CNS disorders (Prof. Dickenson) Flashcards
What CNS disorders are linked to an increase in CNS fct ?
- Pain
- Epilepsy
- Anxiety
- Schizoprenia +ve symptoms
What CNS disorders are linked to decreased CNS activity ?
- Depression
- Parkinson’s
- Alzheimer’s
- Schizoprenia -ve symptoms
Do we have knwon treatments for:
- strokes ?
- PD ?
- AD ?
- Strokes: could be anywhere
- PD –> known pathway, DA treatable
- AD –> known regions, ACh but poorly controlled
What are the 4 steps of the life of a NT ?
- Synthesis
- Release
- Effects
- Removal
How could epilepsy be treated ?
- Epilepsy = excess activity –> need to restore balance
- Increase inhibition (GABA)
- Reduce excitation –> block ion channels (NA+ and Ca2+), block Glu receptors etc.
How could pain be treated ?
- Pain = excess activity
- Increase inhibition –> opioids
- Reduce excitation –> block ion channels / Glu receptors / peripheral pain mediators (prostoglandins) etc.
How could PD be treated ?
Add L-DOPA (=DA precursor) or a DA2R agonist + prevent DA breakdown:
- Selegiline –> blocks DA breakdown in the CNS
- Carbidopa –> blocks L-DOPA breakdown outside the CNS
How could depression be treated ?
Block reuptake of excitatory NTS.
How could Schizophrenia be treated ?
Add a DA antagonist (+ Glu agonist ?)
How do cocaine and NMDA work ?
By blocking excitatory NT reuptake.
How do heroin, nictotine, cannabis and LSD work ?
Mainly on post-synaptic inhibitory receptors.
What are the problems w/ CNS drug therapy ?
- Multiple receptors for NTs
- Actions at multiple sites
- Receptor up/down regulation to drugs
- Blood brain barrier
- Long term changes
- Co-existence of NTs
What are the symptoms of epilepsy ?
- Generalized seizures
- Partial seizures
- Absence seizures
- Movement
- Stiffness
- Jerking
- Consciousness
What causes epilepsy ?
Which drugs could be used treat it ?
Abnormal activity (excess excitation + lack of inhibition) in parts of the brain that control mvnt.
Enhancing inhibition:
Barbiturates –> phenobarbital: Cl- channel open
Benzodiazepines –> diazepam: modulates R, blocks GABA uptake/breakdown
Reducing excitation:
Na channel blockers –> carbamazepine, phenytoin
Ca channel blockers –> gabapentin
What is the main risks associated w/ epileptic drug therapy ?
Sedation.
What are the different (negative) forms that anxiety can take ?
- Panic
- Phobias
- Obsessive-compulsive disorders
- Post-traumatic stress
How can anxiety be treated ?
- Enhance GABA-A fct –> benzodiazepines
- enhance 5-HT inhibitory fct –> buspirone
What are the symptoms of Schizophrenia ?
What causes this symptoms ?
Agitation, paranoia, hallucinations, delusions, withdrawal, poverty of speech,catatonia
Comes from an excess of DA
How could Schizophrenia be treated ?
Reducing DA fct:
- DA 2 receptor blockers –> chlorpromazine
- clozapine –> 5-HT also ?
What are the risks of Schizophrenia drug therapies ?
Motor disorders, sedation, flatness of mood, and may trigger PD like effects…
What are the symptoms of PD ?
What is the cause of the disease ?
Motor disorder: tremor, rigidity.
Reduced DA fct.
What are the risks of PD drugs therapies ?
They can cause nausea and psychosis.
What are the symptoms of AD ?
- Loss of neurons (Amyloid-beta plaques, neurofibrillary tangles)
- Loss of memory
- Cognition
- Loss of comprehension
- Speech disorders
- Agitation
What is the issue w/ ACh treatments in AD ?
Tachrine blocks AChesterases (AChE).
But these drugs affects NM and autonomic fcts as well.
