Parkinson's Disease

Mechanism of Cell death

- Neurones die undergo nercosis, cell swelling , vuculosis and lysis, which are associated with Ca++ overload of cells and membrane damage.

- they are not replaced in adult CNS

- progenitor (stem) cells may occur in some parts of the brain.

Excitotoxicity
- is the pathological process by which nerve cells are damaged and killed by excessive stimulation of neurotransmitters

Glutamate activates by NMDA, AMPA and metabotropic receptors.
Motor system
Eidemiology
Dopaminergic pathways
Metabolism of dopamine
Symptoms
Other symptoms and problems

Treatment of PD

Dompaminergic drugs ( 5 classes)

1. Dopamine precursors (e.g. Levodopa)
   
2. Dopamine receptor agonists (e.g. Apomorphine)
   
3. Monoamine oxidase B inhibitors
   
4. Catechol- O- methyltransferase inhibitors
5. Amantadine

Dopamine precursors
- Levodopa
- Dopa decarboxylase inhibitors

• Benserazide
  
• Carbidopa

SF:

• Dyskinesia
  
• Motor fluctuation ( develop after 5 years onset of the disease)
  

Dopamine receptor agonists
-Pramipexole
- Apomorphine ( expensive)

Monoamine oxidase B inhibitors
-Selegilence
- Rasagilene


Catechol- O- methyltransferase inhibitors (COMT inhibitor)
- Entacapone
-Tolcapone

Amantadine

Antimuscarinic drugs


Treatment strategies