Neurochemistry/ Neuropharm/tox Flashcards Preview

Neuro online course > Neurochemistry/ Neuropharm/tox > Flashcards

Flashcards in Neurochemistry/ Neuropharm/tox Deck (110):
0

Pregnancy category D?

evidence of fetal risk but benefits might outweigh risks

1

pregnancy C?

no human data. animal studies with risk or not avail

2

Pregnancy D AEDs? (3)

VPA
Phenytoin
Carbamazepine

3

Carbamazepine risks w/ pregnancy?
When / how to use?

1. cranial facial, neural tube, doll-like faces, long philtrum, palpebral folds
2. transient hepatic tox
3. if using, supplement w/ vit K, avoid T1

4

Risk of VPA and pregnancy

VPA! (Neural tube, neurobehavioral, craniofacial, cardiac, w/d sx/liver tox

5

What is the action of the tetrodoxin pufferfish?

blocks the voltage gated Na channel and prevents action potential (rising phase)

6

WHat is the presynaptic autonomic ganglion neurotransmitter / receptor?

nicotinic ACh in both PNS and SNS

7

What is the postganglionic receptor/neurotransmitter in the Parasympathetic nervous system?

muscarinic ACH

8

What is the post-ganglionic neurotransmitter / receptor of the sympathetic nervous system?

Norepinephrine / adrenergic
Exception: Muscarinic ACh in sweat glands

9

LEMS pathophys?

Blocks Ca2+ presynaptic channel leading to blockage of ACh release at NMJ

10

Myasthenia Gravis pathophys?

Abs block ACH receptor on post synaptic membrane in NMJ

11

Pathophys of Botulinum?

Prevents ACH release at NMJ by blocking SNAP-25 needed for vesicle fusion

12

Pathophys of autosomal dominant nocturnal frontal epilepsy

Nicotinic ACH receptor defect

13

Alpha bungarotoxin mechanism of action?

Nicotinic ACH receptor antagonist
Alpha: after the synapse, beta: before the synapse

14

Beta bungarotoxin (sea snakes) pathophys?

Before the synapse, causes ACH release
Alpha: after the synapse, beta: before the synapse

15

Latrotoxin (black widow spider)

augments ACh release before the synapse

16

hypermagnesium and effect on NMJ

competes w/ calcium for uptake, so too much causes decreased release of presynaptic ACh at NMJ

17

Mechanism of action of Atropine?

counteracts increased muscarinic action during cholinergic crisis

18

nightshade and jimson weed contain what? effect?

atropine
anticholinergic effect

19

potential mechanism of action of tick paralysis?

decreased ACh release

20

5HT3 receptor use?

target of antinausea drugs

21

Reserpine mechanism of action and issue?

irreversibly inhibits vesicular monoamine transporter (VMAT) and leads to monoamine depletion
A BP med that causes serious depression

22

What sx (2) best differentiates serotonin syndrome and neuroleptic malignant syndrome?

In serotonin syndrome you get diarrhea and myoclonus

23

MDMA drug (ecstasy) acts by what mechanisms/effect? (3)

vesicular monoamine release, oxytocin (enactogenic effect) and excitotoxicity

24

LSD mechanism of action?

5HT-2A partial agonist: hallucinogen

25

Lorcaserin (Belviq)

5HT-2C: weight loss drug

26

Write out the Catecholamine receptor types

QISS: Alpha 1 (q), 2 (i), Beta 1 (s), 2 (s)

QIQ: Muscarinic 1 (q), M2 (i), M3 (q)

SI: Dopamine D1 (s), D2 (i)
QS:Histamine H1 (q), H2 (s)
QS: Vasopressin V1(q), V2(s)

Alpha Adrenergic, Muscarinic, and Dopamine 2 are all inhibitory
Histamine and Vasopressin 2 are stimulatory (no inhibitory)

27

Dopamine pathways (2) in schizophrenia
Dopamine pathways (1) in parkinsons

Schizo: mesocortical, mesolimbic

PD: nigrostriatal

28

tyrosine hydroxylase deficiency causes what disease

rate limiting step for dopamine synthesis
Causes dopa responsive dystonia

29

D1 like what receptor
effect?

Like D5
Has excitatory effect in striatonigral pathway (caudate, putamen, nucleus accumbens)

30

D2 like what and what effect?

inhibitory in striatopallidal
like D3, D4

31

Pathophys of Parkinson's Dz involving what Dopamine receptors / how?

decreased D1 (less excitatory)
increased D2 (inhibitory)
--> inhibition of movement

32

Antipsychotics effect which dopamine receptor system?

D2: blockade (because in schizophrenia there is increased D2 activity)

33

What are the causes of NMS and tardive dyskinesia?

