Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BMB Test 4 Leesy > B7.071 - Drugs Affecting the CNS Dopamine Systems > Flashcards

B7.071 - Drugs Affecting the CNS Dopamine Systems Flashcards

(57 cards)

Start Studying
1
Q

primary strategy of parkinsons treatment

A

replace or mimic dopamine in the neostriatum

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

families of dopamine receptors in the brain

A

D1-like (D2, D5) and D2 like (D2, D3, D4)

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

D2 receptors

A

appear to be most important in parkinsons pathology, (indirect pathway)

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

D3 receptors

A

may mediate neuroprotective effects

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

secondary strategies of treating Parkinsosn

A

Anticholinergics

Amantidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

L-DOPA

A

dopamine precursor, DOPA does not cross BBB

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

motor effects of L-DOPA

A

reversal of rigidity, tremor and bradykinesia and reduced facial expression

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

psychic pharm effects of LDOPA

A

improved mental function

sense of well being

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

GI AEs of LDOPA

A

nausea and vomiting due to stimulation of D2 receptors in CTZ

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

cardiovascular AEs of LDOPA

A

orthostatic hypotension d/t stimulation of dopamine receptors in kidney and vasculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

long term motor AEs of LDOPA

A

fluctuations in efficacy (on off or bradykinetic episodes

wearing off effects

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

neuro AEs of LDOPA

A

abnormal involuntary movements, dystonia, dyskinesias, chorea, oral movements

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

psychic AEs of LDOPA

A

hallucinations, paranoia, mania, anxiety, depression, problems with impulse control d/t stimulation of dopamine receptors in targets of mesolimbic and mesocortical pathways

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

Pimavanserin

A

specifically indicated of PD psychosis, mechanism involved inverse agonist and antagonist activity at 5-HT2A and 2C receptors

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

neuroendocrine AEs of Pimvaserin

A

renewed sexual interest and behavior, hypersexuality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pharmacokinetics of LDOPA

A

Oral, absorption GI Transit time dependent
Peak levels 1/2-2 hrs
t1/2 1-3 hrs

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

metabolism and excretion of LDOPA

A

95% decarboxylated in periphery and excreted in urine which is why you need CARBIDOPA bihhhh

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

Carbidopa

A

blocks AADCin periphery

decreases levodopa dose and side effects

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

MAO-B inhibitors

A

Selegeline
Rasagiline
MAO-B preferentially metabolizes DA (as opposed to MAO-A 5-HT and NE)

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

COMT inhibitors

A

Tolcapone - hepatotoxicity

Entacapone - peripheral only

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

contraindications of LDOPA

A

abrupt discontinuation
close angle glaucoma - can stimulate beta rec
melanoma - LDOPA precursor to melanin
breast feeding - inh prolactin secretion

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

which conditions should LDOPA be used with caution

A

psychosis
cardiac disease
peptic ulcer
open angle glaucoma

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

dopamine agonists monotherapy or add on

Study These Flashcards
A

pramipexole - D2/3 agonist, monotherapy or add on

ropinerole - D2/3

24
Q

dopamine agonists add on with LDOPA

Study These Flashcards
A

bromocriptine - D2 agonist (also used for hyperprolactinemia)

25
mechanism of dopamine agonists
ag at D2 and other dopamine receptors
26
AEs of dopamine agonists
nausea, vomiting, postural hypotension, hallucinations,
27
anticholinergics
benztropine | procyclidine
28
mech of benztropine and procyclidine
block actions of striatal cholinergic neurons Generallly leses effectve than LDOPA can be used alone early on
29
side effects of benzyropine and procyclidine
constipation, urinary hesitance, confusion, hallucinations
30
amantadine
unknown mech, may release dopamine and/or have anticholinergic properties
31
use of amantidine
monotherapy or adjunct to levodopa
32
SEs of amantidine
similar to dopamine anticholinergic effects livedo reticularis, peripheral edema, headache
33
antipsychotic drugs
primarily used to treat schizophrenia aka major tranquilizers or neuroleptics
34
mech of antipsychotics
antagonists of D2 dopamine receptor Serotonin receptors esp 5-HT2 and/or novel D2 like receptors may be involved Antipsychotics also interact with a variety of other receptors which contribute to side effects
35
pharm effects of antipsychotics
initially sedation, decreased agitation + sx improve over weeks to months - sx may be improve by newer drugs but not older/typical antiemetic d/t Dop blockade
36
Early side effects of antipsychotics
neuro - extrapyramidal effects (EPS), dystonia, akathisia, parkinsonian sx d/t blockade of striatal dopamine receptors can be treated with anticholinergics
37
other SE of antipsychotics
increased prolactin release leading to amenorrhea, gynecomastia, galactorrhea weight gain, metabolic syndrome, DM
38
long term SE of antipsychotics
tardive dyskinesia (sterotyped movements and facial disfigurement) perioral tremor blood dyscrasias and agranulocytosis can occur with clozapine**
39
pharmacokinetics of antipsychotics
IM, IV, PO highly lipophilic (x BBB, stored in adipose) Extensive hepatic metabolism
40
typical antipsychotics work for
positive (not -) sx | produce EPS and tardive dyskinesia
41
MOA of typical antipsychotics
All are D2 antagonists | most are antagonists at a variety of other receptors
42
phenothiazines (typical antipsychotics)
``` chlorpromazine Fluphenazine Thioridazine haloperidol thiothixene ```
43
haloperidol
historically the most widely prescribed antipsychotic relatively more selective for dopamine highest incidence of EPS**
44
atypical antipsychotics featues
NO EPS or tardive dyskinesia | Antagonist at 5-HT receptors
45
Clozapine
``` 5-HT2>D2 activity at broad spectrum of rec no EPS or tardive dyskinesia causes agranulocytosis approved for treatment resistant pts ```
46
newer antipsychotics
risperidone lurasidone paliperidone
47
risperidone
5-HT2=D2 | EPS at higher doses
48
Lurasidone
5-HT2, D2, 5HT7
49
paliperidone
primary metabolite of risperidone with lower affinity for 5HT2A receptor
50
which newer antipsychotics have the lowest risk of EPS and tardive dyskinesia
Olanzapine Quetiapine Ziprasidone Aripiprazole
51
olanzapine
5-HT2>D2 | high incidence of weight gain and metabolic syndrome
52
Quetiapine
5-HT2=D2 | High incidence of weight gain and metabolic syndrome
53
Ziprasidone
D2, 5-HT1D antagonist 5-HT1A agonist also inhibits NE and 5-HT reuptake
54
Aripiprazole
D2 & 5-HT1A partial agonist 5-HT2A antagonist Partial agonism at D2 receptors may allow for sufficient stimulation to prevent EPS, while preventing over stimulation
55
other uses of antipsychotics
Management of agintation and psychotic symptoms in acute mania & bipolar, delerium, dementia (associated with increased risk of mortality), alc hallucinosis DURING heavy drinking
56
parkinsons drugs
1. levodopa 2. carbidopa 3. pramipexole 4. ropinirole 5. bromocriptine 6. selegiline 7. entacapone 8. benztropine 9. procyclidine 10. amantadine 11. pimavanserin
57
antipsychotics
1. chlorpromazine 2. fluphenazine 3. thioridazine 4. haloperidol 5. thiothixene 6. clozapine 7. risperidone 8. lurasidone 9. paliperidone 10. olanzapine 11. Quetiapine 12. ziprasidone 13. aripiprazole

BMB Test 4 Leesy (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions