Parkinson’s Pharmacology for Naturopaths

Drugs used to treat Parkinson’s disorder. Most drugs aim to raise dopamine in the brain.

Hi i’m kiana and this is a video on anti-parkinsonism drugs so before we start it’s important to know that parkinson’s symptoms are always due to low dopamine so treatment strategies usually are centered around raising the dopamine in the patient’s brain usually their acetylcholine is too high and the dopamine is low because of this so patients are losing

Dopaminergic neurons in the substantia which is a part of the brain and because of this acetylcholine can’t be inhibited and it builds up so patients with parkinsonism will present these symptoms get the arc capitalist two there rigidity ataxia a flat expression and tremor they’ll also sometimes have like a pill rolling motion in their hands and their gait

Is more of like a shuffling type of gait so before we go into the drugs let’s go through this image a little bit this image is from your notes the powerpoint notes it’s a great image i would highly recommend copying it it’s great so this purple is outside the blood-brain barrier and i want to point out that l-dopa is actually a dopamine analog and that’s the

Drug that’s most commonly used in parkinson’s because it increases dopamine it’s basically literally dopamine l-dopa this enzyme dopa decarboxylase is what breaks down dopamine and will decrease the amount of dopamine in a normal person when we use this drug carbidopa we’re going to inhibit the enzyme dopamine decarboxylase and when we do that we’ll have more

Dopamine to go into the brain because dopamine usually has a hard time crossing the blood-brain barrier but the more that we have the more can get across the blood-brain barrier in these patients and those concepts are really important to know for these drugs all right let’s get to it so levodopa and that is your l-dopa it creates more l-dopa for the brain and

Usually dopamine has a low bioavailability so not much can cross the brain by putting more dopamine there hopefully we’re going to get more into the brain of these parkinson’s patients so if you use this drug in combination with mao or comt inhibitors less drugs should be used and remember these are responsible for the breakdown of norepinephrine and kind of like

Recycling neurotransmitters so you’re not going to break down the dopamine as well if you’re inhibiting kind of like that the recycling system for all those neurotransmitters you have to use less drug if you’re inhibiting what breaks them down carbidopa so this is what inhibits the decarboxylase enzyme i believe it’s decarboxylase yes it is decarboxylase and this

Allows dopamine to not be broken down so more dopamine is staying whole and can go to the brain so when we use levodopa plus carbidopa the levodopa won’t get broken down and more can go into the brain for the patient and that’s what we’re trying to do so in combination with levodopa lower doses of both drugs can be used because that dopamine staying whole it’s

Not being broken down from the levodopa the carbidopa is kind of protecting it from the enzyme dopa decarboxylase primoprexal is a dopamine agonist and it can be used alongside levodopa if the parkinsonism is really severe bromocriptine um you won’t really see it used as much in parkinsonism but it’s a dopamine two agonist it can also cause inflammation in the

Extremities and that’s from being an ergot alkaloid and i think you’ll learn that a little bit later or you may have already learned that but just know it can cause swelling in the arms and legs bromocriptine amantidine so it’s a weak antagonist so it’s blocking the glutamate receptor and again this is hardly used in parkinson’s disease the two drugs you should

Really really know for parkinson’s levodopa and carbidopa focus on those and ethosamine shouldn’t really be here we talked about in the last video okay so here’s a review question for you what drug can increase dopamine level in the brain without actually altering dopamine amount so this is kind of a tricky question the answer i’m looking for here is going

To be carbidopa and again if we look at this image if we inhibit dopa decarboxylase we’re going to have more dopamine and that’s what this drug is doing more dopamine is available not getting broken down a drug is an analog of dopamine and the answer we’re looking for here is levodopa and what two neurotransmitters are out of balance in parkinson’s patients

The answer here is going to be acetylcholine which is high and that causes dopamine to be low remember dopaminergic neurons are lost and dopamine is low because of that and last question here what part of the brain is affected in parkinson’s the substantia good to know you’ll see that a few times in either pathology or even pharmacology you might see it and

One other good thing to know what kind of histology is seen in the brain of parkinson’s patients it’s a type of body that i’m looking for it’s a name see in the brain of parkinson’s patients all right if you guys have any questions on parkinson’s or anti-seizure drugs feel free to send me an email or reach out for help

Transcribed from video
Parkinson's Pharmacology for Naturopaths By Sonoran University of Health Sciences