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Pharmacology > Ch 12-19 > Flashcards

Ch 12-19 Flashcards

1
Q

Neuropharmacolocy

A

Study of drugs that alter processes controlled by the nervous system

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2
Q

How do neurons eleicit responses from other cells?

A

Through axonal conduction and synaptic transmission; effect depends on neurotransmitter and cell type; can modify processes such as skeletal muscle contracton, cardiac output, vascular tone and GI function.

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3
Q

Types of postsynaptic cell:

A

neurons, muscle cells or cells with a secretory gland

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4
Q

Axon conduction

A

process of conductin an action potential down the axon of a neuron; not sellective; e.g. local anesthetic

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5
Q

Synaptic Transmission

A

process by which information is carried accross gap b/n neuron and post-synaptic cell; requires release of neurotransmitter molecules and their binding to receptors on postsynaptic cell; sellective; includes most drugs

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6
Q

5 steps in synaptic transmission

A

1) synthesis,
2) storage
3) release
4) binding
5) termination

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7
Q

Sythesis

A

molecules of transmitter must be present in nerve terminal

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8
Q

storage

A

UNTIL TIME OF RELEASE IN VESICLES IN AXOM TERMINAL

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9
Q

release

A

VESICLES UNDERGO FUSION WITH THE TERMINAL MEMBERANE, RELEASING CONTENTS INTO SYNAPTIC GAP

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10
Q

Binding

A

is reversible

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11
Q

termination

A

3 possible processes:

1) reuptatke, 2) enymatic degradation
3) diffusion

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12
Q

T or F: The activation of a synaptic transmission will have an effect on a receptor funtion equivalent to that produced by the natural transmitter at a particular synapse.

A

True. And the drug can either increase or decrease recptor activation

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13
Q

3 ways inwhich drugs can effect transmitter synthesis

A

increase transmitter synthesis - storage vesicles hold transmitter in elevated amounts and when action potential reaches the axon terminal more transmitter will be released and available to receptors or postsynaptic dell, thus a hightened activation of receptors.

2) decrease transmitter synthesis
3) cause synthesis of transmitters more effective than the natural transmitter itself (super treanmitters).

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14
Q

Agonists

A

Drugs that cause direct activation

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15
Q

Antoagonists

A

Drugs that prevent direct activation

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16
Q

Name some drugs that cause activation:

A

morphine, epinepherine, insuline

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17
Q

Name some drugs that prevent activation:

A

Naloxone, antihistimines, propranolol (for hypertension)

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18
Q

Benzodiazepinesw do poisions act:

A

bbind to receptors and thereby enhance their activity

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19
Q

divisions of the PNS

A

somatic motor system (SMS) - voluntary muscle movement

Autonomic nervous system (ANS) - parasympathetic and sympathetic

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20
Q

Functions of ANS

A

regulate heart, regulate secretory glands, regulate smooth muscles

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21
Q

functions of parasympathetic nervous system

A

Cholinergic: housekeeping, energy conservation: slow heart rate, increase gastric secretions, empty bladder empty bowel, focus - near vision, constrict pupil, contract bronchial smooth muscle

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22
Q

How do poisons work?

A

They act by mimicking or blocking affects of PNS stimulation. i.e. insecticides or nerve gases.

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23
Q

Functions of sympathetic nervous system

A

Regulate cardiovascular system;
regulate body temperature
Fight or flight - increase HR and BP, shunt blood, dilate bronchi, dilate pupils, mobilize glucose

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24
Q

Main elements of feedback loop:

A

1) a sensor - to monitor status of a physiologic process
2) an effector
3) neurons connecting the sensor to the effector

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25
Q

3 homeostatic objectives of the sympathetic nervous system

A

Maintenance of blood flow to the brain
Redistribution of blood flow during exercise
Compensation for loss of blood, primarily by causing vasoconstriction

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26
Q

3 ways inwhich sympathetic nervous system regulates body temp:

A

1) regulating blood flow to the skin; by dilating surce vessels, sympthtic nerves increase blood flo to the skin and accelerate heat loss, or by constricting cutaneous vessels they conserve heat
2) nerves to sweat glands promote secretion of sweat for cooling
3) inducing piloerection to promote heat conservation

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27
Q

Baroreceptor reflex

A

Feedback loop of autonomic nervous system that helps regulate blood pressure; most important feedback loop of the ANS from a pharmacologic perspective; frequently opposes attempts to modify BP with drugs.

