Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 8 Week 1 Colt > Drug Action in the CNS - Craviso > Flashcards

Drug Action in the CNS - Craviso Flashcards

1
Q

Tight junctions in the BBB exist between (astrocytes/endothelial cells)

A

endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What types of things pass through channels in the BBB?

A

small ions and water

Na, K and Cl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What things travel via membrane transport (aka passive diffusion) through the BBB?

A
  1. Small lipophilic molecules (O2 and CO2)
  2. Anesthetics, barbiturates
  3. ethanol
  4. nicotine
  5. caffeine
    (all the things that make you feel good)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What things travel via carrier mediated transport (aka solute carriers) through the BBB?

A

Metabolism products

  1. energy transport systems
    a. (Glucosde via. GLUT-1)
    b. monocarboxylates, lactate, pyruvate (MCT1)
    c. creatine (CrT)
  2. amino acid transport systems
    a. large neutral amino acids (LAT1)
  3. organic cation/anion transporters, aka nucleosides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What things travel via receptor mediated transport through the BBB?

A 
HORMONES HAVE RECEPTORS
insulin
transferrin
leptin
IgG
TNFa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what things travel via adsorption-mediated transcytosis sytems?

A

histone and albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What things are ACTIVELY EFFLUXED from the brain via the BBB?

A

P-glycoprotein
BRCP
MRP 1,2,4,5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the role of P-glycoprotein? (P-gp)

A

membrane transporter that modulates drug distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What types of cells express high levels of Pgp?

A

capillary endothelial cells of the BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which drugs are substrates for Pgp?

A 
chemo agents (vinca alkaloids, doxorubicin), abx like rifampin
anti-epileptics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does high levels of Pgp expression effect drug transmission to the brain?

A

low levels of drug in the brain

it is a hypothesis for refractory epilepsy and multidrug resistance in general

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

membrane transport of drugs via passive diffusion relies on (blank) solubility

A

lipid solubility

the greater the lipid solubility, the faster the penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which two compounds have higher than expected concentration in the brain for their lipid solubility?

A

glucose

L-DOPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which two compounds have lower than expected concentration in the brain for their lipid solubility?

A

phenobarbitol and phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the areas of the brain where the bbb is more permeable?

A 
P-CAMP
AREA POSTREMA
Median eminence
Pituitary gland
Pineal gland
Choroid plexus capillaries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F: viral and fungal infections can increase bbb permeability

A

false; viral and bacterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the best route of drug admin for global delivery?

A

vascular route

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: each neuron has it s own capillary

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Drugs that influence behavior and improve the functional status of patients with neurological or psychiatric diseases act by (blanking or blanking) neural excitability, usually by targeting specific transmitter systems.

A

enhancing or blunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

drugs that effect synthesis, storage, release, reuptake and/or degradation of neurotransmitters; agonist or antagonist activity at nerve terminal autoreceptors
are (pre/post) synaptic modifiers

A

presynaptic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

drugs that are receptor agonist, antagonist or modulatory activity; degradation of neurotransmitters are (pre/post) synaptic modulators

A

post-synaptic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F: drugs may have direct effects on voltage gated ion channels

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

T/F: drugs may have non-specific effects on membranes overall

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the chemoreceptor trigger zone for vomiting?

A

area postrema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What four chemicals does the area postrema sense that induces vomiting?

A

5-HT3
D2
M1
NK1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

can antiemetic drugs be used for post operative and radiation induced emesis?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How do 5-HT3 receptor antagonsists work?

A

serotonin reeptors are Na channels, peripherally block intestinal vagal afferents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the common 5-HT3 receptor antagonist

A 
ZOFRAN
KYTRIL
Anzemet
Lotronex
Aloxi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the only NK1 receptor antagonist

A

Emend, can give oral or IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Do corticosteroids act directly on neurotransmitters?

A

nope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which corticosteroids are used to treat nausea?

A

dexamethasone

methylprednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Substituted benzamides are what class of antagonists?

A

d2 receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what effect to D2 receptor antagonists have on GI motility?

A

increase GI motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

T/F: d2 receptor antagonists may be used alone in anti emetic therapy

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What drug class do you use to treat unproductive N/V?

A 
D2 receptors antagonists
(phenothiazines)
Phenergan
Compazine
H1 antagonists
Doxylamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the common d2 receptor antagonists?

