PARKINSONS

Competes with other AAs to cross BBB

                Require uptake and release from neurones – so require some remaining functioning S.nigra

If given orally L-Dopa is converted to catechloamines and can induce nausea/hypotension. Eventually – dyskinesias and dytonias – timing of induction is key

Parkinsons

Peripheral dopa-decarboxylase inhibitors (reduces peripheral LDOPA SE)

PARKINSONS

Useful to increase the bioavailability of L-dopa – prolong and potentiate the dose of L-Dopa

May allow a reduction in the dose of L-DOPA, prolonging it’s useful life span in a given patient  

PARKINSONS

Dopamine agonists – useful as L-Dopa sparing therapy to prolong instigation of L-Dopa

PARKINSONS

Dopamine agonists – useful as L-Dopa sparing therapy to prolong instigation of L-Dopa. Don’t undergo peripheral conversion and don’t need functioning s.nigra neurones

PARKINSONS

Given to increase available dopamine (requires endgogenous dopamine production, so only useful in early PD)

Anticholinergics

Balance of Ach and dopamine in S.nigra

                These attempt to redress this balance