week 10: CNS Drugs Flashcards
(69 cards)
What are “adaptive changes” and how does this contribute to tolerance and physical dependence?
Adaptive changes occur when the body physiologically adapts to adjust to the drug in the body.
What happens when drugs that elicit adaptive changes are abruptly discontinued?
When the drug is taken away abruptly, your body can go into a state of withdrawal but it’s known as abstinence syndrome due to the adaptive changes.
With Parkinson’s disease - what two NT do we manipulate with pharmacologic interventions?
Dopamine = decreases and this decrease acts as a inhibitory factor in the disease ACH = increases in this disease and acts as an excitatory
what neurotransmitter do you want to manipulate specifically for Parkinson’s through medication usually
we want to increase our dopamine and to do this we use dopamine agonists
3 groups of dopaminergic agents in the context of PD
- Levadopa
- MAO B
- Amantadine
- Dopamine agonist
what is the MOA of levodopa
- directly activates DA receptors
- SO this is a prodrug that needs to be converted to DA in the CNS BUT in order to do this we need to avoid three things (see below)
What MAO B
- we use this in mild to moderate cases
- prevents dopamine breakdown → which usually MAO B breaks down
- this is the 1st line drug because it is selective and reversible
- Selegiline
- Rasagline
what type of drug is a -giline (selegiline)
- prevents dopamine breakdown → which usually MAO B breaks down
- this is the 1st line drug because it is selective and reversible
what is the MOA amantadine
*promotes DA release and inhibits reuptake
what is the MOA Dopamine agonist
*ergot alkaloid = no selective DA receptors
*NON ergot alkaloid = SELECTIVE DA receptor
Act like dopamine
Less effective then L-Dopa BUT less risk of dyskinesia
what drugs are combined with levodopa
COMT inhibitors = carbidopa
Decarboxylase inhibitors = entacapone
what type of drug is carbidopa
COMT inhibitors
what type of drug is entacapone
Decarboxylase inhibitors
what else do you want to avoid with levodopa
Avoid high protein meals
why does levodopa need to be combine with other drugs in order to have an effect
SO this is a prodrug that needs to be converted to DA in the CNS BUT in order to do this we need to avoid three things
What is the difference between MAO-B & MAO-A?
MAO A breaks down serotonin and norepi = there is larger risk of HTN with these patients
MAO B breaks down dopamine = MORE SELECTIVE = so there is less risk of HTN when using a more selective drug
For cognitive impairment what drugs related to NT do we manipulate
AChE = INHIBIT NMDA = Antagonize
three AChE inhibitors commonly used in Alzheimer’s Disease
Donepezil = a reversible drug that is highly protein bound and CNS selective Galantamine = leads to reversible inhibition Rivastigmine = this drug is irreversible and has PNS effects
what class of drug is donepezil and what makes it special
an AChE inhibitor and is a reversible drug that is highly protein bound and CNS sensitive
what type of drug is galatamine
an ACHe inhibitor
this drug leads to reversible inhibition
what AChE inhibitor leads to reversible inhibition
Galantamine
what drug for alziehers leads irreversible and has PNS effects
Rivastigmine
what drug is associated with NMDA
Memantine
what AChE inhibitors is highly protein bound and CNS selective
Donepezil
