Drugs and Behavior Week 7 Notes: PD part two
Drugs and Behavior Week 7 Notes: PD part two 333
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This 3 page Class Notes was uploaded by Sarah Kincaid on Thursday October 13, 2016. The Class Notes belongs to 333 at 1 MDSS-SGSLM-Langley AFB Advanced Education in General Dentistry 12 Months taught by Caine in Fall 2016. Since its upload, it has received 23 views. For similar materials see Drugs and Behavior in Psychology at 1 MDSS-SGSLM-Langley AFB Advanced Education in General Dentistry 12 Months.
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Date Created: 10/13/16
Parkinson’s Disease Part Two Other meds, % loss dopamine Major (aka worst) PD symptom: akinesia Major Tx: voluntary movement Major Sx: involuntary movement Important distinctions in symptoms & side effects - Akinesia: difficulty in movement and initiation of movement - Tremors: not a major symptom, get worse when trying to move - No seizures in PD! - PD is a movement disorder of basal ganglia - Another side effect of l. dopa is weight loss Tolerance/Sensitization: decreased potency Tx (rightward shift, higher ED50), increased potency Sx (leftward shift, lower ED50) - By 7 year, l. dopa is practically useless Therapeutic window: collapses and get side effects before therapeutic effects Most common PD med: Sinemet Second most common PD med: direct dopamine D2 agonist If you could put dopamine directly into brain, where would you put it in a PD patient? - dorsal striatum How does Sinemet work? - L. dopa - Carbidopa - L. dopa, a precursor, is converted by AAD (enzyme) to dopamine - However, dopamine is quickly metabolized and would not have enough time to reach brain - Additionally, dopamine is unable to cross BBB - So, the carbidopa is an enzyme inhibitor of AAD, prevents l. dopa from being converted to dopamine - L. dopa can pass the BBB but carbidopa cannot - Thus l. dopa enters brain where it is converted to dopamine! In PD, the SN dorsal striatum pathway degenerates. This pathway controls voluntary movement. However, PD symptoms do not develop until there is only 20% of striatum dopamine left (80% gone). Where do you find the nuclei for dopamine neurons? - SN Where do you find the dopamine in dopamine neurons? - dorsal striatum Parkinson’s Disease Part Two The VTA ventral striatum pathway is the one upon which Adderall acts. Video meperidine (Demerol): opioid analgesic abused by Hollywood stars in 1980s MPPP: analog of Demerol (like oxycodone is an analog of hydrocodone); mu opioid agonist, like Vicodin, with a heroin high MPTP: toxic by-product when a batch of MPPP is rushed; induced PD MPP+: MPTP is converted into MPP+ by MAO MAO: converts MPTP to dorsal striatum destroying MPP+ MAOI: prevents MAO from converting MPTP MPP+ What are the two causes of idiopathic (of unknown cause) PD? - 99.9% of PD cases - MPP+ in pesticides on our fruits & veggies - Something in environment may decrease dopamine by 50% and then aging does the rest (increasing dopamine loss to at least 80%) – normally you lose a couple %s every couple decades Who knows what causes idiopathic PD and why don’t they tell us? (Barak’s conspiracy theory) - 3 sets of people: oil companies, Republicans, and logging industries o George Bush Sr. & Ronald Reagan tried to kill cannabis with paraquat (and also sprayed fruits and veggies) - Economy (bad since 2007) – if pyridines are banned, many companies will go under because pyridines are so widely used What are the two populations with the most risk for PD? - Agricultural (1/6 chance vs 1/40 over lifetime) - Chemists synthesizing pyridines (14x more likely) Genetic PD - Parkin gene (and possibly lark2) – causes early onset PD - Very rare, 0.10% of cases Risk factor for why you many/may not get PD at 80 - Environmental exposures (manganese, pesticides, pyridines in environment) - Certain genes have an increased/decreased risk of PD but do not cause it o Environment interacting with genes Why not have a preventative PET scan to see whether you will get PD in the future? Parkinson’s Disease Part Two - There’s nothing you can do anyway. The doctor mistakenly said that you could give MAOI to prevent MPTP’s conversion to MPP+, but that won’t work. The damage to dopamine levels is already done. PD % - 1/200 over 40 - 1/100 over 60 - 1/40 over lifetime Review 1/10 chance if things don’t change that your HS kid will have tried Rx opioid recreationally.
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