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Thera XI > 04 CNS Review Alkana > Flashcards

04 CNS Review Alkana Flashcards

1
Q

What is Parkinson disease pathology?

A

Striatal dopamine deficiency syndrome, less than 10% brain DA in basal ganglia (normally 80%)

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2
Q

What is Parkinson disease treatment designed to do?

A

Restore DA/ACh balance

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3
Q

What is the DOC for Parkinson Disease?

A

l-Dopa (plus peripheral decarboxlase inhibitor

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4
Q

What is the peripheral COMT inhibitor used?

A

Tolcapone

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5
Q

What is the DA potentiator used?

A

Amantadine

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6
Q

What is the DA receptor agonist used?

A

Bromociptine

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7
Q

What is the MOA-B inhibitor used?

A

Eldepryl

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8
Q

Parkinson Disease is believed to reflect destruction of what?

A

Dopaminergic cells in the substantia nigra

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9
Q

The therapeutic effects of l-dopa in PD results from increasing brain ______ and its action on ____ receptors?

A

Dopamine; D2

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10
Q

The mechanism of action of Pramipexole (Mirapex) in the treatment of PD is what?

A

Agonist action on D2 receptors

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11
Q

Classical antipsychotic medications are believed to produce their therapeutic effects by blocking what receptors?

A

D2

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12
Q

Classical antipsychotic medications are believed to produce many adverse effects by blocking what receptors?

A

D2

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13
Q

Atypical antipsychotic medications are believed to produce their therapeutic effects by blocking what receptors?

A

5HT2 (the thinking has shifted now to believe that its main mechanism is blocking D2)

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14
Q

Pseudoparkinsonism side effects from Haloperidol is most likely caused because of the blockade what receptors?

A

D2 receptors

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15
Q

What does traditional neurochemical theory propose that Schizophrenia is caused by?

A

Excess limbic dopaminergic (DA) function

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16
Q

What is the significant advantage of second generation antipsychotic agents?

A

Less EPS (<1% tardive dyskinesias)

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17
Q

What is the significant disadvantage of second generation antipsychotic agents?

A

Metabolic effects (weight gain; dyslipidemia, impaired glucose-insulin homeostasis)

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18
Q

For antipsychotic treatment, what two receptor binding may induce cascades that offset adverse effects and increase therapeutic effects?

A

Anticholinergic and 5HT2

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19
Q

The onset of therapeutic effects of atypical antidepressants corresponds best to?

A

Delayed autoreceptor desensitization and increase 5HT and/or NE

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20
Q

A primary therapeutic advantage of second generation vs. first generation antidepressants is?

A

Reduced affinity for mACh and adrenergic receptors (these are the receptors that cause the side effects, otherwise both generations are similar in their affinity for 5HT and NE transporters)

21
Q

What happens with DA transporter blockade?

A

Associated with stimulant rather than antidepressant action

22
Q

What are the three steps in therapeutic effect for antidepressants?

A

First (initial (acute): blocks reuptake of NE and/or 5HT via action on transporter protein). Second (compensatory change to offset blockade (downregulation of transmitter)). Third (delayed - autoreceptor desensitization, upregulation, increase synthesis and release of transmitter)

23
Q

The anxiolytic lorazepam is thought to reduce anxiety by acting as an agonist on _____ receptors?

A

GABA** Slide 78

24
Q

Benzodiazepines are believed to reduce the symptoms of anxiety by?

A

Potentiating GABAa receptors

25
Q

The onset of therapeutic action or effect of SSRIs in treating anxiety disorders corresponds best to?

A

Delayed autoreceptor desensitization and increase 5HT and/or NE

26
Q

Buspirone is believed to reduce the symptoms of anxiety by?

A

Agonist/partial agonist action on 5HT1A receptors

27
Q

What are some fast onset (can be used PRN) drugs to treat anxiety?

A

Benzos. Beta adrenergic antagonists. Antihistamines

28
Q

The onset of therapeutic action or effect of SSRIs in treating anxiety disorders corresponds best to?

A

Delayed autoreceptor desensitization and increase 5HT and/or NE

29
Q

Alcohol is metabolized to _____, which is toxic and can cause flushing

A

Acetaldehyde

30
Q

_____ is a signal of problem drinking?

A

Needing alcohol to cope with daily circumstances

31
Q

Current theories suggest that alcohol cause its sedative, anxiolytic and amnesic effect by_____?

A

Potentiating GABAergic activity in the brain

32
Q

Alcohol dependence is characterized by _____ when alcohol is abruptly discontinued?

A

CNS excitability

33
Q

Women may be more sensitive to the acute and chronic effects of alcohol than men because women have ______ than men?

A

Less active gastric ADH

34
Q

Individuals who lack _____ suffer flushing and other reactions when they drink alcohol because of the buildup of ______

A

AlDH; Acetaldehyde

35
Q

Anti-Heartburn medications like Ranitidine (Zantac) and Famotidine (Pepsid) may block or reduce the flush reaction in individuals who lack ______ by blocking the formation of acetaldehyde from ethanol by _____

A

AlDH2 (form that works very quickly, found in mitochondria); ADH

36
Q

Release of _____ in the brain is believed to be the final common pathway mediating the rewarding effects of alcohol and other drugs of abuse?

A

Dopamine

37
Q

Current theories suggest that Naltrexone reduces ethanol stimulation and euphoria by ________?

A

Antagonizing the effects of ethanol mediated by endogenous opiate receptors

38
Q

The highest risk for causing ethanol-induced brain damage in the fetus occurs with ethanol exposure during ______ of pregnancy?

A

The fist trimester

39
Q

Ethanol can markedly increase the hepatotoxic effect of ______ by inducing ____ with a resultant increase in the production of a hepatotoxic metabolite

A

APAP; CYP 2E1

40
Q

What are the two types of treatments for alcoholism?

A

Disulfiram (Antabuse), Anxiolytics (e.g. Benozs), Glutamate Receptor Modulation (Acamprosate (Campral))

41
Q

How does Disulfiram (Antabuse) work?

A

Inactivates aldehyde dehydrogenase –> acetaldehyde build-up. Crutch to reduce intake. Dangerous adverse effects

42
Q

How does Acamprosate (Campral) work?

A

Reduces craving. Caution in renal impaired

43
Q

Triazolam (Halcion) is a/an ______?

A

Non-selective BZ receptor agonist

44
Q

Zolpidem (Ambien) is a _______?

A

Selective BZ1 non-BZ receptor agonist

45
Q

Rozerem (Ramelteon) is a ________?

A

MT1 and MT2 receptor agonist

46
Q

How do BZ receptor antagonists (Flumazenil (Romazicon)) work for sleep disorders?

A

Blocks BZ non-selective and BZ1 selective agents

47
Q

Marijuana may induce a neuroprotective effect by agonist action on _____ receptors which reduces ____ release

A

CB1; Glu

48
Q

LSD may induce its psychoactive effects by acting as a _____ on ______ receptors

A

Agonist-partial agonist; 5HT2A

Thera XI (16 decks)

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