CNS Pharamacology Flashcards
Name some fast acting drugs on the CNS?
Anaesthetics
Nicotine
Cocaine
Name some slow acting drugs on the CNS.
Antidepressants
Antipsychotics
- several weeks before beneficial effects occur
What is the function of the blood brain barrier?
Maintain a constant environment
Protect the brain from foreign substances
Protect the brain from peripheral transmitters
Name an area of the brain located outside the BBB?
Area postrema - vomit reflex
Name some things that can damage the BBB.
Hypertension
Infection
Trauma
What can happen if the BBB is compromised?
Substance can enter the CNS and cause toxicity
- even prescribed drugs can become dangerous
Which drugs of the CNS are administered enterally and parenterally?
Enteral - lipophylic drugs Parenteral - invasive routes (intrathecal) - meningitis antibiotics - opiate analgesics - regional anaesthetic (epidural)
Name some approaches that can be administered to aid drug entry to the CNS.
Prodrugs (L-DOPA)
Carrier molecules
Transient BBB disruption (mannitol)
Define anaesthetic agents
Drugs used to produce surgical anaesthesia
Give some examples of analgesic agents.
Halothane
Desflurane
Esflourane
Propofol
Define anxiolytics and sedatives
Drugs that cause sleep and reduce anxiety
Synonymous with - hypnotics, sedatives, minor tranquillisers
Give some examples of sedatives.
Barbiturates
Benzodiazepines
Define antipsychotic drugs.
Drugs that are effective in relieving the symptoms of schizophrenic illness (a.k.a. Neuroleptics, antischizophrenics, major tranquillisers)
Gives some examples of antipsychotics drugs.
Clozapine
Chlorpromazine
Haloperidol
Define anti-depressive drugs.
Drugs that alleviate the symptoms of depressive illness
Can also be known as thymoleptics
Give some examples of anti-depressive drugs.
Monoamine oxidase inhibitor (phenelzine)
Tricyclic antidepressants (imipramine)
SSRIs (fluoxetine)
Acute (ketamine)
Define analgesic drugs.
Drugs used clinically for the alleviation of pain (painkillers)
Give some examples of some analgesics.
NSAIDs
Opiates
Carbamazepine
Define psychomotor stimulants.
Drugs that cause wakefulness and euphoria (psychostimulants)
Give some examples of psychomotor stimulants.
Methyphenidate (Ritalin)
Amphetamine (vyvanse)
Cocaine
Caffeine
Define psychotomimetic drugs.
Drugs that cause disturbance of perception and of behaviour that can’t simply be characterised as sedative or stimulant effects.
Also known as hallucinogenic and psychodyspletics
Give some examples of psychotomimetic drugs.
LSD
Marijuana
Mescaline
Phencyclidine
Define cognition enhancer drugs.
Drugs that improve memory and cognitive performance
Give some examples of cognition enhancer drugs.
Tacrine
Donepezil
Name some CNS drugs that don’t fit into a specific category.
Anti-Parkinson drugs
Anti-epilepsy drugs
Drugs to treat addiction and dependence
Lithium
List the neurological diseases that CNS drugs can be used to treat.
Epilepsy Dementia Pain Movement disorders (PD, HD) Pain (neuropathic) Stroke
List the psychiatric diseases that CNS drugs can be used to treat
Depression
Schizophrenia
Anxiety
Sleep disorders
List some other diseases that CNS drugs can help to treat.
Motion sickness
Fever
General anaesthetic
What is the function of dopamine in the nigrostriatal system, and what do disorders of it cause.
Motor control
Parkinson’s
What is the function of dopamine in the mesolimbic/cortical system, and what do disorders of it cause.
Behavioural effects
Schizophrenia
What is the function of dopamine in the tuberohypopyseal system, and what do disorders of it cause.
Suppresses prolactin release
Galactorrhea
What is the function of dopamine in the medulla, and what do disorders of it cause.
Vomit response
Vomiting
What are the main three characteristics of Parkinson’s disease?
Rigidity
Tremor
Bradykinesia
What are the possible causes of degeneration of the nigrostriatal system/Parkinson’s disease?
Genetics - Parkin and other risk genes
Age, can accompany dementia
Infection, ischaemia
Environmental risk factors - toxins, herbicides, pesticides
What therapies are used in Parkinson’s?
Therapies that enhance dopaminergic signalling in the pathway
- replace dopamine (L-DOPA)
- mimic the action of dopamine (D2/3 agonists - bromocriptine)
- reduce breakdown of dopamine (MAOIs - selegiline)
- increase dopamine release from remaining fibres (amantadine)
What are the positive and negative symptoms of schizophrenia?
Positive - delusions, hallucinations, thought disorders
Negative - social withdrawal, emotional flattening, reduced drive, poverty of speech, inability to feel pleasure
Describe the pathophysiology of schizophrenia briefly.
Environmental and genetic factors leading to abnormalities of the cerebral cortex
Alterations in various neurotransmitter systems (dopamine, 5HT, glutamate, GABA)
What is the dopamine theory?
Development of psychotic symptoms can be associated with abnormalities in the mesocortical/limbic pathways
Drugs which deplete dopamine have an antipsychotic action
Drugs which release dopamine generate psychotic symptoms
- needs to be a balance
What are the possible treatment options for schizophrenia?
All antipsychotics are currently D2 receptor blockers
- typical (old) drugs - chlorpromazine and haloperidol
- atypical (newer) drugs - clozapine and asenapine
What are the possible side effects of Parkinson’s treatment?
Schizophrenia symptoms (too much dopamine in mesolimbic) Nausea - caused by peripheral breakdown of dopamine Dopamine dysregulation syndrome - self control problems
What are the possible side effects of Schizophrenic treatment?
Parkinson effects (not enough dopamine in the nigrostriatal)
Sedative effect
Prolactin secretion (not enough dopamine in the tuberohypopyseal)
- breast swelling and galactorrhoea
