Introduction to CNS Drugs Flashcards
T/F: Nearly all drugs with CNS effects act on specific receptors that modulate transmission.
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T/F: CNS drugs are among the most important tools for studying all aspects of CNS physiology.
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T/F: Unraveling the actions of drugs with known clinical efficacy led to the hypotheses regarding the mechanism of disease.
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Organization of the CNS
The CNS is composed of the ____ and _____ and is responsible for integrating sensory information and generating motor output and other behaviors needed to successfully interact with the environment and enhance species survival.
brain and spinal cord
Organization of the CNS
The human brain contains about 100 billion interconnected neurons surrounded by various supporting ________.
glial cells
Throughout the CNS, neurons are either clustered into groups called ______ or are present in layered structures such as the _________ or _________.
nuclei; cerebellum or hippocampus
Organization of the CNS
Electrically excitable cells that process and transmit information via an electrochemical process.
Neurons
The typical neuron, however, possesses a cell body (or soma) and specialized processes called _________ and _______
dendrites and axons
Organization of the CNS : Neurons
Form highly branched complex dendritic “trees,” receive and integrate the input from other neurons and conduct this information to the cell body.
Dendrites
Organization of the CNS : Neurons
Carries the output signal of a neuron from the cell body
Axon
T/F: Neurons have hundreds of dendrites but generally have only one axon, although axons may branch distally to contact multiple targets
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Organization of the CNS : Neurons
Makes contact with other neurons at specialized junctions (synapses)
Axon Terminal
Organization of the CNS : Neurons
Where neurotransmitter chemicals are released that interact with receptors or other neurons
Synapses
Organization of the CNS : Neurons
Receives the synaptic responses from the dendritic tree
Soma
Organization of the CNS:
Large number of non-neuronal support cells, called glia, that perform a variety of essential functions in the CNS.
Neuroglia
T/F: These synaptic responses are integrated at the axon initial segment, which has a high concentration of voltage-gated potassium channels.
F; sodium channels
Organization of the CNS : Neuroglia
Most abundant cell in the brain and play homeostatic support roles, including providing metabolic nutrients to neurons and maintaining extracellular ion concentrations
Involved in the removal and recycling of neurotransmitters after release
Astrocytes
Organization of the CNS : Neuroglia
Cells that wrap around the axons of projection neurons in the CNS forming myelin sheath
Oligodendrocytes
Organization of the CNS : Neuroglia
Specialized macrophages derived from the bone marrow that settle in the CNS and are the major immune defense system in the brain
Microglia
Organization of the CNS
A protective functional separation of the
circulating blood from the extracellular fluid of the CNS that limits the penetration of substances, including drugs.
Blood-Brain Barrier
Ion Channels & Neurotransmitter Receptors:
Respond to changes in the membrane potential of the cell
Voltage-gated channels
Sodium Channel
Blocks channel from outside
Tetrodotoxin (TTX)
Sodium Channel
Slows inactivation, shifts activation
Batrachotoxoin (BTX)
Potassium channels
Blocks “small Ca-activated” K channel
Apamin
Potassium channels
Blocks “big Ca-activated” K channel
Charybdotoxin
Calcium channels
Blocks N-type channel
Omega conotoxin (ω-CTX-GVIA)
Calcium channels
Blocks P-type channel
Agatoxin (ω-AGAIVA)
Ligand-gated channel: Nicotinic ACh Receptor
Irreversible antagonist
α-Bungarotoxin
Ligand-gated channel: GABAA Receptor
Blocks channel
Picrotoxin
Ligand-gated channel: Glycine receptor
Competitive antagonist
Strychnine
Ligand-gated channel: AMPA receptor
Blocks channel
Philanthotoxin
Ion Channel
Apamin, Charybdotoxin
Voltage-gated, Potassium
Ion Channel
Tetrodotoxin (TTX), Batrachotoxoin (BTX)
Voltage-gated, Sodium
Ion Channel
Omega conotoxin (ω-CTX-GVIA), Agatoxin (ω-AGAIVA)
Voltage-gated, Calcium
Ion Channel
α-Bungarotoxin
Ligand-gated, Nicotinic Ach receptor
Ion Channel
Picrotoxin
Ligand-gated, GABAA receptor
Ion Channel
Strychnine
Ligand-gated, Glycine
Ion Channel
Philanthotoxin
Ligand-gated, AMPA
The nerve cells contain two types of channels defined on the basis of the mechanism controlling their gating (opening and closing) :
- Voltage-gated channels
- Ligand-gated channels
Ion Channels
Concentrated on the initial segment of the axons in
nerve cells.
