In: Anatomy and Physiology
Parkinson’s disease is a motor disorder that generally affects people in their later years
a) Why do the motor symptoms occur?
b) Discuss the treatments for Parkinson’s disease
For each treatment, explain the pharmacological mechanism of action, and
Explain what this is doing to the body’s dopaminergic system.
A) Parkinsons is a degenerative and progessive disorder in which the damage of nerve cells happens in the basal ganglia and substantia nigra of brain.
It disrups the balance of dopamine which producing neurons in the substantia nigra in the midbrain and acetylcholine in the basal ganglia.
Dopamine is neurotransmiter which is reposible of extra pyramidal motor system such as posture control, support and voluntary movements or actions. Therefore, as dopamine is affected the motor related symptoms occurs in Parkinson's disease.
B) Treatments for Parkinson's disease.
Physiotherapy is one of treatment for relieving the symptoms. Pharmacologically antiparkinsonian pharmaco therapy is given. The main objective of pharmacotherapy iscto restore and balance the dopaminergic/cholinergic neurotransmiters with two mechanisms.
1. Enhancing the dopaminergic activity - By which neuronal cella replinish with dopamine and balance the activity.
2. Reducing the cholinergic activity - It is possible with the help of antimuscarine drugs which helps in the rediction of tremors and rigidity.
Pharmacological effects
Levapoda - Is a precursor of dopamine. As the dopamine doent cross the blood brain barrier, levapoda is given to the Parkinson's patients. Levapoda decarboxylates and peoduce dopamine in the gastro intestinal tract. The peripheral decarcarboxylase is metabolised in liver and excretes through urine. It shows effects on motor defects in Parkinson's patients inorder to improve. Effects on bradykinesia, rigidity and tremors.
Carbidopa - It is a inhibitor of dopa decarboxylase. The peripheral decarboxylase which is formed due to levadopa is reduced with the effect of carbidopa. Helps in reducing the toxicity or sideeffects of levapoda. Usually used along with levapoda.
Bromocriptine, pergolide and cargoline are derivatives of ergot shows effects on dopamine. Pramipexol and Ropinirole shows effects on monotherapy in Parkinson's patients, it helps in smoothening the proces of levapoda. Rotigotine ( FDA approved) given throght skin. Helps in continious stimulation of dopamine than oral medications.
Other therapies like using MAO inhibitors, antidyskinetic drugs, trophic drugs, neuroprotective drugs and surgery for deep brain stimulation.