CNS II Flashcards
What does serotonin do in the body with regards to platelets? (What receptor)
5HT1= NO Excretion = Vasodilation
5HT2 = platelet aggregation and Vasoconstriciton
What does serotonin do in the body with regards to the cardiovascular system?
Complex physiological role due to roles of different receptor types on CNS, heart, blood vessels and endothelium
What does serotonin do in the body with regard to the airway inflammation (What receptor
Reduces airway due to 5HT-2 receptor activation, modulating the immune response
What does serotonin do in the body with regard to the Gi Tract
Stimulates and modulates enteric nervous system to activate smooth muscle, using several different receptor types
Which biogenic amines may be dysregulated in depression and anxiety?
Norepinephrine, serotonin and dopamine
What does Norepinephrine affect?
Energy Interests
What does dopamine affect?
Motivation/Reward
What does serotonin affect?
Appetite/Impulsive
What decreases Brain derived=neurotrophic factors?
Stress and pain
What is the drug reserpine? MOA
very old blood pressure drug, sedating and many side effects.
Prevents vesicular accumulation of serotonin.
Triptans (What receptor?)
used for migraines (ex.rizatriptan):
agonist at 5HT 1D/1B receptors to reduce pain signals and reduce vasodilation
MAOIs
Monoamine Oxidase Inhibitors
inhibit serotonin breakdown;older class of antidepressants, not first-line now
SSRIs/SNRIs/tricyclics (What receptor)/MOA
block 5HT reuptake at the synaptic cleft
Buspirone (What receptor)
anti-depressant, partial agonist at 5HT 1A receptors (different from SSRIs!)
Anti psychotic drugs (What receptor)
many block 5HT2A/C receptors as part of their mechanism
Anti-emetics (What receptor)
block 5HT3 receptors, which happens to be a sodium ion channel
What should you avoid when taking SSRIs?
Avoid with St. John’s wart and other serotonergic drugs due to risk of serotonin syndrome
What are SNRI used for?
major depression, generalized anxiety disorder and as an adjunct in chronic pain
What are SSRI used for?
The main therapy for: major depression, anxiety, panic attacks, OCD, PTSD
What are Serotonin Receptor antagonists used for?
Useful for depression and anxiety with insomnia
Serotonin Receptor antagonists are Less efficacious than SSRIs or SNRIs but
increase the antidepressant response when used in combination`
Bupropion
Inhibits NET, DAT, and alters VMAT2 to increase norepinephrine and dopamine
What is Buproprion used for?
Adjunctive or alternative antidepressant. Also used for smoking cessation, and potential use in ADHD but not 1st line.
What does Bupropion not do?
Does NOT increase serotonin
What are the issues with Tricyclic Antidepressants
Results in many side effects and lots of t1/2 variability
Why are MAOI not used?
toxicity and many drug interactions (sympathomimetics, TCAs, opioids, certain foods like hard cheese and red wine which contain tyramines)
Benzodiazepines
bind to GABA receptors, resulting in hyperpolarization.
Sedating and addictive effect
What do Cholesterase drugs block?
The breakdown of acetylcholine at the nerve synpase making it more available
What are the approved drugs for alzheimers treatment?
Cholinesterase inhibitors and NMDA receptor antagonists
What does lithium do?
Mood stabilizer
What does escitalopram and mirtazapine do?
Sedating and may help with appetite
What is methylphenidate?
stimulant
What is Carbamazepine and levetiracetam?
Anticonvulsants
What does Somatodendritic autoreceptors do?
Inhibit serotonin exocytosis
Which drugs have a a high rate of interaction?
monoamine oxidase inhibitors
