04 CNS Review Alkana Flashcards Preview

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Flashcards in 04 CNS Review Alkana Deck (48):
1

What is Parkinson disease pathology?

Striatal dopamine deficiency syndrome, less than 10% brain DA in basal ganglia (normally 80%)

2

What is Parkinson disease treatment designed to do?

Restore DA/ACh balance

3

What is the DOC for Parkinson Disease?

l-Dopa (plus peripheral decarboxlase inhibitor

4

What is the peripheral COMT inhibitor used?

Tolcapone

5

What is the DA potentiator used?

Amantadine

6

What is the DA receptor agonist used?

Bromociptine

7

What is the MOA-B inhibitor used?

Eldepryl

8

Parkinson Disease is believed to reflect destruction of what?

Dopaminergic cells in the substantia nigra

9

The therapeutic effects of l-dopa in PD results from increasing brain ______ and its action on ____ receptors?

Dopamine; D2

10

The mechanism of action of Pramipexole (Mirapex) in the treatment of PD is what?

Agonist action on D2 receptors

11

Classical antipsychotic medications are believed to produce their therapeutic effects by blocking what receptors?

D2

12

Classical antipsychotic medications are believed to produce many adverse effects by blocking what receptors?

D2

13

Atypical antipsychotic medications are believed to produce their therapeutic effects by blocking what receptors?

5HT2 (the thinking has shifted now to believe that its main mechanism is blocking D2)

14

Pseudoparkinsonism side effects from Haloperidol is most likely caused because of the blockade what receptors?

D2 receptors

15

What does traditional neurochemical theory propose that Schizophrenia is caused by?

Excess limbic dopaminergic (DA) function

16

What is the significant advantage of second generation antipsychotic agents?

Less EPS (<1% tardive dyskinesias)

17

What is the significant disadvantage of second generation antipsychotic agents?

Metabolic effects (weight gain; dyslipidemia, impaired glucose-insulin homeostasis)

18

For antipsychotic treatment, what two receptor binding may induce cascades that offset adverse effects and increase therapeutic effects?

Anticholinergic and 5HT2

19

The onset of therapeutic effects of atypical antidepressants corresponds best to?

Delayed autoreceptor desensitization and increase 5HT and/or NE

20

A primary therapeutic advantage of second generation vs. first generation antidepressants is?

Reduced affinity for mACh and adrenergic receptors (these are the receptors that cause the side effects, otherwise both generations are similar in their affinity for 5HT and NE transporters)

21

What happens with DA transporter blockade?

Associated with stimulant rather than antidepressant action

22

What are the three steps in therapeutic effect for antidepressants?

First (initial (acute): blocks reuptake of NE and/or 5HT via action on transporter protein). Second (compensatory change to offset blockade (downregulation of transmitter)). Third (delayed - autoreceptor desensitization, upregulation, increase synthesis and release of transmitter)

23

The anxiolytic lorazepam is thought to reduce anxiety by acting as an agonist on _____ receptors?

GABA********** Slide 78

24

Benzodiazepines are believed to reduce the symptoms of anxiety by?

Potentiating GABAa receptors

25

The onset of therapeutic action or effect of SSRIs in treating anxiety disorders corresponds best to?

Delayed autoreceptor desensitization and increase 5HT and/or NE

26

Buspirone is believed to reduce the symptoms of anxiety by?

Agonist/partial agonist action on 5HT1A receptors

27

What are some fast onset (can be used PRN) drugs to treat anxiety?

Benzos. Beta adrenergic antagonists. Antihistamines

28

The onset of therapeutic action or effect of SSRIs in treating anxiety disorders corresponds best to?

Delayed autoreceptor desensitization and increase 5HT and/or NE

29

Alcohol is metabolized to _____, which is toxic and can cause flushing

Acetaldehyde

30

_____ is a signal of problem drinking?

Needing alcohol to cope with daily circumstances

31

Current theories suggest that alcohol cause its sedative, anxiolytic and amnesic effect by_____?

Potentiating GABAergic activity in the brain

32

Alcohol dependence is characterized by _____ when alcohol is abruptly discontinued?

CNS excitability

33

Women may be more sensitive to the acute and chronic effects of alcohol than men because women have ______ than men?

Less active gastric ADH

34

Individuals who lack _____ suffer flushing and other reactions when they drink alcohol because of the buildup of ______

AlDH; Acetaldehyde

35

Anti-Heartburn medications like Ranitidine (Zantac) and Famotidine (Pepsid) may block or reduce the flush reaction in individuals who lack ______ by blocking the formation of acetaldehyde from ethanol by _____

AlDH2 (form that works very quickly, found in mitochondria); ADH

36

Release of _____ in the brain is believed to be the final common pathway mediating the rewarding effects of alcohol and other drugs of abuse?

Dopamine

37

Current theories suggest that Naltrexone reduces ethanol stimulation and euphoria by ________?

Antagonizing the effects of ethanol mediated by endogenous opiate receptors

38

The highest risk for causing ethanol-induced brain damage in the fetus occurs with ethanol exposure during ______ of pregnancy?

The fist trimester

39

Ethanol can markedly increase the hepatotoxic effect of ______ by inducing ____ with a resultant increase in the production of a hepatotoxic metabolite

APAP; CYP 2E1

40

What are the two types of treatments for alcoholism?

Disulfiram (Antabuse), Anxiolytics (e.g. Benozs), Glutamate Receptor Modulation (Acamprosate (Campral))

41

How does Disulfiram (Antabuse) work?

Inactivates aldehyde dehydrogenase --> acetaldehyde build-up. Crutch to reduce intake. Dangerous adverse effects

42

How does Acamprosate (Campral) work?

Reduces craving. Caution in renal impaired

43

Triazolam (Halcion) is a/an ______?

Non-selective BZ receptor agonist

44

Zolpidem (Ambien) is a _______?

Selective BZ1 non-BZ receptor agonist

45

Rozerem (Ramelteon) is a ________?

MT1 and MT2 receptor agonist

46

How do BZ receptor antagonists (Flumazenil (Romazicon)) work for sleep disorders?

Blocks BZ non-selective and BZ1 selective agents

47

Marijuana may induce a neuroprotective effect by agonist action on _____ receptors which reduces ____ release

CB1; Glu

48

LSD may induce its psychoactive effects by acting as a _____ on ______ receptors

Agonist-partial agonist; 5HT2A