CNS

Question 1

D3 agonist

Answer 1

Pramipexole

Question 2

Block L-dopa metabolism in CNS dopamine

Answer 2

Tolcapone

Question 3

Antimuscarinic agents (benztropine) in Parkinsons improve symptoms except

Answer 3

Bradykinesia

Question 4

COMT inhibitors

Answer 4

Entacapone
Tolcapone

Question 5

TCAs

Answer 5

Amitriptyline
Clomipramine
Imipramine

Question 6

SNRIs (Serotonin-norepinephrine reuptake inhibitors)

Answer 6

Venlafaxine
Desvenlafaxine
Duloxetine

Question 7

Cannabinoid receptor agonist = Inverse agonist at CB1 receptors

Answer 7

RIMONABANT
(SE: major depression, increased suicide risk)
Treatment of obesity
Off-label use: Smoking cessation

Question 8

Melatonin receptor agonist

Answer 8

Ramelteon

Question 9

OPIOID RECEPTORS

Answer 9

Mu receptor = Endorphins > enkephalins > dynorphins
(Antagonist: Nalbuphine)
ENDORPHINS = Euphoria, sedation, physical dependence, tolerance

Delta receptor = Enkephalins > endorphins and dynorphins
(Antagonist: Buprenorphine)
ENKEPHALINS = antidepressant, antianxiety, decrease of colonic transit time

Kappa receptor = Dynorphins > > endorphins and enkephalins
(Antagonist: Buprenorphine – longest acting)
Elevated DYNORPHIN = increase pain/ hyperalgesia

Kappa-opioid receptor agonists = antipruritic agent

Nociceptin = structurally similar to dynorphin except for the absence of an N-terminal tyrosine; it acts only at the ORL1 receptor or NOP

NOP receptor ligands = modulation of drug reward, learning, mood, anxiety, and cough processes, and of parkinsonism

Question 10

Failure to speak in full sentences; difficulty in finding words

Answer 10

Dysnomia

Question 11

Correlate best with the severity of the dementia

Answer 11

Neurofibrillary tangles and quantitative neuronal loss

Question 12

3 microscopic changes in Alzheimer’s

Answer 12

1. Alzheimer neurofibrillary changes or “tangles”
2. Neuritic Plaques (beta-amyloid plaque)
3. Granulovacuolar degeneration of neurons

Question 13

N-methyl-D-aspartate (NMDA) receptor antagonist

Answer 13

MEMANTINE

Question 14

CHOLINESTERASE INHIBITORS used in Alzheimer’s

Answer 14

Donepezil
Rivastigmine
Galantamine)

Question 15

HUNTINGTON DISEASE (HUNTINGTON CHOREA) - Disease triad?

Answer 15

Dominant inheritance
Choreoathetosis
Dementia

Question 16

This gradual dilapidation of intellectual function has been characterized as a “subcortical dementia”

Answer 16

HUNTINGTON DISEASE (HUNTINGTON CHOREA)