parkinsonism:

parkinsonism:

Parkinson disease :

Due to destruction of dopenergic neurons.

This loss can be visualized by positron –emission tomography anf dopamine analog flurodopa.

Parkinsonism is due to the imbalance between dopamine and acetylcholine.dopamine level decreases and acetylcholine level increases.

Parkinsonism follows low viral encephalitis or viral lesions.

Treatment :

         I.            Levodopa and carbidopa :

                       it is most preferred combination  because levodopa converts in to dopamine and                        carbidopa causes dopa decarboxylase inhibition.( which degrades levodopa if                            levodopa is taken alone).   

       II.            Selegiline and rasagiline :

                       Selegiline is selective inhibitor of MAO-B

                       Rasagiline is irreversible selective MAO-B inhibitor.

     III.            Catechol –O- methyl transferase inhibitors: (COMT)

                       Entacopone

                       Tolcapone

     IV.            Dopamine receptor agonists:

                       Bromocriptine – ergot alkalod.

                       Apomorphine, pramiperole, ropisirole, rotigotine.

                       Cimetidine

                       Amantadine : anti viral drug.

       V.            Anti – muscuranic agents: they are used as adjuants

                       Benzotropine

                      Trihexyphenidyl

                       Procyclidine

                       biperiden