Central Nervous System

Question 1

Brain

Answer 1

Receives and processes sensory information, initiates responses, sores memories and generates thoughts and emotions

Question 2

Three main neurotransmitters of the brain

Answer 2

Dopamine
Norepinephrine
Serotonin

Question 3

Dopamine?

Answer 3

*Alertness
Clarity vs Ambiguity
Working memory vs Passive
Motivation vs hyper

Question 4

Norepinephrine?

Answer 4

*concentration
Certainty/ doubt
Determination vs obsession
Recall memory vs dementia

Question 5

Serotonin?

Answer 5

*Satisfaction
Relaxation vs insomnia
Pleasure vs anxiety
Learning memory vs disability

Question 6

Dopamine and serotonin?

Answer 6

Appetite

Question 7

Dopamine and norepinephrine?

Answer 7

Attention

Question 8

Norepinephrine and serotonin?

Answer 8

Endurance

• all 3 makes a balanced mood

Question 9

Medical use of CNS drugs

Answer 9

Relieve pain
Suppress disorders of movement or seizures
Induce sleep or arousal
Reduce the desire to eat
Inhibit motion sickness
Treat anxiety, mania, depression or schizophrenia

Question 10

Schizophrenia

Answer 10

Caused by too much dopamine in the brain

Question 11

Positive Symptoms of schizophrenia

Answer 11

Delusions
Hallucinations
Disorganised speech

Question 12

Negative symptoms of schizophrenia

Answer 12

Flattened affect
Reduced speech
Lack of initiative

Question 13

Antipsychotic

Answer 13

They all reduce dopaminergic neurotransmission

Question 14

Treatment for schizophrenia

Answer 14

Medication for treatment
Psychotherapy

Question 15

Typical antipsychotics

Answer 15

Known as the new generation
Can cause extrapyramidal motor control disabilities
Have more side effect
Have fewer withdrawal symptoms

Question 16

Atypical antipsychotics

Answer 16

Known as new generation antipsychotic
Less likely to cause extrapyramidal motor control disabilities
Have fewer side effects
Have more withdrawal symptoms

Question 17

Symptoms of hypomanic and manic episodes

Answer 17

Racing thoughts
Pressured speech
Increased distractibility
Increased energy and restlessness

Question 18

Common bipolar treatments

Answer 18

Mood stabilisers
Antipsychotics
ECT
Talk therapy

Question 19

Affective disorders

Answer 19

Mental illnesses characterised by pathological changes in mood

Question 20

Unipolar disorders

Answer 20

Depression
Mania

Question 21

Bipolar disorders

Answer 21

Major depressive episodes

Question 22

Depression

Answer 22

Chemical dysfunction which causes reduced brain activity

Question 23

Therapy for depression
Non-pharmacological treatment

Answer 23

Psychotherapy
Light therapy
Electro convulsive therapy
Deep brain stimulation

Question 24

Classification of registered antidepressants

Answer 24

Tricyclic antidepressants
Tetracyclic antidepressants
Selective serotonin re-uptake inhibitors
Serotonin and norepinephrine re-uptake inhibitors
Serotonin receptor modulators
Noradrenaline and dopamine reuptake inhibitors
Lithium salts

Question 25

Tricyclic antidepressants

Answer 25

Chemical structure with characteristic of a three ring nucleus AMITRIPTYLINE long half-lives

Question 26

Principal mechanism of action

Answer 26

Blockade of re-uptake of neurotransmitters

Question 27

Selective serotonin re-uptake inhibitor

Answer 27

*More modern and safer than TCA *Principal mechanism of action: Selective inhibition of 5-HT(serotonin reuptake) *Indication are generalised anxiety, panic disorder, social anxiety disorder , ocd, BN, gambling

Question 28

Most important SSRIs

Answer 28

Fluoxetine(Prozac) Citalopram(cipramil) *long half lives

Question 29

Serotonin and noradrenaline re-uptake inhibitors (SNRI)

Answer 29

Used to treat major depressive disorder, anxiety and panic disorders. It is used off-label to treat migraine, diabetic neuropathy, and hot flashes

Question 30

Serotonin receptor modulators(SRMs)

Answer 30

Trazodone (Molipaxin) - at low doses, it acts as a serotonin antagonist, and acts as an agonist while at high doses *strong sedative antidepressant- treat insomnia

Question 31

Noradrenaline and dopamine re-uptake inhibitors

Answer 31

Bupropion - acts as a reuptake inhibitor for the neurotransmitters norepinephrine and dopamine *used for severe depression and smoking cessation treatment * effects are insomnia, excitation, restlessness, lowers epilepsy threshold

Question 32

Lithium

Answer 32

Prophylactic treatment in bipolar disorder Effects- weight gain, GIT disturbances, alopecia Interacts with thiazides to increase Li re absorption

Question 33

Melatonergic antidepressants

Answer 33

Agomelatine Rx of major depressive episodes in adults Has no effect on sexual activity No weight gain Effects: hyperhidrosis, anxiety, and increased liver function tests

Question 34

Vortioxetine

Answer 34

Rx of MDD Takes long to work To side effects Enhance memory and learning

Question 35

Sedative hypnotics

Answer 35

Benzodiazepines Short action: triazolam Intermediate action: alprazolam Long action: flurazepam

Question 36

Benzodiazepines pharmacologic effects

Answer 36

Anticonvulsant effects Anterograde amnesia Reduction muscle tone and coordination Sedation and induction of sleep Reduction in anxiety and aggression

Question 37

Symptoms of benzodiazepine withdrawal

Answer 37

Anxiety Depression Insomnia Irritability, anger or rage Balance problems

Question 38

Anti-epileptic drugs

Answer 38

Aim to inhibit the fast, repetitive neuronal discharges that characterise convulsion

Question 39

Anti-epileptic drug Carbamazepine (Tegretol)

Answer 39

Used to prevent and control seizures Also relieve certain type of nerve pain Can also treat mood disorders Half lifemis 25-65 house with single dose * may cause skin rashes, hepatitis, ataxia, sedation and confusion

Question 40

Anti-epileptics

Answer 40

They are all teratogenic *phenytoin * carbamazepine *Valproate

Question 41

Opioids

Answer 41

Heroin Morfine Codeine Fentanyl Oxycodone

Question 42

Opium

Answer 42

Poppy plant Opiate are substances that are extracted from crude opium Opioid are compound with morphine-like activity