Parkisons disease & anti parkisons disease

2.  First described by James parkinson in 1817 as
paralysis agitans, the ‘’shakig palsy’’.
 Parkinson’s disease is a chronic
neurodegenerative disease associated with
substantial morbidity increased mortality and
high economic burden .
 Incidence of parkinson’s increases with age
but an estimated four percent of people with
PD are diagnosed before the age of 50yr.

3.  Primary motor symptoms.
 Secondary motor symptoms.
 Non motor symptoms.

4.  Resting tremor:A shaking of the hands arms
or legs.
 Bradykinesia:slowness of movement .
 Rigidity:Increase in tone.
 Postural instability (balance problems).
 Impaired balance or difficaltly standing or
walking.

5.  Painful muscle cramps (Dystonia).
 Impaired fine motor dexterity and motor
coordination.
 Impaired gross motor coordination.
 Reduced movement (decreased arm swing).
 Sexual dysfunction.

6.  Loss of sense of smell ,constipation.
 Sleep disorder, mood disorders.

8.  Its likely involves the interaction of host
susceptibility and environmental factors.
 A Small percentage of cases are gentically
linked and genetic factors are being
intensely studied.
 Role of dopamine: Dopamine ,like other
neurotransmitters transmits chemical
messages from one nerve cell to another
across the synapse ,a space between the
presynaptic cell and the postsynaptic
receptors.

9.  Dopamine is secreted into the synapse, from
membrane storage vesicles in the presynaptic
membrane.
 It crosses the synapse and binds to the
postsynaptic membrane ,where it activates
dopamine receptors.
 It can be broken down and rendered inactive by
two enzymes ,MAO(monoamine oxidase) and
COMT(catechol –O-methyl transferase). One
therapeutic strategy introduces a MAO inhibitor
into the synapse, which interrupts the action of
the MAO enzyme and prevents the breakdown of
dopamine .this allows more dopamine to remain
in the synapse and increases the likelihood that
it will bind to postsynaptic membrane.

12.  Drugs affecting brain dopaminergic system.
(a) Dopamine precursor: Levodapa
(b) Peripheral decarboxylase inhibitors:
Carbidopa,Benserazide
(c) Dopaminergic agonists: Bromocriptine
(d) MAO-B inhibitor: Selegiline , Rasagiline
(e) COMT inhibitor: Entacapone , Tolcapone
(f) Glutamate (NMDA
receptor)antagonist:Amantidine

13.  Drugs affecting brain cholinergic system.
(a)Central anticholinergics: Biperiden
,Procyclidine
(b)Antihistamine: Promethazine ,Orphenadrine