal pain and cramping Dizziness Diarrhea Nausea Sedation, tremors, and hypotension Increased urination Pseudoparkinsonism |
| Memantine adverse reactions | Abdominal pain and cramping Dizziness Diarrhea Sedation, tremors, and hypotension Pseudoparkinsonism Myocardial infarction, erectile dysfunction, and suicide ideation |
| Warning Labels on Alzheimer's drugs | May cause dizziness or drowsiness Do not discontinue without medical supervision |
| factors that may reduce the risk for Alzheimer’s disease include | Head injury protection Reduction in cholesterol Adequate intellectual stimulation Decreased obesity |
| Parkinson disease | progressive disorder of the nervous system involving degeneration of dopaminergic neurons in the basal ganglia and nigrostriatal pathways in the brain. |
| average age at onset of Parkinson disease | 60 years |
| Parkinson disease in persons under 40 years has been associated with | ingestion of illicit drugs |
| May increase the long-term risk for development of Parkinson disease from 3% to 5% | Pesticide exposure |
| Carbon monoxide poisoning Heavy metal poisoning (mercury) Infectious diseases such as viral encephalitis and syphilis Metabolic disorders such as Wilson’s disease Familial inheritance of the chromosome 4 gene | May increase the long-term risk for development of Parkinson disease |
| Symptoms of Parkinson disease are caused by | an imbalance between dopamine and acetylcholine |
| cholinergic excitation in Parkinsons produces | tremors, muscle rigidity, and immobility |
| Neurotransmitters involved in Parkinson disease: | Dopamine, GABA, Glutamate, acetylcholine |
| MOA of parkinsons | balance between dopamine (inhibitory neurotransmitter) and acetylcholine-Ach-(excitatory neurotransmitter) |
| Levodopa | used to treat parkinsons crosses protective blood-brain barrier and is converted into dopamine metabolized in the gastrointestinal tract/ only a small percentage actually reaches the neuron to be converted to dopamine. ( Sustained-release low bioavail ) |
| Levodopa and carbidopa | used to treat parkinsons - increases dopamine Carbidopa inhibits the metabolism of levodopa in the GI tract and peripheral tissues and increases levodopa bioavailability by 75% |
| Tolcapone | a prescription medication used as an adjunct to levodopa and carbidopa for the treatment of symptoms in patients with Parkinson's disease a catechol-O-methyltransferase (COMT) inhibitor that boosts the bioavailability of levodopa by up to 50%. |
| adverse reactions parkinsons drugs | Dizziness or lightheadedness Insomnia Confusion Auditory and visual hallucinations Nausea and vomiting Decreased appetite Hypotension and tachycardia |
| adverse reactions Anticholinergics | Dry mouth, blurred vision, constipation, and urinary retention |
| Warning Labels for Anti-Parkinson Disease Drugs | May cause dizziness; may impair ability to drive; limit alcohol Do not discontinue Avoid vitamins and iron supplements within 2 hours of dose— levodopa/carbidopa don’t crush or chew (sustained release) Take with food May discolor urine |
| Huntington Disease | Is a hereditary disorder Is a progressive and degenerative disease of neurons that affects muscle movement, cognitive functions, and emotions Is associated with defects in the basal ganglia Produces excessive, abnormal muscle movement |
| Symptoms of Huntington Disease | Tremors sudden abnormal movements Repetitive movements Speech impairments Difficulty swallowing Facial grimaces Choreiform movements (unpredictable, irregular, jerking) Cognitive impairment and mood changes |
| what causes Huntington Disease | Deficient levels of ACh and GABA l The balance between GABA, ACh, and dopamine is upset, producing the excessive muscle movement |
| tetrabenazine/ Haloperidol | Decrease excessive dopaminergic activity Drugs Used to Treat Huntington Disease tetrabenazine depletes dopamine haloperidol blocks dopamine |
| Adverse Reactions of Anti–Huntington Disease Drugs | Sedation Hypotension Dizziness ⬤ Drugs that deplete dopamine stores Depression ⬤ Drugs that block dopamine receptors Confusion Weight gain, increased appetite Blurred vision, dry mouth, urinary retention |
| Warning Labels for Anti–Huntington Disease Drugs | May cause drowsiness; may impair ability to drive; limit alcohol ⬤ Do not discontinue ⬤ Dilute oral concentrate before administration—haloperidol ⬤ Maintain adequate hydration—haloperidol ⬤ Avoid prolonged exposure to sunlight—haloperidol |
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