2. Parkinson's disease is
a degenerative disorder of
the central nervous system.
The motor symptoms of
Parkinson's disease result from the
death of dopamine-generating
cells in the substantia nigra, a
region of the midbrain.A defect in
dopamine pathway.
In Parkinson’s disease, dopamine
deficiency occurs in basal ganglia.
Major pathologic process- neuronal
degeneration of pigmented
substantia nigra compacta (SNpc) a
region of basal ganglia that
produces dopamine, intrinsically
involved in motor control.
3.
4.
5. Imbalance primarily between
the excitatory neurotransmitter :Acetylcholine and
the inhibitory neurotransmitter :Dopamine
in the Basal Ganglia
Reduction of dopamine
in corpus striatum
affects the balance
between 2
neurotransmitters-
12. Dopamine is a simple organic chemical in the catecholamine family which works as a neurotransmitter
DOPAC is a metabolite of the neurotransmitter dopamine which means that dopamine gets broken down into DOPAC.
AADC :Aromatic L-
amino decarboxylase
COMT :Catechol-O-
methyltransferase
MAO B :Monoamine
oxidase B
DOPAC :3, 4-
dihydroxyphenylaceti
c acid
One mechanism is
believed to be related to
its MAO-B inhibitory
activity, which causes an
increase in extracellular
levels of dopamine in the
striatum.
13. MAO-B is responsible for the
breakdown of dopamine
after its re-uptake from the
synapse
DA is taken up by D1 and D2
receptors and synapses takes
place
14. Rasagiline shows neuroprotective properties by
suppressing mitochondrial apoptosis ,
increasing the expression of
down-regulating the
B-cell
lymphoma 2
B-cell
lymphoma-
extra large
Bcl-2-
associated
death
promoter
Bcl-2-
associated X
protein
(Bax).
anti-
apoptotic
proteins
pro-
apoptotic
16. Absorption
Rasagiline is rapidly absorbed following
oral administration.
The absolute bioavailability of rasagiline is
about 36%.
Rasagiline readily crosses the blood-brain
barrier.
17. Distribution
Volume of distribution-87 L
Rasagiline is
88-94% bound to plasma proteins,
61-63% bound to human albumin over the
concentration range of 1-100 ng/ml.
18. Metabolism
The metabolism of rasagiline proceeds through two main pathways:
N-dealkylation
hydroxylation to yield 1-aminoindan (AI), 3-hydroxy-N-propargyl-1
aminoindan (3-OH-PAI) and 3-hydroxy-1-aminoindan (3-OH-AI).
Rasagiline CYP1A2
Hepatic
Metabolism
1-aminoindan
19. Elimination
Rasagiline undergoes almost
complete biotransformation in the
liver prior to excretion.
Glucuronide conjugation of
rasagiline and its metabolites, with
subsequent urinary excretion, is the
major elimination pathway.
primarily - urine
secondarily – feces
Half life of 3 hours
21. DOSING:
Monotherapy :The recommended dose of
rasagiline is 1 mg once daily when used alone
Adjunct therapy :When combined with levodopa
the recommended starting dose is 0.5 mg once
daily.
22. Toxicity
drowsiness, dizziness, faintness, irritability,
hyperactivity,
agitation, severe headache, hallucinations,
coma;
rapid and irregular pulse,
hypertension, hypotension
respiratory depression and failure,
hyperpyrexia,
diaphoresis,
and cool, clammy skin.
23. Precautions
It should not be used by patients with moderate or
severe liver disease.
Rasagiline should not be administered
with antidepressants that increase serotonin levels -
serotonin syndrome.
Rasagiline should be discontinued at least 14 days
before initiating treatment with antidepressants that
increase serotonin levels.
24. Recent developments
Rasagiline is being investigated for
the treatment of Restless Legs Syndrome
the treatment of Alzheimer's disease
Because of its melanin binding properties, rasagiline was
investigated and found to decrease melanoma growth; it
may be candidate for combination therapy for
melanoma.
25. REFERENCE
www.webmd.com
http://journal.frontiersin.org/article/10.3389/fneur.2011.00068/full
www.ncbi.nlm.nih.gov/pubmed
Pharmacology of Rasagiline, a New MAO-B Inhibitor Drug for the Treatment of
Parkinson’s Disease with Neuroprotective Potential , John P.M. Finberg, Ph.D.*,
RMMJ|www.rmmj.org.il June 2010, Volume 1, Issue 1, e0003
The role of rasagiline in the treatment of Parkinson’s disease, Clinical Intervention in
Aging, 8 May 2010.
MAO-inhibitors in Parkinson’s Disease, Peter Riederer1* and Gerd Laux2,
Experimental Neurobiology , doi:10.5607/en.2011.20.1.1, Vol. 20, pages 1∼17, March
2011
Rasagiline – a novel MAO B inhibitor in Parkinson’s disease therapy, Shimon Lecht et.
Al, Therapeutics and Clinical Risk Management 2007:3(3) 467–474
The neuroprotective mechanism of 1-R-aminoindan, the major metabolite of the anti-
parkinsonian drug rasagiline, O.Bar-Am et al. ,journal of neurochemistry, Journal
Compilation 2010 International Society for Neurochemistry, J. Neurochem. (2010)
112, 1131–1137