CNS Drugs I

Question 1

Dopamine dysfunction in the extrapyramidal motor, limbic cortex, and hypothalamus/pituitary result in?

Answer 1

Parkinsons, psychotic behavior, and suppressing prolactin release

Question 2

What action does GABA have on neurons?

Answer 2

inhibitory, can reduce risk of seizures

Question 3

What action does glutamate have on neurotransmitters?

Answer 3

excitatory; need to reduce this to reduce risk of seizures

Question 4

What are visceral controls of serotonin?

Answer 4

sleep, temp, appetite, neuroendocrine

Question 5

Some behavior disorders are associated with ____.

Answer 5

neurotransmitter imbalance

Question 6

Degeneration/generalized loss of neurons results in __.

Answer 6

dementia

Question 7

Degeneration of upper and lower motor neurons

Answer 7

amyotrophic lateral sclerosis

Question 8

Degeneration of extra-pyramidal motor neurons

Answer 8

Parkinson’s Disease

Question 9

Two examples of neural pathway disruptions

Answer 9

MS, GBS

Question 10

A newer understanding of Parkinson’s classifies it as a ___ _____ disorder.

Answer 10

chronic neurodegenerative

Question 11

The pathology of Parkinson’s is described as _______ in neostriatum.

Answer 11

reduced dopamine/acetylcholine ratio

Question 12

What drugs cause secondary Parkinson’s disease?

Answer 12

1st generation neuroleptics: phenathiazines, haloperidol

Question 13

What are some non-reversible 2ndary Parkinsons”

Answer 13

encephalitis (like from malaria), cerebral vascular incident, toxic

Question 14

What are the 6 main symptoms of Parkinson’s?

Answer 14

Bradykinesia, rigidity, tremors, postural instability, brief recovery in emergencies, mild-mod intellectual impairment

Question 15

Tx strategy for Parkinson’s?

Answer 15

improve dopamine/acetylcholine ratio; help control the symptoms

Question 16

Previous 1st choice pharm tx of Parkinsons

Answer 16

Levodopa/Carbidopa

Question 17

What are the 2 main adverse effects of Levodopa/Carbidopa?

Answer 17

involuntary movements. fluctuating effectiveness

Question 18

How does carbidopa work?

Answer 18

inhibits the breakdown of Levodopa

Question 19

What are the two classes of Dopaminergic Agonists?

Answer 19

Ergot and non-Ergots

Question 20

What is a bad side effect of Dopaminergic agents?

Answer 20

hallucinations; don’t use in ppl with psychosis

Question 21

What are the adverse effects in anticholingeric drugs?

Answer 21

blurred vision, urinary retention, mydriasis

Question 22

When are anticholingeric medications contraindicated for Parkinson use?

Answer 22

glaucoma, prostatic hypertrophy, dementia

Question 23

How do selective MAOIs work?

Answer 23

elevate dopamine levels, enhance levodopa/carbidopa

Question 24

Which isoform do we want to prevent blocking in MAOs?

Answer 24

A: degrades norepi and tyramine
B: degrades dopamine

Question 25

What happens if tyramine is not degraded?

Answer 25

HTN crisis

Question 26

What drug increases dopamine production and works best against bradykinesia?

Answer 26

Amantadine

Question 27

These drugs reduce levodopa degradation reducing on-off syndrome but can cause liver issues?

Answer 27

COMT- Inhibitors

Question 28

Most common form of Parkinson-associated dementia?

Answer 28

late-onset

Question 29

Early onset parkinson-associated dementia is linked to the production of these in the neurons?

Answer 29

Lewy body

Question 30

What stressful symptom is a sign of Lewy Body dementia?

Answer 30

frequent hallucinations

Question 31

What is associated with the reduced life expectancy of Parkinson's?

Answer 31

choking, aspiration pneumonia

Question 32

This disease is characterized by areas of demyelination in the CNS?

Answer 32

MS

Question 33

What are the 3 forms of MS?

Answer 33

relapse-remitting, primary, secondary progressive

Question 34

These drugs for MS are anti-viral and anti-neoplastic because they activate these immune components?

Answer 34

macrophages, natural killer cells, antigen presentation to T cells

Question 35

What is the main interferon toxicity?

Answer 35

neuropsychiatric

Question 36

What are IG therapy risks?

Answer 36

infectious disease, allergic reactions

Question 37

How do IGs work?

Answer 37

F*** up T cell jobs

Question 38

What are risk factors for Dementia?

Answer 38

age, females, head injury, chronic disease (atherosclerosis, diabetes)

Question 39

What are the causes of dementia?

Answer 39

Alzheimers, vascular, lewy body, frontotemporal, cerebral anoxia, vit b def, hypothyroid, chronic alcohol, immunodeficiency syndrome

Question 40

What pathophysiology is indicative of Alzheimers?

Answer 40

plaques and tangles

Question 41

What drugs are said to prevent Alzheimers?

Answer 41

statns, NSAIDs

Question 42

What drugs are used to tx Alzheimers?

Answer 42

Acetylcholinesterase inhibitors, NMDA antagonists

Question 43

What are side effects of acetycholinesterase drugs?

Answer 43

sweating, bladder issues, and more

Question 44

Are acetylcholinesterase inhibitors considered effective?

Answer 44

Effect is not dramatic

Question 45

This is a type of glutamate receptor.

Answer 45

NMDA

Question 46

Name examples of acetylcholinesterase inhibitors

Answer 46

Donepazil, Galantamine, Rivastigmine

Question 47

Name an example of NMDA antagonists.

Answer 47

Memantine

Question 48

What is the most common motor neurodegenerative disorder characterized by the progressive death of both upper and lower motor neurons?

Answer 48

Amyotrophic Lateral Sclerosis

Question 49

What drug is used for the tx of ALS? 2 types.

Answer 49

Riluzole- sodium channel blocker Edaravone- neuroprotective agent