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Y2 Neurology > Applied Neuropharmacology > Flashcards

Applied Neuropharmacology Flashcards

1
Q

how is ACh removed from the synaptic cleft ?

A

the anti-cholesterase enzyme breaks down ACh

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2
Q

how are most neurotransmitters removed from the synaptic cleft ?

A

inactivated neurotransmitters are uptake back into the glial or neurones

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3
Q

describe how an APs stimulate the release of neurotransmitters

A
  1. Na channels open as AP propagates down the neuron
  2. the Na triggers the voltage gated Ca channels to open
  3. this triggers the exocytosis of pre packaged vesicles of transmitter
  4. transmitter diffuses across the cleft to evoke a post synaptic response
  5. neurotransmitters are removed from the synaptic cleft
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4
Q

state the names of some neurotransmitters

A 
acetylcholine
amino acids 
purines 
neuropeptides 
NO 
monoamines
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5
Q

do all neurotransmitters act on the same area of the brain ?

A

no

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6
Q

do all neurotransmitters act on the same receptors in the brain ?

A

no

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7
Q

what are the three main areas which dopamine neurones are distributed around the brain ?

A
  • brain stem
  • basal ganglia
  • limbic system and frontal cortex
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8
Q

what physiological functions are controlled by dopamine neurones ?

A

vomiting
voluntary movements
emotions

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9
Q

what causes parkinsons disease?

A

degeneration of the DA cells in the nigrostriatal pathway

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10
Q

what is the nigrostriatal pathway ?

A

the pathway between the substantia nigra and the striatum (caudate and putamen)

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11
Q

when there is degeneration of DA neurones what does this result with?

A

there is less dopamine releases at the synapses as the neurones have been destroyed
- therefore there is loss in voluntary movements

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12
Q

what is the precursor of dopamine in its synthesis ?

A

glycine

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13
Q

is dopamine converted into other neurotransmitters ?

A

yes

- noradrenaline

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14
Q

state the three stages of dopamine synthesis ?

A

tyrosine -> DOPA - > dopamine

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15
Q

can tyrosine cross the BBB?

A

yes

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16
Q

can tyrosine in the brain be converted to dopamine ?

A

yes

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17
Q

giving patients more amino acid tyrosine, what effect would this have on parkinsons ?

A

would decrease the symptoms as they would be able to produce more dopamine

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18
Q

giving patients more DOPA, what effect would this have on parkinsons ?

A

would decrease the symptoms as they would be able to produce more dopamine

19
Q

can dopamine cross the BBB?

A

no

20
Q

what enzyme can be given to prevent dopamine being produced in the periphery to increase the dopamine in the brain?

A

aromatic amino acid decarboxylase

21
Q

what effect does increasing the dopamine concentration in the brain have on the symptoms of parkinsons ?

A

decrease the symptoms of parkinsons

22
Q

does dopamine have one effect on the brain ?

A

no
- there are 5 different receptors which cause different effects in different areas of the brain depending on which receptors are expressed

23
Q

what two enzymes break down dopamine ?

A

MAO-B

COMT

24
Q

what is the clinical significance of dopamine breakdown?

A

the enzymes which breakdown dopamine can be targeted for pharmacological purpose to increase the conc of dopamine in the body

25
Q

is there a cure for parkinsons ?

A

no

26
Q

what are the clinical signs of parkinsons ?

A

stiffness
slow movements
change in posture
tremor

27
Q

what dopaminergic drugs can be used to treat parkinsons ?

A

DA precursor

DA agonists

28
Q

state the name of the DA precursor?

A

levodopa

29
Q

how do DA agonists work ?

A

they mimic the dopamine and act on the dopaminergic receptors in the synaptic cleft

30
Q

state the three enzymes which can be inhibited to increase dopamine in the body?

A

peripheral AAAD inhibitors

MAOB inhibitors
COMT inhibitors

31
Q

what symptoms do dopaminergic drugs worsen ?

A

Brain stem effects

  • nausea
  • vomiting

Limbic system effects
- psychosis

32
Q

do dopaminergic drugs improve balance and cognition ?

A

no they only effect the rigidity and bradykinesia

33
Q

what type of drugs improve nausea, vomiting and psychosis?

A

dopamine antagonists

34
Q

do dopamine antagonists improve or worsen parkinsonism symptoms ?

A

Worsen

35
Q

what drug can be used for parkinsons patients to treat nausea and vomiting ?

A

domperidone

36
Q

why can domperidone be used in parkinsons patients ?

A

the drug doesn’t cross the BBB so doesn’t prevent dopamine transmission within the brain

37
Q

is domperidone an anti-emetic ?

A

yes

38
Q

can domperidone cross the BBB?

A

no

39
Q

what is dyskinesias ?

A

abnormal involuntary movements

40
Q

can DA antagonists cause parkinsonism symptoms ?

A

yes

41
Q

what disease can noradrenaline be used for?

A

depression

42
Q

what disease can serotonin be used for?

A

depression

migraine

43
Q

what disease can GABA be used for?

A

epilepsy

anxiety

Y2 Neurology (52 decks)

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