Central Nervous System

● It affects the brain and the spinal cord

Parkinson’s Disease
● is a neurodegenerative disorder
● It's a disease in the extrapyramidal system
● low dopamine, high acetylcholine
● Signs and Symptoms
○ Mask like or blank face expression
○ You can’t see different facial expressions on them
● They can’t move their face
○ Stooped posture
○ Having pill-rolling tremor.
● Like a person is rolling pills in their fingers at constant movement.
● Cannot think and control movements
○ Have shuffling gait
● Walking very slow and shuffling.
○ Hard to get them moving if they were laying down or sitting in a chair
○ Dyskinesias caused by levodopa
● Bothersome head bobbing symptoms

● Cause of Parkinson’s Disease

○ caused by the deaths of neurons
● These produce neurotransmitters dopamine.
○ Takes to 70 to 80 percent of lost neurons to see signs and symptoms.
○ Loss of dopamine leads to dopamine and acetylcholine imbalance.
○ The motor function relies on everything to maintain homeostasis.
● Medications
○ We have medications that'll help restore dopamine and acetylcholine balance
○ Parkinsonism drugs have 2 classes;
1. Dopaminergic
○ These medications will try to increase dopamine in the corpus
striatum of the brain;
● Dopamine Agonist
○ Won’t build tolerance
○ No disease progression
● COMT Inhibitors/Blocker
● MLB Inhibitors/Blocker
○ Will balance things out and reduce signs and symptoms
○ Used more commonly than Anti-cholinergic
2. Anti-cholinergic
○ Given to patients for last resort
○ Blocks the effect of acetylcholine in the brain
 ○ Help in decreasing symptoms
○ Not effective as levodopa
○ Triggers sympathetic response
● Increase heart rate
● Increased blood pressure
● Constipation
● Urine retention
● Decreased salivation
○ Anti-Parkinsoism agents.
○ Pharmacotherapy won’t cure but it can reduce the problem
● To help them have a better quality of life
● Perform daily activities with minimal or without assistance
○ Patients prescribed levodopa or a combination
● 2nd medication will be added if the1st medication doesn’t help
● 3rd medication might be added if the two medications don’t work
● Carbidopa is used with levodopa
○ Individualized treatment for patients
● Patients are in close contact with doctors
● Monitor symptoms
● Make sure that the medications are reducing symptoms
○ Levodopa
● Effective drug for Parkinson’s
● Nasal spray
● Can take as needed
● Adverse effects or side effects;
○ Increased dopamine levels in brains
○ Dyskinesias
○ Postural Hypotension
○ Psychosis
● 20%of patients ended up having hallucinations
○ Darkening of sweat
● Wearing light-colored clothing isn’t advisable
○ On-Off Phenomenon
● where medication suddenly stop working
○ Amantadine
● Given if the patient experienced adverse effects from other medication
● Used to treat Dyskinesias
○ High protein foods reduce the levodopa, thus reducing the dopamine.
○ Medications work directly on the dopamine receptors
○ It is to increase the dopamine