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Human Disease and Therapeutics > Week 1 > Flashcards

Week 1 Flashcards

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1
Q

Neuronal cell body

A

Perikaryon (controls cells)

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2
Q

Excitatory neurotransmitter

A

Glutamate

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3
Q

Inhibitory neurotransmitter

A

GABA (gamma aminobutyric acid)

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4
Q

How does direct action work?

A

Neurotransmitter binds to and opens ion channels

Rapid response by altering membrane potential

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5
Q

How does indirect action work?

A

Binds to G protein and caused and indirect response through secondary messengers
Broader actions with longer lasting effects

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6
Q

What is another name for a ligand gated ion channel?

A

ionotropic

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7
Q

What is a metabotropic receptor?

A

Usually a G protein and have long term effects. There are membrane-delimited (all reaction occur in membrane) and Second messenger ones that require intracellular second messengers

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8
Q

What is an autoreceptor?

A

It is when there is a receptor on the never terminal that binds the neurotransmitter that is released (usually a negative feedback)

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9
Q

What is a heteroreceptor?

A

Receptor on other axon terminals through which neurotransmitters from other neuronal types can influence their function

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10
Q

What make the nerve terminal for acetylcholine unique?

A

There is not acetylcholine transporter (has to return as choline) and uses acetylcholine esterases

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11
Q

What do endorphins bind to?

A

m-opioid receptors that inhibit GABA release causing more excitation

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12
Q

In the autonomic nervous system, how many nerves are used?

A

2, a pre-ganglionic and post-ganglionic

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13
Q

All pre-ganglionic nerves use this neurotransmitter and bind to this type of receptor?

A

ACh and nicotinic

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14
Q

Where do sympathetic nerves originate?

A

Thoracolumbar spine

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15
Q

Where do parasympathetic nerves originate?

A

craniosacral

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16
Q

What is unique about the adrenal medulla?

A

It is directly innervated by the pre-ganglionic nerve and causes release of NE and Epi

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17
Q

Where do parasympathetic pre-ganglionic nerves go?

A

To the ganglia that is closest to the effector organs/tissues

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18
Q

Motor neurons use what neurotransmitter and bind to what type of receptor?

A

ACh and Nicotinic

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19
Q

DA activates what receptors?

A

D1-D5 and alpha and beta adrenergic

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20
Q

What is a seizure?

A

a finite clinical manifestation of abnormal & excessive excitation of a population of cortical neurons

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21
Q

What is epilepsy?

A

syndrome characterized by chronic, recurrent seizures unprovoked by systemic or neurologic insults
3 unprovoked seizures=epilepsy

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22
Q

What is epileptogenesis?

A

sequence of events that converts a normal

neuronal network into a hyperexcitable network

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23
Q

Life time prevalence of seizures?

A

9-10% of the population

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24
Q

Prevalence of epilepsy?

