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Copy of Copy of Digital Scrapbook by Drew Banks

Use this fun digital scrapbook template from Prezi to capture and share your life events.
by

Miky Moheb

on 2 March 2014

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Transcript of Copy of Copy of Digital Scrapbook by Drew Banks

Anti-microbial Honey
1- Sinemet
- Very short half-life
- Not active orally
- Precursor of dopamine ,, levodopa
- Levodopa is extensively metabolized peripherally to dopamine by dopa decarboxylase
- Co-adminstration of carbidopa or benserazide -a pripheral dopa decarboxylase inhibitor- will decrease this metabolism , permitting smaller doses of levodopa to be given
"
"
Honey has a long medicinal history.
In lab.
, honey has been shown to inhibit
the growth of food-borne pathogens such
as
E. coli
and
salmonella
, and to fight
Staphylococcus aureus
and
Pseudomonas aeruginosa
,
which are common in hospitals and doctors' offices.
But whether it does the same
in people
hasn't been proven.
**Nausea and vomiting caused by sinemet**
- Levodopa is peripherally metabolised to dopamine
- High peripheral levels of dopamine cause nausea and vomiting.
-Levodopa also causes nausea and vomiting due to irritation of the gastrointestinal tract.
**Treatment of nausea and vomiting**
1- Metoclopramide is a centrally acting dopamine antagonist
- Side effect of Metoclopramide causing deterioration in parkinsonian symptoms
- An oculogyric crisis {OGC } rotating of eyeballs
is an extreme form of extrapyramidal adverse effect.


2-Domperidone is a dopamine antagonist

- Advantage: not pass the blood–brain barrier
- Side effect: unacceptable cardiovascular AE
- Availability: oral and rectal

3- 5HT3 antagonists (e.g. ondansetron)

- Advantage: useful and efficacious, does not adversely affect parkinsonian symptoms as they do not affect dopamine
- Disadvantage: expensive
- Availability: orally and injection

4-Anticholinergics (e.g. cyclizine and cinnarizine)

- Advantage: useful and efficacious
- Side effect:drowsiness, anticholinergic symptoms
- Availability: i.v.
**Reducing the dosage interval rather
than increasing the
dosage**

Achieving adequate dopamine levels
+
Avoiding excessive fluctuation in those levels
=
Produces better control of symptoms.

** Frequent dosing is preferred to long
**On/Off syndrome**
- Levodopa motor complications, including large fluctuations in response and dyskinesias.
- This is known as the on/off syndrome.
- During the ‘on’ period normal function occurs
but there is weakness and restricted mobility during the ‘off’ period.
- The main risk factors for the on/off syndrome :
after six months and the fact that the Parkinson’s disease is treated.
2-Dopamine agonists
- Include bromocriptine, cabergoline, apomorphine
- Action: not converted into dopamine, but have a direct effect on dopamine receptors in the brain.
- Side effect: involuntary movements &hallucinations or sleepiness.
3- Apomorphine
- Action: a potent dopamine agonist, advanced Parkinson’s disease for patients with severe unpredictable ‘off’ periods
- Available as a subcutaneous injection or infusion
4-Monoamine-oxidase B inhibitors
- Such as selegiline and rasagiline
- Used: in the management of early disease
-Both drugs can be used in conjunction
with levodopa preparations to reduce end-of-dose deterioration in advanced disease.
*Entacapone and tolcapone
-Tolcapone :hepatotoxicity.
*Amantadine : antiparkinsonian
-It improves mildbradykinetic symptoms as well as tremor and rigidity. Tolerance occurs
*Anticholinerigics such as orphenadrine, procyclidine and trihexyphenidyl
(benzhexol), block the effect of acetylcholine,
Full transcript