Drugs for Alzheimer's disese/ADHD/Anxiety

Question 1

What NT is deficent in alzheimer’s disease

Answer 1

Ach

Question 2

The treatment of alzheimer’s disease is focused on what

Answer 2

Increasing the amount of Ach in the synapse by inhibiting its breakdown

Question 3

What is the first strategy to tx alzheimer’s disease

Answer 3

to raise Ach levels

Question 4

What prototype drug is used to raise Ach levels

Answer 4

Donepezil

Question 5

What is the MOA of Donepezil

Answer 5

Achesterase inhibitor

Question 6

DUMB BELSS is an acronym that stands for the AE’s associated with cholinergic agonism. What does it stand for?

Answer 6

D-Diarrhea
U-Urination
M-Miosis
B-Bradycardia
E-Excitation (SM & CNS)
L-Lacrimation
S-Salivation
S-Sweating

Question 7

What is the 2nd strategy used to treat alzheimer’s disease

Answer 7

Block glutamate receptors

Question 8

Name two glutamate receptors

Answer 8

NMDA

non-NMDA

Question 9

Name three synthetic agonists that have high affinity to glutamate receptors

Answer 9

NMDA
AMPA
Kainate

Question 10

What is the theory behind treating patient’s with alzheimer’s with a glutamate receptor blocker

Answer 10

NMDA overstimulation is neurotoxic

Question 11

What drug is used to block the glutamate receptor

Answer 11

Memantine

Question 12

Memantine must be administered with what drug to help with the tx of alzheimer’s disease

Answer 12

Donepezil

Question 13

What does ADHD stand for

Answer 13

Attention Deficit Hyperactivity Disorder

Question 14

ADHD is characterized by

Answer 14

persistent pattern of frequent, severe, inattention, hyperactivity, and impulsivity

Question 15

ADHD starts before what age

Answer 15

7

Question 16

What midbrain structure is the target for treating ADHD

Answer 16

Reticular Activating System

Question 17

What two drugs are used to tx ADHD

Answer 17

Methylphenidate (Ritalin)

Amphetamine (Adderall)

Question 18

Methylphenidate’s net effect is increase in what NT in the synapse

Answer 18

Dopamine

Question 19

What is Amphetamine’s MOA

Answer 19

Increases release of catecholoamine (Dopamine, NE)

Question 20

What are the most common AE’s associated with Methylphenidate and Amphetamine

Answer 20

Delayed sleep
H/A
Decreased appetite
Weight loss

Question 21

What drugs classes are used to tx Anxiety

Answer 21

Benzos
NonBenzo-Benzos
Buspirone

Question 22

What 3 NT are known to play a role in anxiety

Answer 22

GABA
5-HT
NE

Question 23

Name the peripheral manifestations of anxiety

Answer 23

NE r/t manifestations include: Mydriasis, HTN, tremors, restlessness, palpitations/tachycardia

Other symptoms:

diarrhea, dizziness, excessive sweating, syncope, butterflies

Question 24

What is the pharmacologic strategy for the tx of anxiety

Answer 24

behavior modification
anxiolytics
autonomic suppression via propanolol
antidepressant

Question 25

What is the MOA of treating anxiety with benzos

Answer 25

GABA agonists that enhances the affinity of GABA for its receptor facilitating opening of the Cl channel

Question 26

Will Benzos alone flux chloride

Answer 26

No, GABA must bind

Question 27

GABA release and Benzo administration yields what affect on the chloride channel

Answer 27

Increased frequency of chloride channel opening

Question 28

GABA release and Barbiturate administration yields what affect on the chloride channel

Answer 28

Increased duration of chloride channel opening

Question 29

What are the main effects of benzo tx

Answer 29

sedation cognitive impairment dependence and withdrawl

Question 30

Name three drugs in the Non Benzo Benzo receptor agonist family

Answer 30

Zolpidem (Ambien) Zaleplon (Sonata) Eszopiclone (Lunesta)

Question 31

What is the MOA of the Non Benzo Benzos

Answer 31

Agonize the GABA receptor, but are not structurally BZDs.

Question 32

What drug can be used to reverse Benzos and non-benzo benzos

Answer 32

Flumazenil

Question 33

What are the non benzo benzos used to tx

Answer 33

Insomnia

Question 34

What should be avoided in both benzos and non benzo benzos

Answer 34

ETOH

Question 35

What are the similarities and differences associated with both benzos and non benzo benzos

Answer 35

both classes cause addiction, drowsiness, and dependence; however, non benzo benzos have show less of these effects than benzos

Question 36

What is the relationship b/t increased anxiety and the NT serotonin

Answer 36

More serotonin (5-HT) =brain more acitive=more anxiety

Question 37

Buspirone's net MOA is

Answer 37

decreased firing of 5-HT neurons and reduced release of 5-HT

Question 38

Tx of anxiety with benzo's verses buspirone is based on interaction with the same target receptor T/F

Answer 38

False benzo=GABA buspirone=5-HT

Question 39

Which tx modality is more effective for treating a depressed patient with anxiety

Answer 39

Buspirone *doesn't cause sedation, dependence, impairment of performance