4. Neuropharmacology Flashcards Preview

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Flashcards in 4. Neuropharmacology Deck (58)
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1

Most important CNS neurotransmitters?

Glutamic acid, GABA, ACh, DA, NE, 5HT, opioid peptides

2

Action of glutamic acid?

Direct coupling and G-protein linked on NMDA -> influx of cation -> excitatory

Potential target for ketamine and PCP

3

Mechanism of ACh?

Excitatory and inhibitory on muscarinic receptors by decreasing/increasing K+ efflux by coupling DAG and cAMP

4

Mechanism of GABA?

Increase K+ influx by direct coupling -> inhibitory
Potential target for anticonvulsant, sedatives, hypnotics, some muscle relaxants

5

What drugs act on GABA?

Barbiturates (duration of Cl- ion channel)
Benzos (frequency of Cl- ion channel)
Propofol (GABA-A)
Baclofen (GABA-B)
Valproic acid (high concentration)

6

Mechanism of flumazenil?

Benzo antagonist (decreases frequency)

7

What nonbenzo drug binds to benzo receptor?

Zolpidem (sleep)
Less tolerance and dependence

8

Name a nonbenzo anxiolytic

Buspirone (partial 5HT1A receptor)
No dependence or withdrawal

9

Side effects of benzos

Sedative, amnestic, anxiolytic, antidepressant, muscle relaxant

Not for T1 preg
May result in hypotension/resp depression if with opioids

10

Benzo withdrawal syndrome

Hypertension, tachycardia, muscle twitching, tremulous, diaphoresis, confusion, dysphoria, seizures

11

Pharm strategy in Parkinson

Increase DA activity and decrease ACh at muscarinic in striatum

12

Midazolam (1-2mg IV): onset and duration

Rapid and shortest

13

Diazepam (2-10mg BID-QID): onset and duration

Rapid and longest
aka Valium

14

Alprazolam (0.25-0.5 mg TID)

Intermediate/Intermediate (Antidepressant effect)
aka Xanax

15

Chlordiazepoxide (5-10mg TID)

Intermediate/Long
aka Librium

16

Lorazepam (1mg TID)

Intermediate/Intermediate (liver ok)
aka Ativan

17

Temazepam (15-30mg)

Intermediate/intermediate (liver ok)
aka Resteril

18

What 3 benzos are not metabolized in the liver?

Alprazolam
Temazepam
Oxazepam

19

What drug increases dopamine function?

Levodopa to dopamine by dopa-decarboxylase
Carbidopa blocks peripheral decarboxylation

20

Tolcapone and entacapone?

COMT inhibitor
Enhances CNS uptake of L-dopa; reduces on-off effects

21

Dopamine receptor agonists (2)

Bromocriptine (hallucinations, confusion, psychosis)
Pramipexole/Ropinirole

22

MAO B inhibitor

Selegiline

23

What drugs decrease ACh function?

Benztropine and trihexyphenidyl (M receptor blockers)
Reduce tremor/rigidity, EPS syndrome, but exacerbates tardive dyskinesia and cause atropine-like effects

24

Why do antipsych drugs cause atropine-like effects, postural hypotension, sexual dysfunction?

Block D2 receptors, muscarinic, alpha receptors

25

Side effects of DR antagonists?

Akathisia, acute dystonic rxn, extrapyramidal dysfunction, prolactinemia

26

Chronic dopaminergic receptor bockage?

Akathisia and tardive dyskinesia months later

27

Neuroleptic malignant syndrome?

Hyperthermia, cardiovascular instability, rigidity, altered MS due to enhanced sensitivity of DR to blocking agents

28

Tx of NMS?

Bromocriptine and dantrolene

29

Mechanism of TCA

Block reuptake of NE and 5HT
Also block muscarinic/alpha receptors (sedation, decrease seizure threshold, cardiotoxicity)

30

Mechanism of SSRI

5HT reuptake blocker
Can cause anxiety, agitation, bruxism, sexual dysfunction, seizure, transitory weight loss