Central Nervous System Flashcards
Brain
Receives and processes sensory information, initiates responses, sores memories and generates thoughts and emotions
Three main neurotransmitters of the brain
Dopamine
Norepinephrine
Serotonin
Dopamine?
*Alertness
Clarity vs Ambiguity
Working memory vs Passive
Motivation vs hyper
Norepinephrine?
*concentration
Certainty/ doubt
Determination vs obsession
Recall memory vs dementia
Serotonin?
*Satisfaction
Relaxation vs insomnia
Pleasure vs anxiety
Learning memory vs disability
Dopamine and serotonin?
Appetite
Dopamine and norepinephrine?
Attention
Norepinephrine and serotonin?
Endurance
- all 3 makes a balanced mood
Medical use of CNS drugs
Relieve pain
Suppress disorders of movement or seizures
Induce sleep or arousal
Reduce the desire to eat
Inhibit motion sickness
Treat anxiety, mania, depression or schizophrenia
Schizophrenia
Caused by too much dopamine in the brain
Positive Symptoms of schizophrenia
Delusions
Hallucinations
Disorganised speech
Negative symptoms of schizophrenia
Flattened affect
Reduced speech
Lack of initiative
Antipsychotic
They all reduce dopaminergic neurotransmission
Treatment for schizophrenia
Medication for treatment
Psychotherapy
Typical antipsychotics
Known as the new generation
Can cause extrapyramidal motor control disabilities
Have more side effect
Have fewer withdrawal symptoms
Atypical antipsychotics
Known as new generation antipsychotic
Less likely to cause extrapyramidal motor control disabilities
Have fewer side effects
Have more withdrawal symptoms
Symptoms of hypomanic and manic episodes
Racing thoughts
Pressured speech
Increased distractibility
Increased energy and restlessness
Common bipolar treatments
Mood stabilisers
Antipsychotics
ECT
Talk therapy
Affective disorders
Mental illnesses characterised by pathological changes in mood
Unipolar disorders
Depression
Mania
Bipolar disorders
Major depressive episodes
Depression
Chemical dysfunction which causes reduced brain activity
Therapy for depression
Non-pharmacological treatment
Psychotherapy
Light therapy
Electro convulsive therapy
Deep brain stimulation
Classification of registered antidepressants
Tricyclic antidepressants
Tetracyclic antidepressants
Selective serotonin re-uptake inhibitors
Serotonin and norepinephrine re-uptake inhibitors
Serotonin receptor modulators
Noradrenaline and dopamine reuptake inhibitors
Lithium salts
Tricyclic antidepressants
Chemical structure with characteristic of a three ring nucleus
AMITRIPTYLINE
long half-lives
Principal mechanism of action
Blockade of re-uptake of neurotransmitters
Selective serotonin re-uptake inhibitor
*More modern and safer than TCA
*Principal mechanism of action: Selective inhibition of 5-HT(serotonin reuptake)
*Indication are generalised anxiety, panic disorder, social anxiety disorder , ocd, BN, gambling
Most important SSRIs
Fluoxetine(Prozac)
Citalopram(cipramil)
*long half lives
Serotonin and noradrenaline re-uptake inhibitors (SNRI)
Used to treat major depressive disorder, anxiety and panic disorders.
It is used off-label to treat migraine, diabetic neuropathy, and hot flashes
Serotonin receptor modulators(SRMs)
Trazodone (Molipaxin)
- at low doses, it acts as a serotonin antagonist, and acts as an agonist while at high doses
*strong sedative antidepressant- treat insomnia
Noradrenaline and dopamine re-uptake inhibitors
Bupropion
- acts as a reuptake inhibitor for the neurotransmitters norepinephrine and dopamine
*used for severe depression and smoking cessation treatment
* effects are insomnia, excitation, restlessness, lowers epilepsy threshold
Lithium
Prophylactic treatment in bipolar disorder
Effects- weight gain, GIT disturbances, alopecia
Interacts with thiazides to increase Li re absorption
Melatonergic antidepressants
Agomelatine
Rx of major depressive episodes in adults
Has no effect on sexual activity
No weight gain
Effects: hyperhidrosis, anxiety, and increased liver function tests
Vortioxetine
Rx of MDD
Takes long to work
To side effects
Enhance memory and learning
Sedative hypnotics
Benzodiazepines
Short action: triazolam
Intermediate action: alprazolam
Long action: flurazepam
Benzodiazepines pharmacologic effects
Anticonvulsant effects
Anterograde amnesia
Reduction muscle tone and coordination
Sedation and induction of sleep
Reduction in anxiety and aggression
Symptoms of benzodiazepine withdrawal
Anxiety
Depression
Insomnia
Irritability, anger or rage
Balance problems
Anti-epileptic drugs
Aim to inhibit the fast, repetitive neuronal discharges that characterise convulsion
Anti-epileptic drug
Carbamazepine (Tegretol)
Used to prevent and control seizures
Also relieve certain type of nerve pain
Can also treat mood disorders
Half lifemis 25-65 house with single dose
* may cause skin rashes, hepatitis, ataxia, sedation and confusion
Anti-epileptics
They are all teratogenic
*phenytoin
* carbamazepine
*Valproate
Opioids
Heroin
Morfine
Codeine
Fentanyl
Oxycodone
Opium
Poppy plant
Opiate are substances that are extracted from crude opium
Opioid are compound with morphine-like activity