A

Reglan (oral, IV, IM)

Tigan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the side effects of D2 receptor antagonists (think of what they act on!

A

restlessness, fatigue, headache, insomnia, confusion, dystonias and tardive dyskinesia (

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

when are oral cannabinoids approved for use?

A

when the pt. doesn’t respond to other drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

oral cannabinoids can be used in conjunction with other drugs for (blank) emesis

A

refractory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the common cannabinoid drugs?

A

marinol

cesamet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the side effects of cannabinoids?

A

euphoria, dysphoria, hallucinations; abuse potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

T/F: smoking marijuana can decrease emesis

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the MOA of H1 receptor antagonists?

A

blocks mAChR

44
Q

What is a delayed release drug used in the N/V in pregnancy?

A

doxylamine

45
Q

what are the SE of the H1 antagonists?

A

sedation and anti-muscarinic effects

46
Q

What class of drugs should you use for motion sickness?

A

short term immediate relief
H1 receptor antagoinists
Dramamine (oral IV)
Antivert for vertigo

long term control:
mACh antagonists
Scopolamine–skin patch placed behind the ear

47
Q

What are the three strategies in antiseizure therapy?

A
  1. Enhance GABAergic neurotransmission
  2. Attenuate glutaminergic neurotransmission
  3. Modify ion conductance through channels
48
Q

What are the four methods of enhancing GABAergic transmission?

A
  1. enhance synth
  2. block degradation
  3. block reuptake
  4. enhance post-synaptic GABAa receptor activity
49
Q

Tiagabine has a (pos/neg) effect on GABA transporter activity

A

negative

50
Q

Vigabatrin has a (pos/neg) effect on GABA-T enzyme

A

negative

51
Q

Benzos and phenobarbitol have a (pos/neg) effect on GABA-a receptors

A

positive

52
Q

T/F: Vigabatrin works on presynaptic cells and glial cells

A

true

53
Q

Do benzos and phenobarbitol work on pre or post synaptic cells?

A

post

54
Q

Modification of GABA transporters happens on which two cells?

A

presynaptic and glial cells

55
Q

how does inhibition of voltage gated Na channels work in antiseizure therapy?

A

blockage prevents depol which prevents vesicular release of glutamate

56
Q

Gabapentin and Pregabaline block the A2d subunit of the L-type (Na/Ca) channel

A

Ca

57
Q

Levetircetam blocks what step in glutaminergic transmission?

A

SV2A enzyme storing glutamate in the vesicles

58
Q

Felbamate blocks the (NMDA/AMPA) receptor on the post synaptic neuron

A

NMDA

59
Q

Topiramate blocks the (NMDA/AMPA) receptor on the post synaptic neuron

A

AMPA/kainate

60
Q

phenytoin and carbamazepine block type 1 voltage gated Na channels on the (pre/post) synaptic neuron

A

presynaptic

61
Q

lamotrigine blocks type (1/2) voltage gated Na channels on the pre synaptic neuron

A

type 2

62
Q

retigabine blocks all (Na/K) channels on the presynaptic neuron

A

K chanels

63
Q

Ethosuximide and valproate block the type 2 Na channels on the (pre/post) synaptic neurone

A

post

64
Q

Alzheimers is caused by a loss of ACh neurons in what two areas of the brain?

A

pyramidal neurons of the hippocampus and cholinergic neurons of the basal forebrain

65
Q

Donepezil is used to treat alzheimer’s by increasing ACh levels via….

A

reversible AChase inhibitor

66
Q

Memantine is a low affinity open channel blocker of (AMPA/kainate) receptors that selectively inhibits the pathological activation of the receptor in Alzheimer’s

A

ampa

67
Q

Parkinson’s is caused by a loss of dopaminergic neurons in what area of the brain?

A

substania nigra

68
Q

parkinson’s leads to a shortage of D neurons in the (intra/extra)pyramidal circuit

A

extrapyramidal

69
Q

What is the main MOA of parkinson’s Tx?

A

increase Dopaminergic neruons via L-DOPA and DM agonists

70
Q

huntington’s is due to a mutation in what protein?

A

htt

71
Q

Chorea is characteristic of (HD/PD)

A

PD

72
Q

chorea is caused by an imbalance in dopamine signaling as well as what other transmitter?

