CNS Disorders Flashcards
Which membrane in the brain are efflux transporters found?
Apical membrane
What is the role of tight junctions in the brain?
Regulate what passes between the brain
Efflux transporters encourage drug delivery to the brain. True or false?
False - they hinder drug delivery
How does someone get a stroke?
Blood vessel is occluded e.g. due to a clot or plaque fragment. This leads to a lack of nutrients and oxygen, resulting in cell death
What are the two areas of lesions?
umbra
penumbra
Is damage to the umbra reversible?
No - it is irreversible
Is damage to the penumbra reversible?
Yes - damage occurs however there is still potential recovery of the neurone
What is a tissue plasminogen activator (tPA)?
A protein found on endothelial cells - it is used in medicines to dissolve blood clots and treat stroke
What is an example of a tPA?
alteplase
What is the NICE recommendation of treating stroke with tPA?
ASAP and within 4.5 hours of symptom onset
What are the two types of stroke and which one is more common?
Ischaemic - more common
Haemorrhagic - less common - death is likely
What are the risk factors for stroke?
Hypertension Smoking Obesity Poor diet, lack of exercise Diabetes
Parkinson’s disease is idopathic. What is meant by that?
Don’t know what causes the disease
What happens in Parkinson’s disease?
Death of dopaminergic neurones - leads to lack of dopamine
What is the substantia nigra?
Part of the basal ganglia in the brain - important in reward and movement
Those that suffer from Parkinson’s disease experience tremors. What are they?
Uncontrolled movement
How can Parkinson’s disease be treated and what is an example of a drug that is used?
Replenish dopamine - Levodopa
What are the two forms of Alzheimer’s disease?
Early onset
Late onset
What age group tend to suffer from early onset Alzheimer’s disease?
Under 65 y/o (only 5% fall into this category)
What is Alzheimer’s disease?
Loss of brain material and volume
Physical reduction in brain size and activity
In patients with Alzheimer’s disease amyloid B aggregates to form _________ which aggregate to form plaques in the brain
oligomers
How many amino acids does the insoluble form of amyloid B have?
42
Alzheimer’s disease can be treated with drugs. True or false?
False - no effective treatment - treat symptoms
What class of drugs is used to treat symptoms of Alzheimer’s disease?
Acetylcholinesterase inhibitors
What happens to serotonin in someone who has depression?
It’s released into the synaptic cleft and instead of being broken down by an enzyme, it is transported back to the presynaptic neurone
What is the therapeutic target for depression?
Serotonin transporter
What class of drugs is used to treat depression?
Selective Serotonin Reuptake Inhibitors (SSRI)
What do SSRIs do?
Maintain serotonin in the synaptic cleft
What is astrocytoma?
Primary type of brain tumour
How can astrocytoma be treated?
Radiotherapy
Surgery and carmustine implants
Surgery and temozolimide
What is oligodendroglioma?
Cancer of the oligodendrocytes (which produce myelin)
What is ependymoma?
Cancer of the ependymal cells
Why is it difficult to deliver drugs to the brain?
BBB
Can’t increase dose due to toxicity issues
