CNS and drugs Flashcards
The autonomic involuntary nervous system has control over?
cardiovascular, digestive, respiratory, Genitourinary
How do medications effect the CNS?
by stimulating or suppressing the firing of neurons
what do CNS drugs do?
Increase sleep patterns, decrease anxiety, Elevate mood, decrease muscle spasms, decrease hyperactivity and Mania, management of psychotic symptoms, slows progression of chronic degradation disease of the brain, decrease pain, induction of anesthesia.
What Neurotransmitter is in adrenergic synapses?
Norepinephrine
where are adrenals synopsis located?
Abundant in the CNS and hypothalamus the limbic system and reticular activating system
What are two major neurotransmitters of the autonomic NS
ACh
and
NE
What does norepinephrine do
excites the brain, waking hours, likely plays a role with mood disorders depression and anxiety
Define cholinergic
capable of producing, altering, or releasing acetylcholine ACH
what do cholinergic synapses do?
They’re stimulatory
where are cholinergic synapse is located?
In the motor cortex and basal ganglia
what diseases are associated with cholinergic synopsis?
Parkinson’s and Alzheimer’s
Dopamine is the precursor to what?
The synthesis of norepinephrine
what does dopamine affect?
arousal and awake
what are subtypes of dopamine what do they do?
D1 is stimulatory D2 is inhibitory
what disease is related to dopamine imbalance
Parkinson’s
what are endorphins
small peptides secreted by neurons
what is gamma aminobutyric acid (GABA)
They are peptides which activate the body’s opiate receptors, causing an analgesic effect.
what is gamma aminobutyric acid (GABA)
naturally occurring amino acid that works as a neurotransmitter in your brain
where are GABA synopsis found
throughout the brain but in basal ganglia and hypothalamus second most common makes up about 30 to 40%
GABA is the primary what?
CNS inhibitor
what drugs are agonists to GABA synopsis?
Benzodiazepines, Barbiturates , and non-benzodiazepines
what is glutamate and what is it responsible for
Important for memory. It is a powerful excitatory neurotransmitter that is released by nerve cells in the brain. It is responsible for sending signals between nerve cells, and under normal conditions it plays an important role in learning and memory. Most common in the brain. Found everywhere, always excitatory, high amounts can be fatal.
Where are serotonergic synopsis found?
The brain but mostly found in platelets mast cells and other peripheral cells.
What is serotonin used for?
Making melatonin and helps with mood, feelings of well-being, and happiness
what happens in a person who has low levels of Serotonin?
Anxiety, impulsive behavior, especially prevalent in suicide attempts, depression
Serotonin is connected to what system in the brain?
The limbic system
What are the five types of anxiety?
Generalized (GAD), panic disorder, social anxiety disorder, OCD, PTSD.
what is associated with the limbic system
emotional expression learning and memory
what is associated with the rectangular activating system
function, stimulation-awake inhibition-asleep, works as a filter
What happens at the basal nuclei and ganglia
skeletal movement and cognitive function-memory learning and planning
extrapyramidal system
tracks from brain to spinal cord, controls voluntary muscles, and posture
Non-pharm treatments Psychotherapy-
Electroconvulsive Therapy, Phototherapy light therapy, repetitive transcranial magnetic stimulation, Vagus nerve stimulation.
These NT can enhance stabilize or elevated mood
serotonin
norepinephrine
GABA
acetylcholine
What antidepressants are most often used?
SSRI’s
what are the four primary classes of antidepressants
Recycling selective serotonin reuptake inhibitors atypical antidepressants monoamine oxidase inhibitors
what neurotransmitters are involved in depression
Serotonin, Norepinephrine GABA, Acetylcholine
TCA-prototype and onset action
impramine- tofranil
2-3 weeks
how does Imipramine work?
blocks reuptake of Serotonin and norepinephrine
adverse effects of imipramine
orthostatic hypertension dizziness, cholinergic effects, one seizure cardiac dysrhythmia and I heart failure Black Box warning suicidal thinking in younger patients
What do oral contraceptives do to impramine?
decrease therapeutic effect
contraindications of impramine
seizure and Suicidal Tendencies urinary retention cardiac hepatic her Parkinson’s
other uses of impramine
nocturnal enuresis, chronic pain, insomnia
SSRI prototype drug and onset time
Fluoxetine Prozac
2 weeks
Prozac adverse effects
N/V-May get better, sexual dysfunction, wait can take up to two weeks to see improvements, weight fluctuation
* no cholinergic effects or orthostatic hypotension
Prozac interactions
Serotonin syndrome grapefruit juice increase serum level, CYP450 drugs CNS depressants.
Prozac Black box
Black Box warning Suicidal Thoughts
What is serotonin syndrome
when multiple drugs are seeking not enhance serotonin which leads to serotonin concentration in the neurons
what is the biggest indicator that serotonin syndrome is occurring in a patient?
Changes in mental status
what other indicators show serotonin syndrome
restlessness dizziness vertigo Ataxia nausea and vomiting hypertension Tremors muscle rigidity sweating psychiatric symptoms hyperpyrexia
What are signs of Parkinson’s
stooped posture masked facial expression virginity forward tilt of trunk 6 elbows reduced arm swing slightly flexed hips and knees shuffling and trembling.
What are the Cardinal symptoms of Parkinson’s
Tremor muscle rigidity bradykinesia postural instability
what is the cause of Parkinson’s
degradation of dopamine-producing neurons ACH and dopamine balance each other out when there is no more dopamine acetylcholine will saturate the area and cause issues with muscle movement.
Name of drug that helps with Parkinson’s and what does it do?
Levodopa
anticholinergic drugs block ACH excitatory response decrease abnormal muscle movement
other uses of levodopa
manganese in CO2 poisoning
what are the adverse effects of levodopa
they can cause psychosis and patients nausea vomiting and the early stages orthostatic hypertension dyskinesia like head bobbing and ticks grimacing and jerking dark urine perspiration drooling
what are the drug interactions with levodopa
antipsychotics MAIOs TCAs antihypertensives and antacids
what’s paired with levodopa and what does it create
Carbidopa creates sinement
how do Carbidopa and levodopa work together?
Carbidopa has no therapeutic effect by itself it cannot cross the blood-brain barrier it inhibits the breakdown of levodopa in the intestines and peripheral tissues so more is available to reach the CNS
what is acute loss effects
when prolonged therapy of levodopa and Carbidopa start to lose effects you can adjust dosing intervals to offsets symptoms and increase in protein and vitamin B6 help.
