CNS Pharmacology Part 2

Question 1

What is the most common form of psychosis?

Answer 1

schizophrenia

Question 2

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

Answer 2

dopamine

Question 3

What are traditional or first generation antipsychotic meds?

Answer 3

strong antagonists of specific dopamine receptors

Question 4

What are atypical or second generation antipsychotic meds?

Answer 4

weak antagonists of dopamine receptors
strong antagonists of specific serotonin receptors

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

Question 5

What are extrapyramidal adverse effects of antipsychotics?

Answer 5

tardive dyskinesia
pseudoparkinsonism
akathisia
dyskinesia and dystonias
neuroleptic malignant syndrome

Question 6

Extrapyramidal symptoms are associated with ______________.

Answer 6

traditional antipsychotics

Question 7

What are other adverse effects of antipsychotics?

Answer 7

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

Question 8

What are therapist considerations for antipsychotics?

Answer 8

changes in behavior
assess for adverse effects
potential movement disorders

Question 9

What is the potential cause of epilepsy?

Answer 9

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

spontaneous discharge of these neurons results in seizure

Question 10

What is a general seizure?

Answer 10

the whole brain is involved

Question 11

What is a focal seizure?

Answer 11

involves specific part of the brain

Question 12

What is the goal of antiseizure medications?

Answer 12

suppress excitability of neurons

Question 13

What are the two strategies to suppress excitability of neurons?

Answer 13

increase activity of inhibitory neurons
decrease activity of excitatory neurons

Question 14

What are classes of first generation antiseizure medications?

Answer 14

barbiturate
benzodiazepine
hydantoins
iminostilbenes
succinimides
valproates

Question 15

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

Answer 15

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

increases inhibitory effect of GABA

Question 16

What are side effects of barbiturates?

Answer 16

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

Question 17

When are benzodiazepines used?

Answer 17

acute treatment of status epilepticus

Question 18

How do benzodiazepines work?

Answer 18

increase inhibitory effect of GABA

Question 19

What are the adverse effects of benzos?

Answer 19

sedation
ataxia
behavioral changes

Question 20

Where do hydantoins fit in seizure medication?

Answer 20

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

Question 21

What is the mechanism of action of hydantoins?

Answer 21

stabilizes the neural membrane

Question 22

What are the adverse effects of hydantoins?

Answer 22

gastric irritation
cerebellar signs
skin disorders
gingival hyperplasia

Question 23

What are iminostilbenes and how do they work?

Answer 23

effective treatment in all types of seizures except absence seizures

appears to stabilize the neural membrane

Question 24

What are adverse effect of iminostilbenes?

Answer 24

water retention
cardiac arrythmias

Question 25

What are succinimides used to treat?

Answer 25

petit mal seizures

Question 26

What are adverse effects of Succinimides?

Answer 26

movement disorders

Question 27

What does valproic acid treat?

Answer 27

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

Question 28

What is the mechanism of action of valproic acid?

Answer 28

stabilize neural membrane and increase levels of GABA in brain

Question 29

What are adverse effects of valproic acid?

Answer 29

temporary hair loss impaired platelet function

Question 30

What is the benefit of second generation antiseizure medications?

Answer 30

seem to have better pharmacokinetic properties (absorption, distribution, metabolism) do not seem to be more effective

Question 31

What is parkinson's disease?

Answer 31

neurologic disorder affecting the basal ganglia causes slow progressive degeneration of dopamine-secreting neurons located in pars compactus of substantia nigra

Question 32

What are the characteristics of Parkinson's?

Answer 32

resting tremor bradykinesia rigidity postural instability

Question 33

What is the main goal of a PD medication?

Answer 33

enhance or replace the lost dopamine

Question 34

What is levodopa and how does it work?

Answer 34

considered best drug for resolving symptoms of PD resolves dopamine deficiency by being converted to dopamine after crossing blood brain barrier

Question 35

What is levodopa administered with?

Answer 35

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

Question 36

What is sinemet?

Answer 36

combines levodopa and carbidopa in one pill

Question 37

What are the adverse effects of levodopa?

Answer 37

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

Question 38

Why are drug holidays sometimes implemented with levodopa?

Answer 38

levodopa becomes less effective over time allows body to recover from toxicity or tolerance

Question 39

What is the use of dopamine agonists in PD?

Answer 39

used alone in early treatment then in conjunction with levodopa have serious side effects

Question 40

What are adverse effects of dopamine agonists?

Answer 40

nausea/vomiting postural hypotension confusion hallucinations

Question 41

What do anticholinergic drugs do for PD?

Answer 41

limit acetylcholine transmission block acetylcholine receptors in basal ganglia

Question 42

What are the adverse effects of anticholinergic drugs?

Answer 42

mood changes confusion cardiac irregularities

Question 43

What are the other two PD drugs?

Answer 43

Amantadine (symmetrel)- unknown MOA originally antiviral monoamine Oxidase B inhibitors-may slow progression of disease