Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GT BSN/CNL PHARM > Drugs for CNS Disorders > Flashcards

Drugs for CNS Disorders Flashcards

1
Q

How many different neurotransmitters are in the CNS? How many in the PSNS?

A

21 in CNS
3 in PSNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CNS functions of acetylcholine

A

memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CNS functions of dopamine

A

reward circuit
motor control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CNS functions of serotonin

A

digestion
sleep
anxiety
mood
social behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CNS functions of histamine

A

wakefulness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CNS functions of glutamate

A

excitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CNS functions of GABA

A

inhibition (brain primarily)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CNS functions of glycine

A

inhibition (spinal cord primarily)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

list examples of adaptive changes

A

cellular atrophy or hypertrophy
metaplasia/dysplasia
alteration in protein synthesis/receptor synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are adaptive changes

A

changes that cells undergo to cope w/ new environment

occurs in response to prolonged drug exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which two neurotransmitters (NT) does parkinsons involve? Which is decreased in this disease?

A

dopamine (decreased)
acetylcholine (allowed to act unopposed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are extrapyramidal side effects (EPS)? What type of drugs elicit these effects?

A

parkinson’s like effects (slowed movement, rigidity, shuffled gait) due to drugs that block dopamine receptors in the CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List the drugs that increase dopamine for use in Parkinsons

A

levodopa
MAO-B
amantadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is levodopa

A

a precursor to dopamine (is converted to dopamine in the CNS and directly activates dopamine receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List two drugs that augment levodopa

A

decarboxylase inhibitors

COMT inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do decarboxylase inhibitors work?

A

*no therapeutic effects of their own!

inhibit levodopa breakdown in peripheral tissues & intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do COMT inhibitors work?

A

*no therapeutic effects of their own

inhibit levodopa breakdown in peripheral tissues & intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Besides increasing dopamine, how else is Parkinson’s treated?

A

blocking ACh

restores the ACh/DA balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why can we not just give exogenous dopamine?

A

dopamine can’t cross BBB
dopamine has too short of 1/2 life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List a decarboyxlase inhibitor

A

carbidopa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List a COMT inhibitor

A

entacapone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why should patients on levodopa avoid high protein diets?

A

amino acids compete for transporters to cross the BBB

(thus less levodopa gets to the CNS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long does levodopa work for patients?

