Pharmacologic Management ofParkinsonismand Other Movement DisordersThe Movement disorders include(1) Tremor(2) Parkinson's disease(4) Chorea(3)Huntington'sdisease(5) Ballismus(6)Athetosis and Dystonia(7) Tics(8)Dyskinesias(9)Wilson'sDisease
Pharmacologic Management of Parkinsonism and Other Movement Disorders The Movement disorders include (1) Tremor (2) Parkinson’s disease (3) Huntington’s disease (4) Chorea (5) Ballismus (6) Athetosis and Dystonia (7) Tics (8)Dyskinesias (9)Wilson’s Disease
PARKINSONISM(ParalysisAgitansThe most prominent features of parkinsonismare tremor,rigidity, bradykinesia, and posturalinstability
PARKINSONISM (Paralysis Agitans) The most prominent features of parkinsonism are tremor,rigidity, bradykinesia, and postural instability
Etiology: the loss of striatal dopamine produces an imbalangeAchDAInhibitoryExcitatoryNormalneurotransmitterneurotransmitter(balance)DAParkinsonismAchInhibitory(imbalance)neurotransmitterExcitatoryneurotransmitter
Etiology: the loss of striatal dopamine produces an imbalance Normal (balance) Parkinsonism (imbalance) Inhibitory neurotransmitter DA Ach Excitatory neurotransmitter Inhibitory neurotransmitter Excitatory neurotransmitter Ach DA
Therapy of ParkinsonismSince there is no cure for parkinsonism, the aim ofpharmacological therapy is to relieve symptomaticThese drugs includea:Increases brain dopamine levelslevodopab:Dopamine agonistsdirectly stimulate DA receptors
Therapy of Parkinsonism Since there is no cure for parkinsonism, the aim of pharmacological therapy is to relieve symptomatic These drugs include a:Increases brain dopamine levels levodopa b:Dopamine agonists directly stimulate DA receptors
c: Monoamine oxidase (MAO) inhibitorsprevent dopaminemetabolismrasagilined: Anticholinergic agentswhich reduce the excitatory activity within thestriatumPergolide andPramipexolee: catechol-O-methyl transferase (COMT) inhibitorsprevent dopamine metabolismtolcapone and entacapone
c: Monoamine oxidase (MAO) inhibitors prevent dopamine metabolism rasagiline d: Anticholinergic agents which reduce the excitatory activity within the striatum Pergolide and Pramipexole e: catechol-O-methyl transferase (COMT) inhibitors prevent dopamine metabolism tolcapone and entacapone