Drugs for Alzheimer's disese/ADHD/Anxiety Flashcards
What NT is deficent in alzheimer’s disease
Ach
The treatment of alzheimer’s disease is focused on what
Increasing the amount of Ach in the synapse by inhibiting its breakdown
What is the first strategy to tx alzheimer’s disease
to raise Ach levels
What prototype drug is used to raise Ach levels
Donepezil
What is the MOA of Donepezil
Achesterase inhibitor
DUMB BELSS is an acronym that stands for the AE’s associated with cholinergic agonism. What does it stand for?
D-Diarrhea U-Urination M-Miosis B-Bradycardia E-Excitation (SM & CNS) L-Lacrimation S-Salivation S-Sweating
What is the 2nd strategy used to treat alzheimer’s disease
Block glutamate receptors
Name two glutamate receptors
NMDA
non-NMDA
Name three synthetic agonists that have high affinity to glutamate receptors
NMDA
AMPA
Kainate
What is the theory behind treating patient’s with alzheimer’s with a glutamate receptor blocker
NMDA overstimulation is neurotoxic
What drug is used to block the glutamate receptor
Memantine
Memantine must be administered with what drug to help with the tx of alzheimer’s disease
Donepezil
What does ADHD stand for
Attention Deficit Hyperactivity Disorder
ADHD is characterized by
persistent pattern of frequent, severe, inattention, hyperactivity, and impulsivity
ADHD starts before what age
7
What midbrain structure is the target for treating ADHD
Reticular Activating System
What two drugs are used to tx ADHD
Methylphenidate (Ritalin)
Amphetamine (Adderall)
Methylphenidate’s net effect is increase in what NT in the synapse
Dopamine
What is Amphetamine’s MOA
Increases release of catecholoamine (Dopamine, NE)
What are the most common AE’s associated with Methylphenidate and Amphetamine
Delayed sleep
H/A
Decreased appetite
Weight loss
What drugs classes are used to tx Anxiety
Benzos
NonBenzo-Benzos
Buspirone
What 3 NT are known to play a role in anxiety
GABA
5-HT
NE
Name the peripheral manifestations of anxiety
NE r/t manifestations include: Mydriasis, HTN, tremors, restlessness, palpitations/tachycardia
Other symptoms:
diarrhea, dizziness, excessive sweating, syncope, butterflies
What is the pharmacologic strategy for the tx of anxiety
behavior modification
anxiolytics
autonomic suppression via propanolol
antidepressant
What is the MOA of treating anxiety with benzos
GABA agonists that enhances the affinity of GABA for its receptor facilitating opening of the Cl channel
Will Benzos alone flux chloride
No, GABA must bind
GABA release and Benzo administration yields what affect on the chloride channel
Increased frequency of chloride channel opening
GABA release and Barbiturate administration yields what affect on the chloride channel
Increased duration of chloride channel opening
What are the main effects of benzo tx
sedation
cognitive impairment
dependence and withdrawl
Name three drugs in the Non Benzo Benzo receptor agonist family
Zolpidem (Ambien)
Zaleplon (Sonata)
Eszopiclone (Lunesta)
What is the MOA of the Non Benzo Benzos
Agonize the GABA receptor, but are not structurally BZDs.
What drug can be used to reverse Benzos and non-benzo benzos
Flumazenil
What are the non benzo benzos used to tx
Insomnia
What should be avoided in both benzos and non benzo benzos
ETOH
What are the similarities and differences associated with both benzos and non benzo benzos
both classes cause addiction, drowsiness, and dependence; however, non benzo benzos have show less of these effects than benzos
What is the relationship b/t increased anxiety and the NT serotonin
More serotonin (5-HT) =brain more acitive=more anxiety
Buspirone’s net MOA is
decreased firing of 5-HT neurons and reduced release of 5-HT
Tx of anxiety with benzo’s verses buspirone is based on interaction with the same target receptor T/F
False
benzo=GABA
buspirone=5-HT
Which tx modality is more effective for treating a depressed patient with anxiety
Buspirone
*doesn’t cause sedation, dependence, impairment of performance
