Exam 2 CNS

Question 1

Chronotropy

Answer 1

Heart rate - due to conduction system of the heart

Question 2

Inotrophy

Answer 2

Contractility of heart - due to contraction of heart muscle

Question 3

Lusitropy

Answer 3

Relaxation of heart - in between beats does heart go back to “rested” before contracting again

Question 4

Glutamate

Answer 4

Major excitatory NT: everywhere

• receptors are ion channels (NMDA, AMPDA)
• ligand binding depolarizers neuron, creates or transmits an impulse

Question 5

GABA and Glycine

Answer 5

Major inhibitory NTs

• GABA released throughout CNS
• Glycine released in brain stem & spinal cord (no drugs on this system)

Question 6

Monoamine NTs

Answer 6

Dopamine
N/E
5-HT (serotonin)

Question 7

Benzodiazepines

Answer 7

Sedation
Muscle relaxation
Paradoxical stimulatory effects
Cognition (anterograde amnesia)

Question 8

Diazepam, alprazolam, temazepam

Answer 8

Benzodiazepines
Diazepam - muscle relaxation
Xanax/Valium - anti-anxiety activity

Question 9

Zolpidem and zapelon

Answer 9

Non-benzo GABA agonists

• hyperpolarizes neuron
• treats insomnia

Question 10

Suvorexant (Belsomra)

Answer 10

Orexin antagonist

-sleep/wake cycle

Question 11

Mechanism for attacking spasticity

Answer 11

• decrease a utility of nerve fibers that excite motor neurons
• increase activity of inhibitory interneurons (GABA)

Question 12

Benzodiazepines (GABAa)

Baclofen (GABAb)

Answer 12

Muscle relaxants

GABA agonists

Question 13

Tizanidine

Answer 13

Muscle relaxant

Central alpha-2nd agonist

Question 14

Dantrolene

Answer 14

Muscle relaxant 
Calcium blocker (ryanodine receptor)

Question 15

Carisoprodol, cyclobenzaprine, chlorzoxazone

Answer 15

Muscle relaxant, CNS agent

Mechanism unclear

Question 16

Amitriptyline and imipramine

Answer 16

Tricyclic antidepressants

• Non-selectively inhibit reuptake of amine NTs from synaptic cleft
• Blocks specific 5-HT receptors

Question 17

Fluoxetine, paroxetine, citalopram, sertraline

Answer 17

SSRIs

• selectively inhibit 5-HT reuptake
• block specific 5-HT receptors
• less ADRs

Question 18

Venlafaxine

Answer 18

SNRI (serotonergic/adrenergic)

• selective reuptake of BOTH 5-HT and NE
• less ADR than TCAs

Question 19

Bupropion

Answer 19

DNRI (dopaminergic/noradrenergic)

• selective reuptake of DA and NE
• least ADR occurrence

Question 20

Lithium

Answer 20

Drug of choice for manic phase of bipolar disorder

-cleared by the kidney

Question 21

Phenytoin

Answer 21

Anti-epileptic
Sodium channel blocker
-lots of ADRs (interactions with enzymes/protein binding: MK kinetics)
-weird metabolism

Question 22

Carbamazepine

Answer 22

Anti-epileptic
Sodium blocker
-lots of ADR (hypersensitivity)

Question 23

Ethosuximide

Answer 23

Anti-epileptic
Calcium blocker
-drug of choice for absence seizures (can make seizures worse)

Question 24

Gabapentin

Answer 24

Anti-epileptic
Affects calcium channels
Used as pain modulator too

Question 25

Lamotrigine

Answer 25

Anti-epileptic Sodium/glutamate blocking activity Used in bipolar disorder -hypersensitivity

Question 26

Valproate

Answer 26

Anti-epileptic Broad spectrum AED, many MOA\ Servers GI effects & hypersensitivity Used for pain/bipolar disorder

Question 27

Mesolimbic

Answer 27

Reward pathway | Affects emotions, behavior

Question 28

Mesocortical

Answer 28

Affects cognition and processing of information

Question 29

Nigrostriatal

Answer 29

Affects movement

Question 30

Tuberoinfundibular

Answer 30

Regulates prolactin levels

Question 31

Parkinson's Disease

Answer 31

Loss of dopaminergic neurons in Nigrostriatal tract (motor cortex)

Question 32

L-Dopa

Answer 32

For Parkinson's Enters CNS but broken down by DOPA decarboxylase and COMT -Broken down by MAO

Question 33

Carbidopa (given w/ L-Dopa as sinemet)

Answer 33

- peripheral Dopa decarboxylase inhibitor | - increases DA in CNS

Question 34

Tolcapone

Answer 34

COMT inhibitor | Parkinson's

Question 35

Selegeline

Answer 35

MAO inhibitor | Parkinson's

Question 36

Chlorpromazine

Answer 36

Phenothiazines, neuroleptic -1950s/1960s -non-specific D2 receptor blockade in mesolimbic/mesocortical tracts ADRs: off target effects - Ach, H, NE block

Question 37

Haloperidol

Answer 37

Neuroleptic for psychosis -1950s/1960s Increases D2 blocking activity -D blocks in other tracts

Question 38

Clozapine, Risperidone, and Aripiprazole

Answer 38

-atypical (newer) agents for treatment of psychosis 5-HT (and D2) antagonist Less ADRs