CNS Pharmacology Part 2 Flashcards
What is the most common form of psychosis?
schizophrenia
Schizophrenia appears to be caused by an overactivity of ______________ pathways in certain areas of the brain.
dopamine
What are traditional or first generation antipsychotic meds?
strong antagonists of specific dopamine receptors
What are atypical or second generation antipsychotic meds?
weak antagonists of dopamine receptors
strong antagonists of specific serotonin receptors
appear to have fewer risks and fewer side effects than traditional meds
What are extrapyramidal adverse effects of antipsychotics?
tardive dyskinesia
pseudoparkinsonism
akathisia
dyskinesia and dystonias
neuroleptic malignant syndrome
Extrapyramidal symptoms are associated with ______________.
traditional antipsychotics
What are other adverse effects of antipsychotics?
sedation
anticholinergic effects (blurred vision, constipation, dry mouth)
orthostatic hypotension
photosensitivity
What are therapist considerations for antipsychotics?
changes in behavior
assess for adverse effects
potential movement disorders
What is the potential cause of epilepsy?
the presence of a group of “irritable” or hyperexcitable neurons located in the cerebral cortex
spontaneous discharge of these neurons results in seizure
What is a general seizure?
the whole brain is involved
What is a focal seizure?
involves specific part of the brain
What is the goal of antiseizure medications?
suppress excitability of neurons
What are the two strategies to suppress excitability of neurons?
increase activity of inhibitory neurons
decrease activity of excitatory neurons
What are classes of first generation antiseizure medications?
barbiturate
benzodiazepine
hydantoins
iminostilbenes
succinimides
valproates
Barbiturates are effective in treating which types of seizures? How?
generalized tonic-clonic
simple and complex partial (focal) seizures
increases inhibitory effect of GABA
What are side effects of barbiturates?
nystagmus
ataxia
folate deficiency
vitamin K deficiency
increase in seizures and hyperactivity may occur in children
When are benzodiazepines used?
acute treatment of status epilepticus
How do benzodiazepines work?
increase inhibitory effect of GABA
What are the adverse effects of benzos?
sedation
ataxia
behavioral changes
Where do hydantoins fit in seizure medication?
often the first drug considered in treatment
effective in treating partial seizures and general tonic-clonic seizures
What is the mechanism of action of hydantoins?
stabilizes the neural membrane
What are the adverse effects of hydantoins?
gastric irritation
cerebellar signs
skin disorders
gingival hyperplasia
What are iminostilbenes and how do they work?
effective treatment in all types of seizures except absence seizures
appears to stabilize the neural membrane
What are adverse effect of iminostilbenes?
water retention
cardiac arrythmias
What are succinimides used to treat?
petit mal seizures
What are adverse effects of Succinimides?
movement disorders
What does valproic acid treat?
primarily used to treat absence seizures
also used to treat manic phase of bipolar disorder
What is the mechanism of action of valproic acid?
stabilize neural membrane and increase levels of GABA in brain
What are adverse effects of valproic acid?
temporary hair loss
impaired platelet function
What is the benefit of second generation antiseizure medications?
seem to have better pharmacokinetic properties (absorption, distribution, metabolism)
do not seem to be more effective
What is parkinson’s disease?
neurologic disorder affecting the basal ganglia
causes slow progressive degeneration of dopamine-secreting neurons located in pars compactus of substantia nigra
What are the characteristics of Parkinson’s?
resting tremor
bradykinesia
rigidity
postural instability
What is the main goal of a PD medication?
enhance or replace the lost dopamine
What is levodopa and how does it work?
considered best drug for resolving symptoms of PD
resolves dopamine deficiency by being converted to dopamine after crossing blood brain barrier
What is levodopa administered with?
carbidopa
inhibits the premature breakdown of levodopa -> reduces dosage of levodopa
What is sinemet?
combines levodopa and carbidopa in one pill
What are the adverse effects of levodopa?
GI problems
cardiovascular problems
dyskinesias
behavioral changes
diminished response to levodopa
fluctuations to response
Why are drug holidays sometimes implemented with levodopa?
levodopa becomes less effective over time
allows body to recover from toxicity or tolerance
What is the use of dopamine agonists in PD?
used alone in early treatment then in conjunction with levodopa
have serious side effects
What are adverse effects of dopamine agonists?
nausea/vomiting
postural hypotension
confusion
hallucinations
What do anticholinergic drugs do for PD?
limit acetylcholine transmission
block acetylcholine receptors in basal ganglia
What are the adverse effects of anticholinergic drugs?
mood changes
confusion
cardiac irregularities
What are the other two PD drugs?
Amantadine (symmetrel)- unknown MOA
originally antiviral
monoamine Oxidase B inhibitors-may slow progression of disease