A

1%

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25
What is the biggest inherited cause of epilepsy?
Ion channel issues
26
What is the fastest growing cause of acquired reasons for epilepsy?
Trauma
27
What are common seizure precipitants?
``` Metabolic and/or Electrolyte Imbalance Stimulant or other pro-convulsant intoxication Sedative or ethanol withdrawal Sleep deprivation Reduction or inadequate ASD treatment Hormonal variations Stress Fever or systemic infection Concussion and/or closed head injury ```
28
Who is at most risk of getting epilepsy?
The young and the old
29
What is the common cause of epilepsy among all ages?
status epilepticus, a seizure lasting longer than 3 minutes
30
Simple partial seizure
Localized Minimal spread Normal awareness, memory and consciousness Short duration Could be different areas of the cortex that are involved
31
Complex partial seizure
Localized onset but spreads awareness, memory, and/or consciousness are lost during seizure short duration
32
Secondarily generalized seizure
begin as partial but end as generalized. tonic (stiffening) and clonic (jerking) phases and postictal phase
33
Another name for tonic-clonic seizure?
grand-mal
34
Another name for absence seizure?
petit-mal
35
What is characteristic of an absence seizure?
spike wave pattern
36
Are grand-mals synchronized or asynchronized?
Synchronized
37
Ideal ASD?
Effective for the Seizure Type Wide therapeutic index No organ toxicity No teratogenicity No drug-drug interactions Long half-life (t1/2) No protein binding Water soluble (easily absorbed) No active metabolites
38
What is the biggest difference between old and new ASDs?
newer drugs have fewer drug enzyme interactions
39
What are the three main mechanisms for ASDs?
1-increase inhibition 2-reduce excitation 3-modulate inhibition and/or excitation
40
Carbamazepine
Used for all types of seizures May cause steven-johnson's syndrome May cause increased absence seizures Block use-dependent voltage gated ion channels Na+ to stop re-firing of neurons
41
What are the dietary concerns with grapefruit?
They causes an increase in carbamazepine levels because they block the enzyme that metabolizes it
42
Ethosuximide
only drug that focuses on absence seizures | reduces t-type Ca 2+ channel currents
43
Phenobarbitol
``` All types of seizures cheap long term cognitive, memory, and behavior effects Big time INDUCER may cause absence seizures ```
44
Phenytoin
all types gingival hyperplasia zero order kinetics at high doses Block use-dependent voltage gated ion channels Na+ to stop re-firing of neurons
45
Topiramate
all types Weight loss inc. metabolism of estrogen word-finding difficulty
46
Valproic acid
``` all types weight gain reye-like syndrome, hepatic failure don't give if pt has liver issues neural tube defects (spina bifida) ```
47
What are the two types of parasympathetic receptors?
Nicotinic and muscarinic
48
Muscarinic agonists, functions, antagonists?
Agonists-ACh, bethanechol, pilocarpine Function-rest and digest Antagonists-atropine, scopolamine
49
What are the 2 nicotinic receptors?
Muscle and Neuronal
50
Nicotinic (muscle) agonist, function, and antagonist?
Agonist-ACh Function-neuromuscular junction Antagonist-succinylcholine
51
Nicotinic (neuronal) agonist, function, and antagonist?
Agonist-ACh Function-autonomic ganglia, adrenal medulla, CNS Antagonist-mecamylamine
52
What are the two classes of neuromuscular blockers?
Depolarizing-succinylcholine, depolarized neuron making it so it cannot react to further signals Non-depolarizing-competes with ACh
53
3 cholinesterase inhibitors
physostigmine-short duration, used for glaucoma antidote for atropine Donepezil-used for Alzheimer's Sarin-nerve gas
54
What does botulinum toxin do?
Prevent release of ACh
55
What cholinergic drugs are used in dentistry?
Cevimeline-xerostomia in Sjogren's | Pilocarpine-xerostomia in radiotherapy
56
Alpha 1 receptors
``` Agonist-Epi>NE, phenylephrine Tissues and actions -radial muscle of iris/dilates pupil -GU and GI sphincters/contract -Vasculature/Contracts Antagonist-prazosin ```
57
Alpha 2 receptors
``` Agonist-Epi>NE, clonidine, guanfacine Tissues and actions -Vasculature/Contracts -NE terminals/decrease NE release -Brainstem/decrease NE release ```
58
If a drug ends in -olol what is it?
Beta blocker
59
Beta 1 receptors?
Agonist-Epi=NE, isoproterenol Tissue and action -Heart/everything increases Antagonists-propranolol
60
Beta 2 receptors?
Agonists-Epi>>>>NE, isproterenol, albuterol, and terbutaline Tissue and actions -Ciliary muscle of eye/ relaxation for far vision -vasculature/relaxation/dilation of skeletal muscle vasculature -lung smooth muscle/relaxation -bladder and uterine wall/relaxation Antagonists-propranolol
61
What happen in the liver under adrenergic stimulation of Beta 2 and Alpha receptors?
Gluconeogenesis and glycogenolysis
62
D1 receptors?
Agonist-DA and fenoldapam Tissue and action -Kidney/increase blood flow, increase GFR, and sodium excretion -vasculature and heart/vasodilation
63
D2 receptors?
Agonist-DA Tissues and actions -DA nerve terminals/negative feeback -chemoreceptor trigger zone/nausea and vomiting
64
Barorecetors do what?
Maintain BP
65
Depending on the speed that Epi is given and the dose what happens?
Slow dose not much, increase HR and decrease TPR | High dose-more alphas get involved so increased HR and increased TPR
66
What does Epi do to the eye?
dilates pupil (mydriasis)
67
How can pilocarpine be used to treat glaucoma?
acts on muscarinic receptors on iris sphincter muscle causing them to contract, also causes ciliary muscles to contract opening the trabecular meshwork through increased tension. This facilitates fluid flow decreasing the pressure.
68
What are the mixed adrenergic drugs?
ephedrine, ephedra, and pseudoephedrine | uses as decongestants and dietary supplements
69
How do indirect adrenergic drugs (Amphetamines, cocaine, methylphenidate, SSRIs, TCA,s) work?
Block re-uptake of DA
70
What can food with tyramine do if taking an MAO inhibitor?
if taking an MAO inhibitor it gets into the blood stream and gets into nerve terminals and displaces NE
71
Non-selective alpha antagonists?
phenoxybenzamine, phentolamine | Orthostatic hypotension
72
What is tamsulosin?
Flomax, benign prostatic hypertrophy | alpha 1 antagonist

Human Disease and Therapeutics (4 decks)

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