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pharmacology > CNS Pharmacology Part 2 > Flashcards

CNS Pharmacology Part 2 Flashcards

1
Q

What is the most common form of psychosis?

A

schizophrenia

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2
Q

Schizophrenia appears to be caused by an overactivity of ______________ pathways in certain areas of the brain.

A

dopamine

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3
Q

What are traditional or first generation antipsychotic meds?

A

strong antagonists of specific dopamine receptors

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4
Q

What are atypical or second generation antipsychotic meds?

A

weak antagonists of dopamine receptors
strong antagonists of specific serotonin receptors

appear to have fewer risks and fewer side effects than traditional meds

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5
Q

What are extrapyramidal adverse effects of antipsychotics?

A

tardive dyskinesia
pseudoparkinsonism
akathisia
dyskinesia and dystonias
neuroleptic malignant syndrome

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6
Q

Extrapyramidal symptoms are associated with ______________.

A

traditional antipsychotics

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7
Q

What are other adverse effects of antipsychotics?

A

sedation
anticholinergic effects (blurred vision, constipation, dry mouth)
orthostatic hypotension
photosensitivity

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8
Q

What are therapist considerations for antipsychotics?

A

changes in behavior
assess for adverse effects
potential movement disorders

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9
Q

What is the potential cause of epilepsy?

A

the presence of a group of “irritable” or hyperexcitable neurons located in the cerebral cortex

spontaneous discharge of these neurons results in seizure

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10
Q

What is a general seizure?

A

the whole brain is involved

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11
Q

What is a focal seizure?

A

involves specific part of the brain

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12
Q

What is the goal of antiseizure medications?

A

suppress excitability of neurons

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13
Q

What are the two strategies to suppress excitability of neurons?

A

increase activity of inhibitory neurons
decrease activity of excitatory neurons

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14
Q

What are classes of first generation antiseizure medications?

A

barbiturate
benzodiazepine
hydantoins
iminostilbenes
succinimides
valproates

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15
Q

Barbiturates are effective in treating which types of seizures? How?

A

generalized tonic-clonic
simple and complex partial (focal) seizures

increases inhibitory effect of GABA

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16
Q

What are side effects of barbiturates?

A

nystagmus
ataxia
folate deficiency
vitamin K deficiency
increase in seizures and hyperactivity may occur in children

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17
Q

When are benzodiazepines used?

A

acute treatment of status epilepticus

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18
Q

How do benzodiazepines work?

A

increase inhibitory effect of GABA

19
Q

What are the adverse effects of benzos?

A

sedation
ataxia
behavioral changes

20
Q

Where do hydantoins fit in seizure medication?

A

often the first drug considered in treatment
effective in treating partial seizures and general tonic-clonic seizures

21
Q

What is the mechanism of action of hydantoins?

A

stabilizes the neural membrane

22
Q

What are the adverse effects of hydantoins?

A

gastric irritation
cerebellar signs
skin disorders
gingival hyperplasia

23
Q

What are iminostilbenes and how do they work?

A

effective treatment in all types of seizures except absence seizures

appears to stabilize the neural membrane

24
Q

What are adverse effect of iminostilbenes?

A

water retention
cardiac arrythmias

25
Q

What are succinimides used to treat?

A

petit mal seizures

26
Q

What are adverse effects of Succinimides?

A

movement disorders

27
Q

What does valproic acid treat?

A

primarily used to treat absence seizures
also used to treat manic phase of bipolar disorder

28
Q

What is the mechanism of action of valproic acid?

A

stabilize neural membrane and increase levels of GABA in brain

29
Q

What are adverse effects of valproic acid?

A

temporary hair loss
impaired platelet function

30
Q

What is the benefit of second generation antiseizure medications?

A

seem to have better pharmacokinetic properties (absorption, distribution, metabolism)

do not seem to be more effective

31
Q

What is parkinson’s disease?

A

neurologic disorder affecting the basal ganglia

causes slow progressive degeneration of dopamine-secreting neurons located in pars compactus of substantia nigra

32
Q

What are the characteristics of Parkinson’s?

A

resting tremor
bradykinesia
rigidity
postural instability

33
Q

What is the main goal of a PD medication?

A

enhance or replace the lost dopamine

34
Q

What is levodopa and how does it work?

A

considered best drug for resolving symptoms of PD

resolves dopamine deficiency by being converted to dopamine after crossing blood brain barrier

35
Q

What is levodopa administered with?

A

carbidopa

inhibits the premature breakdown of levodopa -> reduces dosage of levodopa

36
Q

What is sinemet?

A

combines levodopa and carbidopa in one pill

37
Q

What are the adverse effects of levodopa?

A

GI problems
cardiovascular problems
dyskinesias
behavioral changes
diminished response to levodopa
fluctuations to response

38
Q

Why are drug holidays sometimes implemented with levodopa?

A

levodopa becomes less effective over time

allows body to recover from toxicity or tolerance

39
Q

What is the use of dopamine agonists in PD?

A

used alone in early treatment then in conjunction with levodopa

have serious side effects

40
Q

What are adverse effects of dopamine agonists?

A

nausea/vomiting
postural hypotension
confusion
hallucinations

41
Q

What do anticholinergic drugs do for PD?

A

limit acetylcholine transmission
block acetylcholine receptors in basal ganglia

42
Q

What are the adverse effects of anticholinergic drugs?

A

mood changes
confusion
cardiac irregularities

43
Q

What are the other two PD drugs?

A

Amantadine (symmetrel)- unknown MOA
originally antiviral

monoamine Oxidase B inhibitors-may slow progression of disease

pharmacology (7 decks)

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