Excess D2 blockade

34

Possible treatment of NMS? why effective? (3)

Bromocriptine to overcome D2 blockade
Bromocriptine is a D2>1 agonist

Ropinirole
Pramipexole: D2 agonists

35

Selegiline mechanism of action?

MAO-B inhibition
(effect on DA degradation only)

36

Function of alpha 2 adrenergic receptor
-name three drugs that act at this receptor

an auto/heteroreceptor for negative feedback. Ligand binding inhibits further NE release
1/2. Tenex/clonidine are alpha 2 agonists: decrease NE in synapse
3. Mirtazipine is an alpha 2 antagonist: leads to more NE in synapse

37

what is the mechanism of the disease Shy Drager syndrome / Multiple system atrophy?

alpha adrenergic degradation

-think alpha synucleinopathy / alpha adrenergic depletion

38

Cocaine mechanism of action?

NE/E reuptake inhibitor

39

describe NMDA rec properties
-what nt?

glutamate
-lets in Na, K, (Ca)
-blocked by Mg, so needs depolarization too: for learning

40

How do phencyclidine and Ketamine work?

Block NMDA (decrease glutamate)

41

Amnestic shellfish mechanism of action?

Kainate glutamate receptor agonist

42

chickpea toxicity / lathyrism

AMPA glutamate agonist

43

What is a treatment of ALS that causes inhibition of release of glutamate

Riluzole

44

Mechanism of the PD-Dementia-ALS complex of guam?

cyad plant activates NMDA

45

Phenobarbitol has what effect on glutamate?

Its a Kainate antagonist
(seizure med)

46

Felbamate mechanism of action?

mGluR antagonist AED

47

GABA receptor: 3 types

A/C: ligand inhibitory Cl- channels
B: metabotropic inhibitory

48

Drugs for Gaba A receptor agonist? (3 AEDs)

BZD, barbiturate, topiramate

49

Which GABA A agonist drug binds to a site outside the pore?

BZD

50

Drug for GABA B agonist?

baclofen

51

Mechanism of action of Sabril/Vigabatrin

blocks GABA transaminase to prevent breakdown

52

Mechanism of Tiagabine (Gabitril)

blocks GABA reuptake --> incr gaba effect

53

GABA C where?

retina only

54

Ben Affleck is photographed frequently and Bars are open late?

Benzos increase GABA channel opening frequency
Barbs increase GABA channel opening time

55

Angelman pathophys of seizures?

Chromosome 15 depletion of GABA A receptor

56

3 epilepsy syndromes caused by GABA A efects?

1. GEFS
2. autosomal dominant JME
3. absence / febrile sz in childhood

57

GABA pathophys of Huntingtons?

loss of GABA in striatum leading to decreased inhibition of substantia nigra and more DA production causing chorea

58

Glycine is used as neurotransmitter where with what effect?

inhibitory of spinal cord (Renshaw cells - inhibits alpha motor neurons)

59

Tetanus mechanism of action

blocks GABA and glycine release by cleaving synaptobrevin in presynaptic terminal of inhibitory neurons

60

CYP450 and PB, dilantin, carbamazepine?

induces so decreases drug levels

61

Cigarettes and CYP?

1A2 inducer, so decreases drug levels of many psych meds

62

CYP450 and St. John's wort?

inducer

63

CYP450 and SSRIs

inhibitor: increases other drug levels

64

The big 5 CYP450 inhibitors that can cause toxic levels of other drugs?

SSRI
Ketoconazole
Emycin
Grapefruit
Cimetidine

65

The potential target of CYP450 drug interactions (victims 7)

OCP - yikes!
VPA
Haldol
Protease inhibitors
Midazolam
Vincristime
Carbamazepine

66

AED w/o phase I metab?

Lorazepam, Lamotrigine
2 others: Oxazepam and Temazepam OTLL (out the liver l.)

67

triptan mech of action?

5HT 1D agonist to constrict cerebral arteries

68

bupropion mech of action

Blocks DA and NE reuptake
DNRI
B/c no serotonin: less Gi/sexual se
b/c of NE: more activating for anhedonia

69

Mirtazapine (remeron) mech of action?

1. alpha 2 antagonist: antidepressant
2. 5HT2/3 antagonist: decr sex/gi s/e
3. alpha 1 antagonist: orthostasis
4. H1 antagonist: sedating
**Different effects at different doses**

70

MAOA vs B?

A: for breakdown of NE and 5HT
B: for breakdown of DA

71

Mechanism of action of 2nd generation vs 1st generation antipsychotics?

Gen1: DA antagonist
Gen2: DA2 antagonist and 5HT2 antagonist

72

Geodon / Ziprasidone mechanism of action?

5HT and DA antagonist
5HT reuptake inhibitor

So antipsychotic and antidepressant properties

73

Aripiprazole (Abilify) mechanism of action?

5HT 1 alpha partial agonist
5HT 2 alpha: antagonist
(double increase in serotonin)
D2 partial agonist/antagonist: so lower rates of NMS

74

Mechanism of action of amphetamine?

1. direct release of DA/NE through degranulation
2. reuptake inhibition
3. prevents MAOI catabolism
Triple threat

75

How does Buprenorphine work?

opioid kappa antag, mu partial agonist/antagonist
-effect differs depending on whether heroine is on board
-packaged with naloxone to avoid crush/iV diversion reduction

76

What are the three anticholinesterase inhibitors used in Alzheimers and what are the special properties?

1. Donepezil
2. Rivastigmine: ACHei and butyrl cholinesterase inhibition
3. Galantamine: ACHEi and nicotinic receptor agonist

77

Na Channel blockers for AEDS?

OXcarb/Carb, Phenytin, VPA, Topamax, Lamotrigine

78

Pregnancy issue with benzos?

Class C: oral cleft

79

Pregnancy issue with VPA

Class D: neural tube, neurodevelopment (autism), malformations

80

SSRI fetal issue

cardiac

81

Major lamotrigine interactions with other drugs?

1. VPA: VPA cuts metabolism of lamictal in half!
2. Narcolepsy drug sodium oxybate
3. propoxyphene (Darvon: pain killeR)

82

toxin drug to think about w/ NMJ presentation in IV drug users

botulinum from black tar heroin injection contaminated with spores

83

what does strychnine do?

blocks glycine postsynaptically via Cl channel

84

lathyrism is what and does what?

toxic chick pea in india
binds aMPA, causes spastic paraparesis, UMN/LMN death

85

Cycad seeds consumed by flying foxes and fruit bats gives what disease?

ALS-PDC complex in Guam Japan

86

scorpion stings cause what?

regional pain/paresthesias, cholinergic tox, myoclonus/dystonia

87

black widow spider causes what?

latrotoxin stimulates presynaptic channels and causes neurotransmitter release peripherally w/ muscle/chest pain, agitation

88

mechanism of tick paralysis

blocks axonal sodium channels and ACh release

89

Ciguatera toxin does what?
Tx?

opens sodium channels and cases spontaneous depolarization and nodes impairing conduction. perioral/limb paresthesias, Gi sx
Tx w/ mannitol IV within first 10 hr

90

tetrodotoxin causes what?

blocks action potentials at Na channel (rising phase) causes euphoria, perioral paresthesias, GI sx/paralysis, loss of brainstem reflexes, cardiopulm failure and death in 20-30 min

91

Manganese tox vs Parkinson's

Manganese affects pallidum but spares substantia nigra vs PD
Manganese: action tremor
PD: resting tremor

92

what toxin? GI illness, metallic taste, garlic odor, sensorimotor neuropathy, skin changes, Mees lines, loss of hair

arsenic poisoning

93

What does zinc tox cause?

copper deficiency with mito sx/looks like B12 def

94

mees lines

fingernail stripes, arsenic

95

welders get what tox

manganese, PD like picture

96

gingivitis, tremor, neuropsych sx, ataxia, acrodynia of fingers and toes

mercury poisoning

97

what is gamma hydroxybutyric acid?

date rape drug

98

Drug that can cause a B12 like combined myeloneuropathy?

NO sniffing

99

drug situation that can cause PD like syndrome

meperidine (Demerol/opiate) contaminated with MPTP

100

black urine / hemoglobinuria, diarrhea

acute arsenic poisoning

101

axonal neuropathy, Mees lines, hyperkeratosis of palms/soles

chronic arsenic exposure

102

what causes pallidus necrosis, extrapyramidal signs, parkinsonism, szs, irritability - what poisoning

carbon monoxide

103

antifreeze / ethylene glycol causes what

Corneal reflexes lost
Convulsions
Coma
Cyanosis

104

what causes acrodynia in children

inorganic mercury poisoning esp in kids

105

pink extremities, tachycardia, sweating on trunk, hypertension, encephalopathy is what and what poisoning do you see it with?

inorganic mercury poisoning: Acrodynia

106

distal paresthesias, ataxia, constricted visual fields and cortical vision loss causes what?

organic mercury tox

107

what is the drug in rat poisoning and what does it cause?

strychnine causes apprehension, nausea, muscle spasms and twitching, opisthotonus, seizures, rhabdo/renal failure
(glycine inhibitor)

108

What does thallium cause?

affects NA/K pump, causes GI sx, alopecia, axonal neuropathy, may have Mee's lines, GBS like syndrome

109

drug found in paint thinner, fuel, glue and what does it cause?

Toluene
emotional lability, tremor, optic/cerebral/cerebellar atrophy, white matter changes