A

approx 5yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

adverse effects of levodopa

A
  • N/V
  • dyskinesias
  • postural hypotension
  • psychosis (20%)
  • anxiety/agitation or cognitive changes
  • darkening of sweat/urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Drug interaction with levodopa
MAOI (severe HTN risk)
26
List two types of dopamine agonists
ergot alkaloids (i.e. bromocriptine, cabergoline) nonergot alkaloids (i.e. pramipexole, ropinirole, etc.)
27
Adverse effects of the nonergot alkaloids
nausea/vomiting dizziness daytime somnolence constipation weakness hallucinations
28
List three nonergot alkaloid derivatives (dopamine receptor agonists)
pramipexole ropinirole rotigotine
29
When is apomorphine used?
rescue treatment in episodes of hypomobility with advanced Parkinsons
30
How do MAO-B inhibitors work?
prevent breakdown of dopamine
31
What does MAO-A metabolize?
5-HT (serotonin) NE (norepinephrine)
32
Do MAO-B inhibitors cause hypertension?
Not at therapeutic doses - they only inhibit the breakdown of DA. At higher doses, they lose their selectivity and can cause HTN
33
List two MAO-B inhibitors
selegiline rasagline
34
Adverse effects of MAO-B inhibitors
orthostatic hypotension dizziness GI symptoms in high doses = HTN d/t MAO-A inhibition
35
How does amantadine work?
Increases DA availability
36
Adverse effects of amantadine
CNS = confusion, dizziness, anxiety peripheral = anticholinergic effects (mild) long term therapy (>1m) = risk for mottled skin discoloration
37
How do centrally acting anticholinergic drugs work in the treatment of PD?
Decreases ACh transmission (restores DA/ACh balance).
38
Adverse effects of centrally acting anticholinergic drugs?
CNS = sedation, confusion, hallucinations peripheral = anticholinergic effects (tachycardia, dry mouth, constipation, etc.)
39
Three drug classes used in Alzheimer's treatment
Acetylcholinesterase inhibitors NMDA receptor antagonists 2nd generation antipsychotics
40
List acetylcholinesterase inhibitors that are used for Alzheimer's.
donepezil galantamine rivastigmine
41
List the NMDA receptor antagonist that is used for Alzheimer's
memantine
42
How do AChE inhibitors work in Alzheimer's?
improve ACh-mediated neurotransmission can only improve this transmission in nerves that haven't yet been destroyed.
43
Adverse effects of AChE inhibitors
peripheral cholinergic effects (bronchospasm, bradycardia, salivation, diarrhea, etc.)
44
Contraindications for AChE inhibitors
COPD/asthma severe bradycardia or heart block
45
Differentiate between the AChE inhibitors used for Alzheimers
- donepezil = more selective for CNS & highly protein bound - rivastigmine = more PNS effects
46
What is the difference between immunomodulators and immunosuppressants?
modulators are suppress a more targeted aspect of the immune system versus suppressants suppress the immune system as a whole - thus suppressants are less safe
47
adverse effects of immunosuppressants
bone marrow suppression heart damage fetal damage infections decrease vaccine response injection site reactions
48
why do we avoid live vaccines with immunosuppressants?
the live vaccine may be a large enough dose to result in systemic infection if the immune system is suppressed
49
adverse effects of immunomodulators
hypersensitivity infections myelosuppression liver injury (LFT elevation) decreased vaccine response flu-like reactions depression injection site reactions
50
What are the differences between traditional and new generation antiseizure drugs?
traditional: - well established - less well tolerated - more complex PK - CYP450 metabolism = drug interactions - not safe in pregnancy
51
List a few traditional antiseizure drugs
phenytoin fosphenytoin cabamazepine valproate ethosuximide phenobarbital primidone
52
List a few new generation antiseizure drugs
oxycarbazepine lamotrigine gabapentin pregabalin levetiracetam topiramate tiagabine
53
Worst antiseizure drug to take during pregnancy
valproate
54
How does phenytoin work?
Na+ channel inhibition in active neurons (i.e. doesn't depress the ENTIRE CNS, only hyperactive neurons)
55
Why does phenytoin require monitoring of drug levels
small increases in doses results in large increases in plasma concentration (i.e. easy to reach toxic levels with small dose changes)
56
adverse effects of phenytoin
CNS = sedation, etc. gingival hyperplasia measles-like rash teratogenic CV (dysrhythmias & hypotension) necrosis w/ IV extravasation
57
Three causes of drug interactions with phenytoin
1. phenytoin is a CYP450 inducer (changes concentration of other drugs) 2. phenytoin is metabolized by CYP450 3. CNS depression can be amplified w/ other CNS depressants
58
Mechanism of carbamazepine
Selective inhibition of Na+ channels
59
Adverse effects of carbamazepine
CNS depression Bone marrow suppression H2O retention Rashes + photosensitivity
60
Mechanism of valproic acid
GABA enhancement Selective Na+ inhibition
61
Adverse effects of valproate
Pancreatitis Liver failure Teratogenesis Weight gain Hair loss Tremor
62
Mechanism of action of ethosuximide
Suppression of Ca++ influx
63
Mechanism of action of phenobarbital
potentiation of GABA (used more for anesthesia than for antiseizure actions now)
64
Adverse effects of phenobarbital
Cns depression Acute intermittent porphyria Altered vitamin D metabolism Physical dependence
65
Other uses for antiseizure medications (besides seizure prevention)
Dysrhythmias Bipolar disorder treatment Neuralgia Migraines Anesthesia Fibromyalgia pain Cluster headaches
66
Drugs used to terminate seizures
Benzodiazepines (Lorazepam, diazepam)
67
Mechanism of action of benzodiazepines
GABA potentiation
68
Drugs for spasticity
Baclofen Dantrolene Diazepam Tizanidine
69
Mechanism of baclofen
Mimics GABA at the hyperreflexive motor neurons in spinal cord
70
Mechanism of dantrolene
Decreases Ca++ efflux from sarcoplasmic reticulum in muscle cells (Also used in malignant hyperthermia!)
71
What is a big picture difference between baclofen and dantrolene
Baclofen is centrally acting and dantrolene is peripherally acting (Thus Baclofen doesn’t result in muscle weakness but dantrolene does)
72
Drug used in muscle spasm
Cyclobenzaprine
73
Mechanism of cyclobenzaprine
Inhibition of neuro transmission in motor neuron pathways in brainstem
74
Drug interactions with cyclobenzaprine
ALCOHOL! MAOIs, TCAs, SSRIs, SNRIs

GT BSN/CNL PHARM (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions