CNS Drugs I Flashcards
Exam 2
Dopamine dysfunction in the extrapyramidal motor, limbic cortex, and hypothalamus/pituitary result in?
Parkinsons, psychotic behavior, and suppressing prolactin release
What action does GABA have on neurons?
inhibitory, can reduce risk of seizures
What action does glutamate have on neurotransmitters?
excitatory; need to reduce this to reduce risk of seizures
What are visceral controls of serotonin?
sleep, temp, appetite, neuroendocrine
Some behavior disorders are associated with ____.
neurotransmitter imbalance
Degeneration/generalized loss of neurons results in __.
dementia
Degeneration of upper and lower motor neurons
amyotrophic lateral sclerosis
Degeneration of extra-pyramidal motor neurons
Parkinson’s Disease
Two examples of neural pathway disruptions
MS, GBS
A newer understanding of Parkinson’s classifies it as a ___ _____ disorder.
chronic neurodegenerative
The pathology of Parkinson’s is described as _______ in neostriatum.
reduced dopamine/acetylcholine ratio
What drugs cause secondary Parkinson’s disease?
1st generation neuroleptics: phenathiazines, haloperidol
What are some non-reversible 2ndary Parkinsons”
encephalitis (like from malaria), cerebral vascular incident, toxic
What are the 6 main symptoms of Parkinson’s?
Bradykinesia, rigidity, tremors, postural instability, brief recovery in emergencies, mild-mod intellectual impairment
Tx strategy for Parkinson’s?
improve dopamine/acetylcholine ratio; help control the symptoms
Previous 1st choice pharm tx of Parkinsons
Levodopa/Carbidopa
What are the 2 main adverse effects of Levodopa/Carbidopa?
involuntary movements. fluctuating effectiveness
How does carbidopa work?
inhibits the breakdown of Levodopa
What are the two classes of Dopaminergic Agonists?
Ergot and non-Ergots
What is a bad side effect of Dopaminergic agents?
hallucinations; don’t use in ppl with psychosis
What are the adverse effects in anticholingeric drugs?
blurred vision, urinary retention, mydriasis
When are anticholingeric medications contraindicated for Parkinson use?
glaucoma, prostatic hypertrophy, dementia
How do selective MAOIs work?
elevate dopamine levels, enhance levodopa/carbidopa
Which isoform do we want to prevent blocking in MAOs?
A: degrades norepi and tyramine
B: degrades dopamine
What happens if tyramine is not degraded?
HTN crisis
What drug increases dopamine production and works best against bradykinesia?
Amantadine
These drugs reduce levodopa degradation reducing on-off syndrome but can cause liver issues?
COMT- Inhibitors
Most common form of Parkinson-associated dementia?
late-onset
Early onset parkinson-associated dementia is linked to the production of these in the neurons?
Lewy body
What stressful symptom is a sign of Lewy Body dementia?
frequent hallucinations
What is associated with the reduced life expectancy of Parkinson’s?
choking, aspiration pneumonia
This disease is characterized by areas of demyelination in the CNS?
MS
What are the 3 forms of MS?
relapse-remitting, primary, secondary progressive
These drugs for MS are anti-viral and anti-neoplastic because they activate these immune components?
macrophages, natural killer cells, antigen presentation to T cells
What is the main interferon toxicity?
neuropsychiatric
What are IG therapy risks?
infectious disease, allergic reactions
How do IGs work?
F*** up T cell jobs
What are risk factors for Dementia?
age, females, head injury, chronic disease (atherosclerosis, diabetes)
What are the causes of dementia?
Alzheimers, vascular, lewy body, frontotemporal, cerebral anoxia, vit b def, hypothyroid, chronic alcohol, immunodeficiency syndrome
What pathophysiology is indicative of Alzheimers?
plaques and tangles
What drugs are said to prevent Alzheimers?
statns, NSAIDs
What drugs are used to tx Alzheimers?
Acetylcholinesterase inhibitors, NMDA antagonists
What are side effects of acetycholinesterase drugs?
sweating, bladder issues, and more
Are acetylcholinesterase inhibitors considered effective?
Effect is not dramatic
This is a type of glutamate receptor.
NMDA
Name examples of acetylcholinesterase inhibitors
Donepazil, Galantamine, Rivastigmine
Name an example of NMDA antagonists.
Memantine
What is the most common motor neurodegenerative disorder characterized by the progressive death of both upper and lower motor neurons?
Amyotrophic Lateral Sclerosis
What drug is used for the tx of ALS? 2 types.
Riluzole- sodium channel blocker
Edaravone- neuroprotective agent