Drugs for Degenerative Diseases of the Nervous System Chapter 20

Parkinson’s Disease Progressive loss of dopamine Tremor, muscle rigidity Abnormal movement and posture Symptoms known as parkinsonism Tremors Muscle rigidity Bradykinesia Postural instability Affective flattening

Health Problems in Parkinsons’ Patients Primarily affects muscle movement Patients often experience other health issues Anxiety, depression Sleep disturbances Dementia Autonomic nervous system disturbances

Parkinson's Gait before and after L-Dopa http://www.youtube.com/watch?feature=player_detailpage&v=sf1N0Zf5IqA

http://www.youtube.com/watch?feature=player_detailpage&v=IHDFQfmkKlg

Levodopa (Larodopa) Antiparkinson Agent; Dopaminergic Agent Mechanism of action: restores dopamine within nerve terminals Primary use: to restore dopamine function or stimulate dopamine receptors within the brain

Benztropine Mesylate (Cogentin) Antiparkinson Agent; Anticholinergic Agents Mechanism of action: block acetylcholine; inhibit over activity in brain Primary use: in early stages of disease

Alzheimer’s Disease Most common degenerative disease of CNS Progressive loss of brain function Memory loss, confusion, dementia Cause unknown Possible causes Genetic defects Chronic inflammation Excess free radicals Environmental factors

Protein fragments in brain (normally broken down and excreted) Twisted protein threads inside nerve cell. Tubules that transport nutrients and other important substances from one part of the nerve cell to another Plaque start to develop first in area of brain used for memory and cognitive functioning

Alzheimer’s Disease Structural Damage in Brain: Symptoms: Consists of Amyloid plaques Neurofibrillary tangles Loss of connection between neurons Structural changes cause loss of neuron number and function Impaired memory and judgment Confusion and disorientation Inability to recognize family and friends Aggressive behavior Depression Psychoses, including paranoia and delusions Anxiety

Donepezil Hydrochloride (Aricept) Alzheimer’s Disease Agent; Acetylcholinesterase (AChE) Inhibitors Mechanism of action: to prevent breakdown of acetylcholine; enhance transmission in neurons Primary use: slow progression of the disease

Drugs for Degenerative Diseases of the Nervous System Goals Increased ease of movement Decrease in symptoms Understanding of drug regimen/disease Adherence to drug regimen Reporting of side effects