A

gaba

73
Q

Tetrabenazine is used to treat HD by depleting dopamine via selectively and reversibly inhibiting which enzyme?

A

VMAT2

74
Q

T/F: D2 receptor antagonists control movement as well as psychosis associated with HD

A

true

75
Q

ALS is caused by a degeneration of which three nerve tracts?

A
  1. spinal
  2. bulbar
  3. cortical
    ^^motor neurons
76
Q

Muscle weakness, muscle atrophy, fasciculations,spasticity, dysarthria, dysphagia and respiratory compromise are characteristic of which degenerative dz?

A

ALS

77
Q

Treatment of ALS involves inhibiting (glutamate/glycine) release

A

glutamate

78
Q

Tx of ALS involves of (NMDA/kainate/both) type glutamate receptors

A

true

79
Q

T/F: Tx of ALS involves blocking VGCCs

A

false; voltage gated Na channels

80
Q

Riluzole is a drug used to treat ALS by blocking voltage gated (blank) channels

A

Na

81
Q

Baclofen is a drug used to treat spasticitiy in ALS by targeting the GABA-(a/b) receptor

A

B

82
Q

Tizanindine is an (a1/a2)-adrenergic receptor agonist used in ALS treatment

A

a2

83
Q

What are the two ways that toelrance to CNS drugs is developed?

A

pharmocokinetic aka altered metabolism

physiologic aka long term alterations

84
Q

Describe the physiologic changes that result in CNS drug tolerance?

A

up or down regulation of receptors

changes at other synapses for other neurotransmitters

85
Q

T/F: tolerance to one drug will produce tolerance to other drugs within the same class

A

true aka cross tolerance

86
Q

drug use pimarily to receive rewarding effects is what type of SUD?

A

psychologic

87
Q

drug use primarily to avoid withdrawal symptoms is what type of SUD?

A

physiologic

88
Q

What is cross-dependence?

A

drugs within the same class support individuals physically dependent on other drugs in the same class; useful during detox

89
Q

drugs of high abuse are schedule what?

A

shedule 1

90
Q

what are the prescribing restrictions on sched. 2 drugs?

A

no telephone Rx, no refills

91
Q

What are the restrtictions on sched. 3 drugs?

A

Rx must be rewritten after six months or five refills

92
Q

What are the restrictions on sched. 4 drugs?

A

must be rewritten after six months or five refills, but diff. penalties for illegal possession

93
Q

T/F: sched. 5 drugs are available OTC

A

true

94
Q

T/F: schedule 1 drugs can be used for medical treatment

A

yes, only GHB for narcolepsy and marijuana in some states

95
Q

ACE inhibitors can show what types of psychiatric symptoms?

A

mania, anxiety, hallucinations, depression, psychosis

96
Q

Acetazolamides can show what types of psychiatric symptoms?

A

depression, delirium, confusion, stupor (elderly are very prone)

97
Q

Clarithromycin can show what types of psychiatric symptoms?

A

mania

98
Q

Digoxin can show what types of psychiatric symptoms?

A

delirium, depression, psychosis, visual hallucinations (elderly at high risk)

99
Q

Mefloquine can show what types of psychiatric symptoms?

A

vivid dreams or nightmares

100
Q

metronidazole can show what types of psychiatric symptoms?

A

depression, agitation, confusion

101
Q

What are the non-CNS drugs that can show what types of psychiatric symptoms?

A 
ACE inhibitor
Acetazolamide
Clarithromycin
Digoxin
Mefloquine
Metronidazole
102
Q

drugs with high lipophilicity will cross the bbb and store in what tissues?

A

fat

103
Q

drugs with a high degree of plasma protein binding have what factor that must be considered?

A

other drugs that displace its binding will result in more side effects and higher serum concentration

104
Q

what is the depot effect?

A

drugs that store in fat can be released over time after the actual administration of the drug has stopped

105
Q

What are considerations specific to the liver that you should take into account when writing an rx?

A

Status of liver function
Individual variations in rate of metabolism
Saturation kinetics
Conversion to an inactive versus an active metabolite
Inhibition by other drugs
Induction of metabolism by itself or another drug

106
Q

What are specific concerns when prescribing drugs for the elderly?

A 
CONCERNS:
Diminished hepatic and renal function 
Paradoxical reactions
Polypharmacy
Greater susceptibility to side effects (some may be life-threatening)

Block 8 Week 1 Colt (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions