CNS Pharmacology III: Drug Treatments of CNS Disorders Flashcards
What are the POSITIVE symptoms of Schizophrenia?
- Delusions
- Hallucinations
TRUE OR FALSE:
Antipsychotic drugs treat the negative symptoms of Schizophrenia but not the positive symptoms?
False.
Treat the POSITIVE symptoms
In the Dopamine (DA) Hypothesis of Schizophrenia, is there increased or decreased DA transmission in the Nigrostriatal Pathway?
INCREASED DA transmission
In the Dopamine (DA) Hypothesis of Schizophrenia, which subtype of receptors are acted on in the Mesolimbic Pathway?
D2 receptors
* Overactive D2 receptors may cause “positive symptoms”
In the Dopamine (DA) Hypothesis of Schizophrenia, which subtype of receptors are acted on in the Mesocortical Pathway?
D1 receptors
* Decreased D1 activity may cause “negative symptoms”
What DA strategies can be effective treatments for Schizophrenia?
- DECREASE DA activity in the limbic areas
- INCREASE DA activity in prefrontal cortex
Would an increase or decrease in Serotonin cause hypo function of DA system in the prefrontal cortex?
Increase
What type of drugs are Anti-Psychotic drugs in regards to receptors?
D2 Antagonists
What are TWO examples of Typical Anti-Psychotic drugs?
- Chlorpromazine
- Haloperidol
What are TWO examples of Atypical Anti-Psychotic drugs?
- Clozapine
- Risperidone
What are the FIVE classes of Antidepressant Drugs?
- Monoamine Oxidase Inhibitors (MAOIs)
- Tricyclic Antidepressants (TCAs)
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Noradrenaline Selective Reuptake Inhibitors (NRIs)
- Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs)
What is the mechanism of action of MAOIs?
- Inhibit MAOa (that metabolises monoamines)
- Boosts levels of 5-HT, DA, and NA
Which MAOI drugs are Non-Selective?
- Tranylcypromine
- Phenelzine
Which MAOI drugs are MAO-A Selective?
- Clorgyline
- Moclobemide
Which MAOI drug is MAO-B Selective (mainly DA)?
Selegiline
Which class of MAOIs are the most effective antidepressant?
MAO-A inhibitors
What are THREE examples of TCA drugs?
- Imipramine
- Clomipramine (5-HT selective)
- Desipramine (NA selective)
What is the mechanism of action for TCAs?
Blocks reuptake of NA and 5-HT
What are TWO examples of SSRI drugs?
- Fluoxetine (Prozac)
- Sertraline
What is the mechanism of action of SSRIs?
- SSRIs increase levels of 5-HT in the synaptic cleft
- Prevents 5-HT reuptake by binding to transporters
What is an example of an NRI drug?
Reboxetine
What is an example of an SNRI drug?
Venlafaxine
What further exacerbates loss of DA nigrostriatal neurons in PD?
Enhancement of sriatal cholinergic neurons
* may cause resting tremor
What are FIVE pharmacological treatments for PD?
- Increase synthesis of DA (L-DOPA)
- Stimulate DA receptors with agonists (Bromocriptine)
- Inhibit degradation of DA (Selegiline - MAO-B inhibitor)
- Increase release of DA (Amantadine)
- Reduce the overactivity of cholinergic neurons (Benztropine - Muscarininc antagonist)
TRUE OR FALSE:
L-DOPA has a large First Pass metabolism?
True.
High doses must be given to be able to cross the BBB
How does Carbidopa affect L-DOPA?
- Inhibits L-DOPA decarboxylation in GI tract, so increases L-DOPA in CNS
- Decreases L-DOPA dose required
- Diminishes peripheral side-effects
How does Selegiline affect L-DOPA?
Inhibits dopamine degradation
(MAO-B inhibitor)
How does Entacapone affect L-DOPA?
Inhibits COMT, thereby inhibiting L-DOPA degradation in periphery
What is the treatment strategy and clinical therapy for Cholinergic Neurons in AD?
- INCREASE cholinergic neurotransmission
- Acetylcholine Esterase Inhibitors to enhance acetylcholine action
What is the treatment strategy and clinical therapy for Glutamatergic Neurons in AD?
- DECREASE glutamate neurotransmission
- NMDA receptor antagonists to reduce excitotoxic damage to neurons
What are THREE Acetylcholine Esterase Inhibitor drugs used to treat AD?
- Donepezil
- Rivastigmine
- Galantamine
What is a NMDA Receptor Antagonist drug used to treat AD?
Memantine
