I.WhatisParkinsonsDisease.docVIP

Chapter 18: Drugs Used to Treat Parkinson’s Disease What is Parkinson’s Disease? Characterized by a hypo-dopaminergic state loss of dopamine neurons Localized primarily in midbrain (substantia nigra, A9,) Genetic Link to Parkinson’s Disease Genetic analysis from families with PD by Duke U. shows evidence that mutations on gene 6 7 were common with late-onset PD. Also possible involvement with chromosomes 5,9,8, alpha-synuclein protein Suggests that subtypes of PD will prove important in determining better drug therapies Previously thought that undetermined environmental factors cause onset Subtypes Idiopathic (Parkinsonism) – genetic link made (20% of all cases) but not induced by an obvious stimulus Secondary – related to recreational drug use, stroke, intense trauma or other stimuli Incidence Apx. 500,000 Americans suffering from Parkinson’s today 1% of all adults over 65 only clinically diagnosed when dopamine levels are at 20% of normal Clinical Features Four primary clinical symptoms: bradykinesia – (aka on/off function) difficulty initiating or stopping movements muscle “cogwheel” rigidity – seen as motion ( lock ( motion ( lock, etc. (demonstrate) resting tremor gait disturbances – shuffling feet and disturbances in posture Many secondary afflictions (See Table 18.1 in Book) Types of Treatment Dopamine replacement therapy (drugs) dopamine agonists dopamine breakdown inhibitors, ex: COMT inhibitors Alternative therapies stem cell theory/ implants Pallidotomy Additional considerations exercise physical therapy cognitive therapy acupuncture support groups Goals of Treatment Replace dopaminergic function Reverse loss of dopamine Give patient a chance to live a normal life as possible keep patient healthy with exercise and proper diet keep patient in a positive mind frame Drug Treatment L-DOPA (levodopa) Logic states that if Parkinson’s is caused by a loss of dopamine then a drug should be used to replace that lost dopamine Dopamine itself does not cross th