Central Nervous System Drugs

Question 1

What is Neuropharmacology?

Answer 1

Study of drugs that alter processes controlled by the nervous system.

Question 2

Axonal Conduction and Synaptic Transmission

Answer 2

Axonal Conduction - conducting an action potential down the axon of the neuron and only local anesthesia is capable of suppressing it.

Synaptic Transmission - process by which is carried across the gap between neuron and postsynaptic cell

Question 3

Central Nervous Drugs

Answer 3

• used for psychiatric disorders, suppression of seizures, relief of pain, production of anesthesia

Question 4

21 Compounds That Serves as Neurotransmitters in CNS Drugs

Answer 4

MONOAMINE
- Dopamine
- Epinephrine
- Serotonin

AMINO ACID
- Aspartate
- GABA
- Glutamate
- Glycine

PURINE
- Adenosine
- Adenosine mophosphate
- Adenosine triphosphate

OPIOID PEPTIDES
- Dynorphines
- Endorphines
- Enkaphalins

NONOPIOID PEPTIDES
- Neurotensin
- Oxytocin
- Somatostatin
- Substance P
- Vasopressin

OTHERS
-Acetylcholine
- Histamine GABA

Question 5

Blood Brain Barrier

Answer 5

• impedes the entry of drug into the brain
• passage is limited to lipid-soluble agents via specific transport systems
• protects the brain from injuries

Question 6

Attention Deficit/Hyperactivity Disorder (ADHD)

Answer 6

• Dysregulation of the transmitters serotonin, norepinephrine, dopamine
• Characteristics: inattentiveness, inability to concentrate, restlessness, hyperactivity, inability to complete tasks and impulsivity

Question 7

Narcolepsy

Answer 7

• Characterized by falling asleep during normal waking activities
• unable to move and may collapse
• medication may includes modafinil and methylprenidate

Question 8

A CNS Stimulants that stimulate the release of norepinephrine and dopamine from the brain and SNS

Answer 8

Amphetamines

Question 9

Parkinson’s Disease

Answer 9

• slowly progressive neurodegenerative disorder characterized by tremor, rigidity, postural instability and slowed movement.
• affects the extrapyramidal system which influences movement.
• we can help them by removing disregulated motor movements associated with it

Question 10

Dopaminergic Drugs

Answer 10

• first line medication
• directly or indirectly caus activation of dopamine receptors.

Question 11

Anticholinergic Agents

Answer 11

• drugs that block receptors for acetylcholine (ACh)

Question 12

Dopamine Replacement

Answer 12

• Converted to dopamine and activates dopamine receptors
• Levodopa/Carbidopa

Question 13

Dopamine Agonists

Answer 13

• directly activetes dopamine receptors
• pramipexole, ropinirole, bromocriptine

Question 14

Comt inhibitors

Answer 14

• inhibits breakdown of levodopa
• entacapone, tolcapone

Question 15

Dopamine Releaser

Answer 15

• Anti-viral but promotes release of dopamine
• amantadine

Question 16

Mao-B Inhibitors

Answer 16

• inhibits breakdown of dopamine
• selegiline, rasagiline

Question 17

Epilepsy

Answer 17

Group of disorders characterized by excessive excitability of neurons in the CNS

Question 18

Partial Seizures

Answer 18

Excitation undergoes limited spread from the focus to adjacent cortical areas.

Question 19

Generalized Seizures

Answer 19

Excitation spreads widely throughout both hemispheres of the brain

Question 20

Things to do when you see a patient experiencing a seizure beside the street or even inside the hospital (Seizure Precautions)

Answer 20

1. Remove all the objects or even crowds that might be dangerous when tonic clonic happens.
2. Loosen the clothing
3. Turn the patient to the side-lying position
4. Never put anything on patient’s mouth
5. Time the seizure if it’s more than 2 minutes call the ambulance

Question 21

Status Epilepticus

Answer 21

Seizure is more than 2-5 minutes

Question 22

Valproic Acid

Answer 22

Works on all types of seizures.

Question 23

Mechanism Action of Anti-Epileptic Drugs

Answer 23

• Suppress sodium
• suppress calcium influx
• antagonize glutamate
• potentiation of GABA

Question 24

Under Hydantoins, this kind of drug stabilize nerve cells to keep them from getting overexcited by increasing efflux or decreasing influx of sodium ions and most commonly prescribed anticonvulsant drug

Answer 24

PHENYTOIN

Question 25

A type of drug under Barbiturates that suppress seizures by potentiating the effects of GABA, effective against partial seizures and generalized tonic-clonic seizures but not absence seizures and can be used as daytime sedative ‘sleeping pills

Answer 25

Phenobarbital

Question 26

A type of drug under Iminostilbenes that supresses neuronal discharge by delaying recovery of sodium channels and has fewer side effects than phenytoin and phenobarbital.

Answer 26

Carbamazepine

Question 27

Under the therapeutic classifications as sedative-hypnotic and usually used as anti-anxiety medication but can also be the drug of choice for patients that has seizures.

Answer 27

Benzodiazepine

Question 28

Drugs under Benzodiazepine

Answer 28

Diazepam - restricted to acute treatment of status epilepticus (not recommended for long-term use due to high potential for addiction)
IV Lorazepam - DOC for acute management of status epilepticus
Clonazepam - treatment for absence, atypical absence seizure.

Question 29

Gabapentin

Answer 29

Bind to a carrier protein and act at a receptor resulting in increased GABA in the brain.

Question 30

Muscle Spasm

Answer 30

• involuntary contraction of a muscle or muscle group
• often painful and decreases level of functioning

Question 31

3 Classes of Acting Agent for Msule Spasm

Answer 31

1. Centrally-Acting Agent - treatment of acute muscle spasms caused by anxiety, pain and trauma and treat spasticity from conditions as MS and cerebral palsy
2. Direct-Acting Agent
3. Baclofen - mimics inhibitory actions of GABA in the CNS

Question 32

Neuromuscular Blocking Drugs

Answer 32

Relax skeletal muscles by disrupting the transmission of impulses at the motor end point

Question 33

Abstinence Syndrome

Answer 33

Major substances associated with substance use disorder such as alcohol, tobacco, etc.