Voltage-gated Ion Channels
Ion Channels
Responsible for fast action potentials.
Voltage-gated Ion Channels
Ion Channels
Responsible for action potential propagation
Sodium Channels
Ion Channels
Cell bodies and dendrites also have voltage-sensitive ion channels for potassium and calcium.
Voltage-gated Ion Channels
Ion Channels
Responsible for fast synaptic transmission typical of hierarchical pathways in the CNS
Ligand-gated channels
Neurotransmitter Receptor:
These receptors consist of multiple subunits, and binding of the neurotransmitter ligand directly opens the channel
Ligand-gated Ion Channels or Ionotropic Receptors
2 Classes of Neurotransmitter Receptor
- Ligand-gated Ion Channels or Ionotropic Receptors
- Metabotropic Receptors
Neurotransmitter Receptor
Binding does not result in the direct gating of a channel
Metabotropic Receptors
Neurotransmitter Receptor
Chemically-gated
Ligand-gated Ion Channels or Ionotropic Receptors
Neurotransmitter Receptor
Respond to chemical neurotransmitters (NTAs) that bind to receptor subunits of the channel.
Ligand-gated Ion Channels or Ionotropic Receptors
Neurotransmitter Receptor
Seven transmembrane G protein-coupled receptors (GPCRs)
Metabotropic Receptors
Neurotransmitter Receptor
Binding engages the G-protein that results in the production of second messengers that modulate the voltage-gated channels.
Metabotropic Receptors
In neurons, activation of metabotropic neurotransmitter receptors often leads to the modulation of voltage-gated channels. These interactions can occur entirely within the plane of the membrane are referred to as _______________ pathways
membrane-delimited
Membrane-Delimited Pathways
- Potassium channels
- Calcium channels
T/F: An important consequence of the involvement of G proteins in receptor signaling is that, in contrast to the brief effect of ionotropic receptors, the effects of metabotropic receptor activation can last tens of seconds to minutes.
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predominate in the diffuse neuronal systems in the CNS
Metabotropic receptors
Metabotropic receptors can also modulate voltage-gated channels less directly by the generation of ______________
diffusible second messengers
The Synapse and Synaptic Potentials
Types of receptor channel coupling in ligand-gated ion channels activation and inactivation
- A receptor that acts directly on the channel protein.
- A receptor that is coupled to the ion channel through a G protein.
- A receptor coupled to a G protein that modulates the formation of diffusible second messengers.
The Synapse and Synaptic Potentials
Diffusible second messengers
a. Cyclic adenosine monophosphate (cAMP)
b. Inositol trisphosphate (IP3)
c. Diacylglycerol (DAG)
Synaptic Potentials:
When an excitatory pathways is stimulated, a small depolarization or ________________________ is recorded. This potential is due to the excitatory transmitter acting on ionotropic receptor, causing an increase in cation permeability
Excitatory Postsynaptic Potentials (EPSPs)
Role of the Ion current carried by the Channel
Depolarizing potential change
Excitatory Postsynaptic Potentials (EPSPs)
Role of the Ion current carried by the Channel (EPSP)
Generated by
- Opening of sodium or calcium channels
- Closing of potassium channels in some synapses
EPSPs
T/F: As additional excitatory synapses are activated, there is a graded summation of the EPSPs to increase the size of the depolarization.
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When an inhibitory pathway is stimulated, the postsynaptic membrane is hyperpolarized owing to the selective opening of chloride channels, producing an ___________________
Inhibitory Postsynaptic Potential (IPSP)
EPSPs
__ Na+, __ K+, __ Ca2+
↑ Na+, ↓ K+, ↑ Ca2+
Role of the Ion current carried by the Channel
Hyperpolarizing potential change
Inhibitory Postsynaptic Potentials (IPSPs)
IPSPs
Generated by
Opening of potassium or chloride channels.