28
Q

Process of baroreceptor relex

A

1) Baroreceptors located in carotid sinus and aortic arch monitor changes in blood pressure and send info to brain;
2) in response, the brain sends impulses along nerves of autonomic nervous system, instructing heart and blood vessels to restore BP to normal

29
Q

Autonomic tone

A
  • the steady, day-to-day influence exerted by autonomic nervous system on a particular organ or organ system; provides a basal level of control over which relex regulation is superimposed,
30
Q

Which nervous system is the predominant tone for the vascular system?

A

he sympathetic nervous system.

31
Q

Most organs rely on which nervous system to provide the predominant tone?

A

The parasympathetic nervous system

32
Q

3 patterns of autonomic innervation and regulation:

A

Innervation by both divisions of the ANS in which the effects of the 2 divisions are opposed
Innervation by both divisions of the autonomic nervous system in which the effects of the 2 are complementary
Innervation and regulation by only one

33
Q

The general sites where drugs can affect the sympathetic and parasympathetic nervous systems:

A

1) the synapses b/n preganglionic and postganglionic neurons (includes adrenal meddula for sympathetic) and
2) the junctions between postganglionic neurons and their effector organs

34
Q

Sympatholitic
(sympathetic antagonists)
(andronergic antagonists)

A

Drugs that decrease or block sympathetic nervous system response

35
Q

Parasympatholitic

A

Drugs that decrease or block parasympathetic nervous system responses

36
Q

T or F: Drugs that affect the autonomic system, affect many organ and have many uses.

A

True

37
Q

Beta receptors are on the ____and on the ____, and alpha receptors are on the ______.

A

heart and lungs, receptors on the blood vessels

38
Q

The sympathetic system, in response to a stimulus, will send epinephrine to shut down blood flow to the _____.

A
  • gastrointestinal tract
39
Q

Albuterol

A
  • an adrenergic beta2 agonist used in asthma for bronchodilation; also causes rise in HR and BP.
40
Q

Beta blockers are drugs often used to treat ______ and _____.

A

= high blood pressure and high eye pressure (glaucoma); main concern is bronchospasms in asthmatics b/s it constricts the lungs as well as the blood vessels to heart and eyes.

41
Q

In parasympathetic nervous system, ______ binds to ______.

A
  • acytelcholine, muscarinic receptors.
42
Q

Bethanechol is a _____.

A
  • cholinergic, muscarinic agonist; used to stimulate BM and urine output
43
Q

Indirect cholinergic agonism

A
  • Acetylcholinesterase inhibitors block breakdown of acetylcholine to increase its levels
44
Q

The suffix for names of Acetylcholinesterase inhibbitors

A

“-ygmine”

45
Q

Atropinecholinergic

A
  • a cholinergic muscarenic antagonist; or an anticholinergic; or an antimuscarenic; or a parasympatholytic
46
Q

Uses of Atropine

A
  • speed up HR
  • used as an antidote for organophosphate poisoning
  • used to treat diarrhea
47
Q

Mydriasis

A

-dilating the pupils; can be done with sympathomimetic adrenergic drugs or anticholinergic parasympatholytic drugs

48
Q

Myosis

A
  • constricting the pupils; can be done with sympatholytic adrenergic antagonist drugs or cholinergic parasympathomimetic drugs
49
Q

Adrenergic blockers or cholinergic drugs can ____ lacrimal glands to _____.

