Mid 2: Anxiolitics

Question 1

Lithium and GABA

Answer 1

promotes gaba neurotransmission

increases gaba levels in csf, facilitates gaba release, upregs gaba receptors in postsynaptic

Question 2

Lithium symptom treatment

Answer 2

Reduces manic phase of bipolar

Question 3

Lithium side effects

Answer 3

Nausea, polyuria and thirst, tremor

Question 4

Lithium half life and therapeutic window

Answer 4

long half life, narrow therapeutic window

Question 5

lithium and dopamine

Answer 5

inhibits dopamine neurotransmission

prevents cyclical dysregulation of d neurotransmission due to D2 receptor downreg that normally occurs after mania

Question 6

Lithium and glutamate

Answer 6

downregulates nmda receptor

Question 7

Lithium molecular pathway

Answer 7

enters via na channels

inhibits inositol phosphatases that turn IP2 to IP1 and that turn IP1 to free inositol

this blocks regeneration of pip2 and therefore the pip2 dag signalling cascade

prevents activation of PKC

blocking this path affects central adrenergic, muscarinic, and serotonergic transmission

Question 8

Lithium neuroprotective factors

Answer 8

activates creb which increases transcription of BDNF and Bcl-2 which are neuroprotective

Question 9

Lumateperone

Answer 9

bipolar treatment

antagonizes 5ht2a receptors and D2 and D1 receptors. moderat ssri effects

Question 10

Valproic acid and mech

Answer 10

bipolar treatment

anticonvulsant

increased gaba conc and inhib of VG sodium channels

Question 11

benzodiazapines uses and mech

Answer 11

anti anxiety and aggression

sedation and sleep induction

muscle relaxant (centrally)

anti-epileptic

potentiate activation of gabaA recptors by positive allosteric modulation

Question 12

diazepam

Answer 12

benzodiazepine

Question 13

lorazepam

Answer 13

benzodiazapene

Question 14

clonazepam

Answer 14

benzodiazepene

Question 15

Benzo metabolism

Answer 15

benzos that have nordazepam as a metabolic product halve longer half life b/c it is bio active

Question 16

Benzo selectivity and subunit binding

Answer 16

non-selective, bind alpha 1,2,,3,5 gabaA subunits

Question 17

Benzo anxiolytic brain region

Answer 17

amyg

Question 18

benzo hypnotic brain region

Answer 18

VLPO

Question 19

Benzo side effects

Answer 19

drowsy
ataxia
dependence
tolerance
dangerous w/ alcohol
anterograde amnesia

Question 20

Zolpidem

Answer 20

non benzo anxiolytic

Question 21

zopiclone

Answer 21

non benzo anxiolytic

Question 22

non benzo anxiolytic benefits

Answer 22

treat insomnia without disrupting sleep cycle

fewer motor, cog, and mem side effects

rapid onset short duration of action

Question 23

zaleplon and zolpidem receptor binding

Answer 23

selective to alpha one subunit of gabaA.

Question 24

buspirone

Answer 24

serotinergic anxiolytic

Question 25

buspirone effects and mech

Answer 25

5ht-1a agonist that interacts with somatodendritic negative feedback (autoreceptors) decreases release of serotonin

Question 26

clonidine and mech

Answer 26

noradrenergic anxiolytic alpha 2 agonist

Question 27

flunitrazepam/rohypnol

Answer 27

benzo roofies

Question 28

GHB

Answer 28

acts on gabba receptor

Question 29

ketamine mech

Answer 29

nmda receptor antag

Question 30

LSD and mescaline mech

Answer 30

high affinity binding to 5-ht2a receptor