Parkinsonism

DR.UMA KADAM M.B.B.S. MD ASSOCIATE PROFESSOR PHARMACOLOGY SKNMC

ANTI-PARKNSONIAN DRUGS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],Dopamine Acetylcholine

GABA DOPAMINE ACETYLCHOLINE PARKINSONISM + -

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DRUGS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Pathophysiology of Parkinson’s Disease Increased production of free radicals (reactive oxygen species) and deficiency of antioxidant mechanisms O 2 O 2 H 2 O 2 OH • - 2H 2 O Hydroxyl radical Hydrogen peroxide Superoxide radical +e - +e - + OH - 2H + +e - +e - ,[object Object],[object Object],[object Object],[object Object]

Evidence for Free Radical Hypothesis ,[object Object],[object Object],[object Object],[object Object],[object Object]

↓ GSH Mitochondrial Damage ↑ H 2 O 2 FREE RADICALS Cell Death Mitochondrial Damage Excitotoxicity ↑ Cytosolic Ca 2+ Ca 2+ activated Degradative enzymes DA Fe 2+ ↑ Free radical Production (?PD) ↓ Free radical Defenses (?ALS)

"On/off" Effect: ,[object Object],[object Object],[object Object]

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DRUG INTERACTIONS WITH L DOPA: ,[object Object],[object Object],[object Object],[object Object]

DRUG INTERACTIONS CONT…… ,[object Object],[object Object],[object Object]

DRUG INTERACTIONS CONT……. ,[object Object]

On the Horizon ,[object Object],[object Object],[object Object]

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Parkinsonism

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Parkinsonism