Advanced Pharmacology Exam 2
Neurology Part 1
Alzheimer’s Disease (Ach Deficiency)
- Progressive degenerative disease ultimately resulting in cerebral atrophy
- Signs and Symptoms: Difficulty performing tasks, difficulty reading and writing, loss of memory and delusions, depression and ag...
advanced pharmacology exam 2 neurology part 1 alzheimer’s disease ach deficiency progressive degenerative disease ultimately resulting in cerebral atrophy signs and symptoms difficulty perfor
Written for
Advanced Pharmacology
All documents for this subject (1257)
Seller
Follow
ACADEMICAIDSTORE
Reviews received
Content preview
Advanced Pharmacology Exam 2
Neurology Part 1
Alzheimer’s Disease (Ach Deficiency)
- Progressive degenerative disease ultimately resulting in
cerebral atrophy
- Signs and Symptoms: Difficulty performing tasks, difficulty reading
and writing, loss of memory and delusions, depression and
agitation.
Medications used in the treatment of Alzheimer’s Disease:
Cholinesterase Inhibitors:
- Donepezil (Aricept) = May cause Insomnia
- Rivastigmine (Exelon) = Hepatoxicity
- Galantamine (Razadyne) = Weight Gain
o Mechanism of Action: Selectively inhibit cholinesterase [enzyme
that hydrolyzes (inactivates) Ach] in the CNS
▪ (Increase Ach concentrations in the cerebral cortex)
o May slow deterioration of cognitive function
▪ Preserves memory, learning and attention.
o Side Effects (ALL): Diarrhea, Urination, Miosis,
Bronchospasm, Emesis, Lacrimation, Salvation (SLOWLY
TITRATE)
o Drug Interactions: Anticholinergic Drugs, Donepezil is a minor
substrate of CYP 3A4
o Cholinergic Crisis S/Sxs: Salivation, Lacrimation,
Urination, Defecation, Gastric Upset, Emesis
NMDA receptor antagonist
, - Memantine (Namenda)
o Mechanism of Action: NMDA (glutamate receptor) antagonist
▪ Attenuates excitotoxic effects of
glutamate (neuroprotective)
o No CYP 450 drug interactions
o Indicated for moderate to severe disease
▪ Often used in combination with cholinesterase inhibitors
o Adverse Effects:
▪ Constipation
▪ Headache, confusion, dizziness, hallucinations
▪ Hypertension
o Available in combination with donepezil (Namzaric)
o Both formulations given via oral route
- Combination
o Donepezil + Memantine (Namzaric)
Parkinson’s Disease (Lack of Dopamine)
- Degenerative disease of the basal ganglia, resulting in gradual decline in
motor, autonomic and cognitive functioning.
- Severe loss (about 80%) of dopaminergic neurons of the substantia nigra
o Presence of Lewy Bodies (intracellular inclusions)
o Creates imbalance of acetylcholine and dopamine
- No treatment = progresses to an akinetic state (5-10 years) Mortality due
to immobility (aspiration pneumonia, clotting disorders)
- DA receptors (5 totals, grouped into D1 and 2)
o D1 – stimulate synthesis of cyclic AMP (excitatory)
2
, o D2 – Inhibit cyclic AMP synthesis, suppress CA currents, activate
K currents (inhibitory)
Medications used in the Treatment of Parkinson’s Disease:
Dopaminergic Agents:
- Levodopa
o Biosynthetic precursor of dopamine
▪ Increased the concentration of dopamine in the brain
o Metabolized in the peripheral tissue Decarboxylase and Catechol-O-
methyl transferase (COMT)
o Less than 1% of administered drug reaches the brain if given as
monotherapy (always need decarboxylase inhibitor and often
also need COMT-inhibitor)
o Adverse Effects:
▪ N/V (Antacid may help 30-60 minutes before dose)
▪ Orthostatic hypotension, sedation
▪ Depression, delirium, paranoia, delusions, hallucinations (CNS
effects associated with long-term use)
▪ Motor fluctuations (end of dose wearing off; peak-
dose dyskinesia)
o ALWAYS given in combination with Carbidopa.
Decarboxylase Inhibitor:
- Carbidopa
o Mechanism of Action: Inhibits conversion of levodopa to dopamine
in peripheral tissues
▪ Increase amount of levodopa that enters the brain
▪ Decreases GI and cardiovascular adverse effects due to
less conversion in peripheral tissue
o Wearing off phenomenon
3
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ACADEMICAIDSTORE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.49. You're not tied to anything after your purchase.
