Cognitive Enhancers

Question 1

e) Main drugs used to enhance cognitive performance (often in the absence of medical advice)

Answer 1

i) Caffeine
ii) Amphetamines
iii) Methylphenidate
iv) Modafinil

Question 2

i) improve mental performance in fatigued subjects (simple, tedious tasks)
ii) increase ability to focus and maintain self control. In addition to reducing fatigue,

Answer 2

g) Amphetamines

Question 3

reduces fatigue and has a positive effect on long-term memory consolidation

Answer 3

h) Methylphenidate

Question 4

improves attention in rested individuals, while improving wakefulness, memory and executive functions in sleep-deprived individuals

Answer 4

i) Modafinil

Question 5

ii) Overactivity and limited attention span disrupt their education and social development
iii) Thought to be disorder of NE and DA pathways in the frontal cortex and basal ganglia

Answer 5

2) ADHA

Question 6

2) ADHA

b) Characterized by co-existence of what three things?

Answer 6

i) Inattentive
ii) Hyperactivity
iii) Impulsive

Question 7

g) Brain Pathways and ADHD

i) Thought to be disorder of NE and DA pathways in the _____________ and _________

Answer 7

frontal cortex and basal ganglia

Question 8

3) Neurotransmitters and ADHD

a) _________ (NE) and __________(DA) pathways are involved in maintaining and focusing attention

Answer 8

Prefrontal and mesocortical

Question 9

4) Drugs Used to Treat ADHD
a) CNS stimulants
i) Examples
___________ and ________
ii) 80% to 90% effective in children
iii) First-line treatments

Answer 9

(1) Amphetamines

(2) Methylphenidate

Question 10

5) CNS stimulants

Answer 10

b) Methylphenidate

a) Amphetamines

Question 11

5) CNS stimulants

a) Amphetamines

Answer 11

i) Immediate-release (Dexedrine)

ii) Sustained-release (Dexedrine Spansules, and Adderall XR) formulations

Question 12

5) CNS stimulants

b) Methylphenidate

Answer 12

i) Immediate-release (Ritalin)

ii) Sustained-release (Concerta and Metadate CD)

Question 13

a) Areas of the prefrontal and limbic cortex involved with focusing and maintaining attention and prioritizing behaviors are activated by psychostimulants at ___________ doses

Answer 13

low (therapeutic)

Question 14

b) Areas of the brain involved in motor activity and arousal get activated at ___________ doses

Answer 14

higher (euphoric or toxic)

Question 15

c) People who abuse amphetamine may develop reverse tolerance
i) Become psychotic with chronic use of the drug, even without dose escalation

Answer 15

sensitization

Question 16

a) Highly selective NE reuptake inhibitor

b) also elevates DA levels in the prefrontal cortex but not in the nucleus accumbens or the striatum

Answer 16

9) Atomoxetine (Strattera)

Question 17

c) Only ADHD medication that has no abuse potential

i) Not a controlled substance

Answer 17

9) Atomoxetine (Strattera)

Question 18

mediates the euphoric properties (i.e., abuse liability) of the psychostimulant

Answer 18

ii) Nucleus accumbens

Question 19

9) Atomoxetine (Strattera) Adverse effects

Answer 19

e) Adverse effects
i) nausea, vomiting, weight loss
ii) sleep problems
iii) liver damage

Question 20

10) Alzheimer Disease

Main pathological features

Answer 20

i) amyloid plaques
ii) neurofibrillary tangles
iii) loss of neurons (particularly cholinergic neurons of the basal forebrain)

Question 21

aggregates of the Aβ fragment of amyloid precursor protein (APP), a normal neuronal membrane protein, produced by the action of β- and γ-secretases

Answer 21

c) Amyloid plaques

Question 22

h) Loss of _____________is believed to account for much of the learning and memory deficit in AD

Answer 22

cholinergic neurons

Question 23

epidemiological studies suggested that some ______ reduce the likelihood of developing AD

Answer 23

NSAIDs

Question 24

a) Cholinesterase Inhibitors
b) _______ - first drug approved for treating AD
i) Enhancement of cholinergic transmission
ii) Slight improvements in tests of memory/cognition in ~40% of AD patients
iii) No improvement in other functional measures that affect quality of life

Answer 24

Tacrine

Question 25

a) Cholinesterase Inhibitors - Tacrine side effects

Answer 25

(1) Nausea, abdominal cramps, etc.

v) Hepatotoxicity, so no longer used

Question 26

i) Cholinesterase Inhibitors - Same basis as tacrine, also limited efficacy
ii) Produce a measurable, but slight, improvement of cognitive function in AD patients
iii) Less toxicity than tacrine

Answer 26

c) Donepezil, rivastigmine, galantamine

Question 27

d) Overall, small improvement in cognitive function, with no effect on disease progression.

Answer 27

e) Cholinesterase Inhibitors

Question 28

b) Weak antagonist at NMDA receptors
c) Orally active
d) Produces a modest cognitive improvement in moderate or severe AD
e) Not neuroprotective

Answer 28

a) Memantine

Question 29

f) Possible mechanism
i) Selective inhibition of excessive, pathological NMDA receptor activation
ii) Preserves more physiological NMDA receptor activation

Answer 29

Memantine

Question 30

g) Long plasma half-life
h) Used in conjunction with cholinesterase inhibitors or by itself
i) Slows cognitive deterioration and decreases caregiver burden for patients with moderate to severe AD

Answer 30

Memantine