CNS pt 1 Flashcards
What are the types of neurotransmitters?
Excitatory, inhibitory, or both
What kind of neurotransmitters are excitatory
Norepinephrine and epinephrine
What type of neurotransmitters are inhibitory?
Acetylcholine and dopamine
What monoamine neurotransmitters can lead to depression?
Norepinephrine, serotonin, dopamine
What are the steps of neurotransmitters signals?
- Extrications signal travels down the axon
- Neurotransmitter molecules are released into the synapse
- Molecules bind to the receptor site
- The signal is picked up by the second neuron and is either passed along (excitatory) or halted (inhibitory)
- The signal is picked up by the first neuron resulting in reuotake of excess neurotransmitter
What is the reabsorption back into the pre synaptic neuron called?
Re uptake
Where is the limbiv system located and what does it control
Bellow the cerebrum above the brain stem
It affects emotions, behavior, motivation, long term memory, and smell. It also houses the receptors that modulate depression
What are the threes important areas in the limbic system?
Amygdala, thalamus, and hippocampus
What are most neurological disorders caused by?
Inappropriate production, release, reception, and breakdown or reuptake of neurotransmitters
What causes depression?
Diminished activity of norepinephrine in the locus coeruleus in the pons and diminished serotonin in the raphe nuclei
What are promising drugs to use in depression with difficult to treat patients?
Pramipexole and modafinil
How is it determined when depression should be treated with pharmacological methods
Symptoms must be present for most of the day, most days of the week, for at least two weeks
What drug classes are used for unipolar depression
MAOIs, TCAs, SSRIs, SNRIs, DNRIs
What are the first generation drugs used as antidepressants
TCAs and MAOIs
What are the dual /atypical agents used in depression
SNRIs and DRNIs
What are the known SSRIs?
Fluoxetine, sertraline, and citalopram
How do SSRIs work?
They block 5Ht (seratonin) by binding at reuptake cite and leads to a higher serotonin concentration
When are therapeutic benefits of SSRIs seen?
10-20 days
What are the AEs of SSRIs
Sexual dysfunction, GI, CNS, and weight loss then gain
What are the very common side effects of SSRIs
Agitation, sleep and sexual dysfunction
What are the signs of serotonin syndrome?
Agitation, confusion, tremor, hyyperreflexia, shivering, diarrhea, and fever
How soon after starting SSRIs can serotonin syndrome start
2-72 hours
What is the washout period between MOAIs and SSRIs to avoid serotonin syndrome?
At least 5 half lives which is usually five weeks
What other meds should you avoid with SSRIs that can cause serotonin syndrome
MAOIs and lithium, TCas, atypical antidepressants, triptans, and analgesics
