Cognitive enhancers Flashcards
What are some of the cognitive enhancers?
- Psycho-stimulants like Ritalin, amphetamines
- Atomoxetine
- Galanatamine
- Rivastigmine
- Tacrine
- Mermantine
- Modafinil
What is ADHD?
Overactivity and limited attnetion span which can disrupt educational and social dev.
- impulsivity and hyperacitivty
- thought to be involved NE and DA pathways of FC and BG
- estimated that occurs in 10% of children
What does the acadamy of pediatric guidelines state about the DX of ADHD?
Children need to have a least 6 attn symptoms or 6 hyperactivity/impulsivity symptoms
- must happen before the age of 7
- the symptoms must be present in multiple settings
What are ADHD first-line treatment?
Psycho-stimulants
- have a calming effect and tolerance develops at slower rate in pts with ADHD
what are the areas involved with focusing and attn?
Prefrontal and limbic systems- which are also involvedin prioritizing behaviors
What is the MOA of strattera and what is it used for?
Highly selectively NET inhibitor!
Used to treat adult ADHD
Is there abuse potential involved with someone taking Strattera?
No, its not involved with DA pathways of the nucleus accumbens or striatum but its does elevated DA levels in the prefrontal cortex
What is the mechanism of action of modafinil?
DA increased in striatum and NucA
NE increase release in hypothalamus
5ht increased in amygdala and frontal cortex
-also elevates hypothalamic Histamine, activated glutamanergic channels and inhibits GABA NT
What are the main pathological features of AD?
- Amyloid plaques
- neurofibillary tangles
- loss of neurons (especially in cholinergic neuron of basal forebrain)
What is APP?
Amyloid precursor protein, which is a normal neuronal protein
- not well understood what it does but
1. synaptic repair
2. Anterograde neuronal transport
3. iron export
4. hormonal regulation
How is APP made?
It is cleaved at 2 sites of the APP gene
- one by beta secretases
- another by gamma secretases
- mutations in the gene or cleaving sites can lead to defective proteins and later accumulation of amyloid aggregates
What are neurofibrillary tangles?
They are intracellular aggregates of highly phosphorylated form of normal neuronal protein TAU
What can account for loss of memory and learning in a pt with AD?
Loss of cholinergic neurons
What are some potential treatment mechanisms for AD?
- Beta-secretase inhibitors
- Gamma secretase inhibitors and modulators
- Ab (amyloids) vaccines and monoclonal antibodies
- Ab Aggregation inhibitors
- Tau lowering and anti-aggregation compounds
- Regulators of abnormal inflammatory mechanisms
What is ApoE4 protein and its connection with AD?
It is a protein that decreases clearance of extracellular AB
- thus too much of it would be bad or some varients of the protein are better at decreasing clearance
