A centrally active muscarinic antagonist that has been used in the symptomatic treatment of Parkinson disease. Benztropine also inhibits the uptake of dopamine.
Parkinson Disease
A progressive, degenerative neurologic disease characterized by a tremor that is maximal
at rest, retropulsion (i.e. a tendency to fall backwards), rigidity, stooped posture,
slowness of voluntary movements, and a masklike facial expression. Pathologic features
include loss of melanin containing neurons in the substantia nigra and other pigmented
nuclei of the brainstem. Lewy bodies are present in the substantia nigra and locus
coeruleus but may also be found in a related condition
characterized by dementia in combination with varying degrees of parkinsonism.
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Lewy Body Disease
A neurodegenerative disease characterized by dementia, mild parkinsonism, and fluctuations
in attention and alertness. The neuropsychiatric manifestations tend to precede the onset
of bradykinesia, muscle rigidity, and other extrapyramidal signs. Delusions and visual
hallucinations are relatively frequent in this condition. Histologic examination reveals
Lewy bodies in the cerebral cortex and brain stem. Senile plaques and
other pathologic features characteristic of Alzheimer disease may also be present.
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Pharmacologic Action
Antiparkinson Agent
Agents used in the treatment of Parkinson's disease. The most commonly used drugs
act on the dopaminergic system
in the striatum and basal ganglia or are centrally acting muscarinic antagonists.
Muscarinic Antagonist
Drugs that bind to but do not activate muscarinic cholinergic receptors,
thereby blocking the actions of endogenous acetylcholine or exogenous agonists.
Muscarinic antagonists have widespread effects including actions on the iris and
ciliary muscle of the eye, the heart and blood vessels, secretions of the respiratory
tract, GI system, and salivary glands, GI motility, urinary bladder tone, and the
central nervous system. Antagonists that discriminate among the various muscarinic
receptor subtypes and
might allow better control of peripheral and central actions are under development.
