Week5: T3(1): Pharmacological interventions: medications and their effects

Question 1

What is a presynaptic neuron?

Answer 1

The neuron that releases neurotransmitter

Question 2

What is a postsynaptic neuron?

Answer 2

The neuron that is receiving the information.

Question 3

What is a synapse?

Answer 3

Gap between pre-and postsynaptic neurons; about 20 nanometers.

Question 4

What is agonist?

Answer 4

A compound that binds to a receptor and causes a biological response. Neurotransmitters that come within the brain are agonists; they cause biological response when they bind. Ex. Dopamine, serotonin, acetylcholine, GABA, glutamate.

Question 5

What is antagonist?

Answer 5

An antagonist is a medication that binds to a receptor and blocks a biological response. Many medications are antagonists - they block a response.

Question 6

What is all endogenous ligand?

Answer 6

Neurotransmitter that comes within the brain. A ligand is a protein that attaches (binds) to another protein called a receptor; receptor proteins have specific sites into which the ligands fit like keys into locks. Endogenous ligands are those that are produced in the body, not those introduced into the body, such as certain drugs.

Question 7

Antipsychotics

Answer 7

1. Antipsychotics involve modulation of the dopaminergic system.
2. They are are postsynaptic dopamine antagonists.
3. Circulate widely, but (should) only affect dopamine receptors
4. Antipsychotics target the mesolimbic pathway whose functions are regulating reward and salience. Specifically, the threat perception. People are more likely to become paranoid.
5. For antipsychotic to be effective, it needs to block between 60 per cent and 70 per cent of that signal

Question 8

What is dysphoria?

Answer 8

A lack of pleasure from everyday activities. Side effect of antipsychotic medication. A results of the medication disrupting the the reward processing part of the brain; the blockage of dopamine receptors is not only to the salient area but also the reward area.

Question 9

What is iatrogenic?

Answer 9

Iatrogenic means ‘caused by medication, ’classical/typical antipsychotics can worsen negative symptoms with schizophrenic patients.

Question 10

What are atypical medications?

Answer 10

Neuroatypicals for schysophrenia, block dopamine, but also increases dopamine release in certain parts of the brain, which are deprived from sufficient dopamine. In order to overcome the problem lack of drive, motivation and social engagement, there need to be more dopamine, not less.
They reduce enough dopamine excess in the mesolimbic system to treat paranoia, but they don’t cause the same problems in the frontal lobe. There are other side effects in terms of weight gain and more.

Question 11

How do antipsychotics affect the nigrostriatal and the tuberoinfundibular?

Answer 11

The nigrostriatal helps regulate movement. The tuberoinfundibular, part of the hypothalmic-pituitary axis which is involved in hormonal or endocrine functions (breast milk, production, menstruation, libido). antipsychotics cause extrapyramidal side effects,

Question 12

What are extrapyramidal side effects?

Answer 12

Movement problems caused by dysregulation of the nigrostriatal pathway, amenorrhea, galactorrhea and libido.

Question 13

What are amenorrhea, which is the and galactorrhea.

Answer 13

Amenorrhea = cessation of menstruation, 
Galactorrhea = inappropriate production of breast milk

Question 14

What is the monoamine hypothesis?

Answer 14

Depression is caused by a lack of serotonin and noradrenaline (which are monoamine NTs).
Research showed it was incorrect.
Depressed people have normal levels of serotonin and noradrenaline.

Question 15

What is the refined hypothesis to the monamine hypothesis?

Answer 15

Depressed people have abnormal intracellular responses to these.

Question 16

How are antidepressants hypothesized to be working?

Answer 16

Serotonin and noradrenaline above normal levels of the NTs compensates for the abnormal intracellular responses to these NTs.

Question 17

What is Mirtazapine?

Answer 17

An antidepressant of the class NaSSAs, (Noradrenergic and Specific Serotonergic Antidepressant). That medication is not allowing the neuron to shut itself down. A presynaptic “off switch” to the shutting of a neuron that otherwise would stop releasing the NTs.

Question 18

What is SSRIs?

Answer 18

An antidepressant, serotonin specific re-uptake Inhibitor. The most common class of antidepressant. Some drugs in this class are Fluxetine, Paroxetine, Sertraline, Citalopram. These drugs block the re-uptake only of serotonin.

Question 19

What are NARIs drugs?

Answer 19

Noradrenergic re-uptake inhibitors. In this class there is only one drug, Reboxetine. It only blocks the re-update on noradrenaline neurons.

Question 20

What are NARIs drugs?

Answer 20

NARIs, noradrenergic re-uptake inhibitors

Question 21

What are SNRIs and TCADs?

Answer 21

SNRIs, a medication class of serotonin-noradrenaline re-uptake inhibitors. In the class are Venlafaxine and Duloxetine .
TCADs, tricyclic antidepressants, a medication class of serotonin-noradrenaline re-uptake inhibitors. In this class Amitriptyline is an example. 
Both classes block the re-uptake of serotonin and noradrenaline

Question 22

What is the difference between SNRIs, and TCADs?

Answer 22

SNRIs are a newer class of drug. They produce fewer side effects in a therapeutic dose, and they’re safer in overdose.

Question 23

What is MAOIs drugs?

Answer 23

Monoamine oxidase inhibitors. They stop the process of broking down of the neurotransmitter in the synapse by an enzyme = process in the synapse of oxidising monoamines