IPSPs
__ K+, __ Cl- postsynaptic, __ Ca2+ presynaptic
↑ K+, ↑ Cl- postsynaptic, ↓ Ca2+ presynaptic
Sites of drug action:
Steps at which drugs can alter synaptic transmission
- Action potential in presynaptic fiber
- Synthesis of transmitter
- Storage
- Metabolism
- Release
- Reuptake into the nerve ending or uptake into a glial cell
- Degradation
- Receptor for the transmitter
- Receptor-induced increase / decrease ionic conductance
- Retrogade signaling
Sites and Mechanisms of Drug Action
T/F Some drugs exert their effect through indirect interactions with molecular components of ion channels on axons.
F; direct interactions
Sites and Mechanisms of Drug Action
drugs exert their effect through direct interactions
- Carbamazepine
- Phenytoin
- Local anesthetics and some drugs used for
general anesthesia
Q
Sites and Mechanisms of Drug Action
Interfere with the action of second messengers
Activate or Block
Sites of drug action:
T/F: No uptake mechanism has been found for any of the numerous CNS peptides, and it has yet to be demonstrated whether specific enzymatic degradation terminates the action of peptide transmitters
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Sites and Mechanisms of Drug Action
Most drugs exert their effect mainly at the ____.
synapses
Sites and Mechanisms of Drug Action
T/F Drugs may act presynaptically to alter synthesis, storage, release, reuptake & metabolism of transmitter chemicals.
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Sites and Mechanisms of Drug Action
Inhibits synthesis of serotonin
Parachlorophenylalanine
Sites and Mechanisms of Drug Action
Inhibits storage of catecholamines
Reserpine
Sites and Mechanisms of Drug Action
Inhibits release of catecholamines
Amphetamine
Sites and Mechanisms of Drug Action
Inhibits degradation of acetylcholine
Anticholinesterase
Sites and Mechanisms of Drug Action
Can be depressed by blockade of transmitter synthesis or storage
Presynaptic Drugs
Sites and Mechanisms of Drug Action
The transmitter receptor provides the primary site of drug action
Postsynaptic Region
Cellular Organization of the Brain
Control major sensory and motor functions
Hierarchal System
Cellular Organization of the Brain
Two types of neuronal system:
- Hierarchical system
- Diffused/Non-specific neuronal system
Cellular Organization of the Brain
Contains large myelinated, rapidly conducting fibers; pathways are clearly delineated.
Hierarchal System
Cellular Organization of the Brain
Excitability of the CNS
Hierarchal System
Cellular Organization of the Brain
Small Inhibitory Interneurons (Local Circuit Neurons) Transmitters
Gamma amino butyric acid (GABA), Glycine
Cellular Organization of the Brain
Major Excitatory Transmitters : Aspartate, Glutamate
Hierarchal System
Cellular Organization of the Brain
Broadly distributed, with single cells frequently sending processes to many different parts of the brain-tangential
Diffused / Non-Specific Neuronal System
Diffused / Non-Specific Neuronal System
Periodic enlargements that contain transmitter vesicles
Varicosities
Diffused / Non-Specific Neuronal System
Located in the axons
Varicosities
Diffused / Non-Specific Neuronal System (Transmitters)
NE, dopamine and serotonin
Noradrenergic Amines
Diffused / Non-Specific Neuronal System (Transmitters)
Act on metabotropic receptors
Peptides
Diffused / Non-Specific Neuronal System
Noradrenergic cell bodies are found primarily in a compact cell group _________.
locus caeruleus
Diffused / Non-Specific Neuronal System
found in the midline raphe nuclei in the forebrain and send extraordinarily divergent projections to nearly all regions of the CNS
Serotonin neurons
Cellular Organization of the Brain
Other diffusely projecting neurotransmitter pathways include the histamine and orexin systems
Diffused / Non-Specific Neuronal System