A

stiumlate lacrimal glands to make tears

50
Q

Inotropes

A
  • drugs that increase the force of contraction
51
Q

Etiology of Parkinson’s is idiopathic but some possible causes are:

A
  • Oxidative damage
  • Environmental toxins
  • Genetic predisposition
  • Accelerated aging
  • Drugs
52
Q

Discuss the dopamine/acetylcholine imballance in Parkinson’s:

A
  • There is too little dopamine to inhibit neurons that release gamma-aminobutyric acid (GABA).
  • There is too much ACh compared with dopamine, and the ACh excites the neurons that release GABA.
  • The excess GABA causes the movement disorder.
53
Q

The relative ACh excess in Parkinson’s disease also causes:

A
  • diaphoresis, excess sebaceous secretion, salivation, lacrimation, constipation, prolonged urination and urinary incontinence.
54
Q

Anticholinergic agents cause these CNS side effects in the elderly

A

(confusion, sedation, delirium, hallucinations),

55
Q

Patients taking anticholinergic drugs for Parkinson’s disease should be warned of and assessed for the following side effects:

A
  • Dry mouth
  • Blurred vision, photophobia, and increased intraocular pressure
  • Urinary retention and constipation
  • Tachycardia
56
Q

Dopaminergic drugs ______ the balance between dopamine and ACh in the CNS

A
  • help restore
57
Q

5 categories of dopaminergic drugs

A
  • Dopamine replacement
  • Dopamine agonist
  • Dopamine releaser
  • Catecholamine-O-methyltransferase (COMT) inhibitor
  • Monoamine oxidase–B (MAO-B) inhibitor
58
Q

_______ (e.g., donepezil [Aricept]) are FDA approved for the treatment of Alzheimer’s disease, but only slow the disease by a few months.

A

Cholinesterase inhibitors

59
Q

Risk factors/ concerns with Cholinesterase inhibitors

A
  • The drugs increase ACh and enhance transmission in remaining healthy neurons only.
  • Systemic cholinergic effect can cause nausea, vomiting, dyspepsia, diarrhea, dizziness, headache, and bronchoconstriction.
  • The drugs have vagotonic effects on the sinoatrial and atrioventricular (AV) nodes; they can cause bradycardia and AV block.
  • Cholinergic effects can cause gastrointestinal (GI) bleeding, especially in those with a history of ulcer and those taking nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Anticholinergic drugs such as sedating antihistamines, tricyclic antidepressants and bladder control drugs reduce response and can worsen dementia.
  • About 70% of patients will not respond. Those who do have only minimal improvements in memory and reasoning for a short time (months).
  • Doses must be slowly titrated up until side effects are intolerable. Doses should be slowly tapered down when the drug is no longer effective to avoid rapid disease progression.
60
Q

Memantine (Namenda) increases glutamate in the brain by blocking its ability to bind to the NMDA receptor. Glutamate is a neurotransmitter that has been associated with learning and memory. Memantine is FDA approved for use alone or in combination with cholinergic agents in the treatment of Alzheimer’s disease. Memantine improves cognition to a small extent and slows the rate of cognitive decline. What does NMDA stand for?

A

N-methyl-Daspartate (NMDA) Antagonists

61
Q

Seizures are caused by ….

A
  • spontaneous, uncontrolled, transitory, and disorganized discharges of hyperexcitable neurons in a specific area (focus) in the brain
62
Q

There are two basic problems in a seizure:

A
  • An abnormal focus of discharge origin

* An abnormal spread of the discharge across the brain

63
Q

antiepileptic drugs [AEDs])

A
  • antiseizure drugs; work by way of a number of different mechanisms involving sodium channels and GABA and glutamate neurons.
64
Q

most common 1st generation AEDs

A
  1. Phenytoin (Dilantin)
  2. Fosphenytoin (Cerebyx)
  3. Phenobarbital and phenobarbital prodrug primidone (Mysoline)
  4. Carbamazepine (Tegretol, Carbatrol)
  5. Valproic acid (Depakene, Depakote, Depacon)
  6. Ethosuximide (Zarontin)
65
Q

examples of 2nd generation AEDs

A
  • Oxcarbazepine (Trileptal)
  • Lamotrigine (Lamictal)
  • Gabapentin (Neurontin)
  • Pregabalin (Lyrica)
  • Topiramate (Topamax)
  • Levetiracetam (Keppra)
66
Q

Diazepam

A
  • a benzodiazepine used for sedative, muscle relaxant, anxiolytic and AED activity.

Pharmacology (6 decks)

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