Neuro/Psych Flashcards
Give examples of benzodiazepines:
Diazepam
Lorazepam
Midazolam
What is the mechanism of action of benzodiazepines?
Increases GABA affinity for GABA receptor
GABA binding to receptor increases chloride flow through chloride channels
Hyperpolarization occurs - reducing activity of limbic, thalamic and hypothalamic areas of the brain.
When are benzodiazepines used?
Anxiety, epilepsy, muscle spasm and alcohol withdrawal
What are side effects of benzodiazepines?
Sedation
Ataxia
Altered mental status
Insomnia
Give examples of anti-psychotic drugs:
1. First generation anti-psychotics Act non selectively on D1-like and D2-like receptors - Haloperidol - Chlorpromazine 2. Atypical anti-psychotics Varying effects on dopamine and serotonin receptors - Olanzapine - Clozapine
What is the mechanism of action of anti-psychotics?
Mechanism of action:
Block dopamine receptors
Action on mesolimbic and nigrostriatal parts of brain
Also have anti-histaminergic and anti-cholinergic effects
These effects reduce positive symptoms of schizophrenia and can cause sedation and provide anti-emetic activity.
When are anti-psychotics prescribed?
Schizophrenia Mania Delusions, hallucinations Behavioral problems Antiemetic (Haloperidol)
What are the side effects of anti-psychotics?
Sedation (anti-histaminergic effect)
Postural hypotension, tachycardia (anti-adrenergic effect)
Urinary retention, dry mouth, blurry vision (anti-cholinergic effect)
Give examples of tricyclic antidepressants:
Amitriptyline
Imipramine
Doxepin
What is the mechanism of action of tricyclic antidepressants?
Stops the reuptake of monoamines
Binds to monoamine pump at pre-synaptic cleft
The reduced reuptake of norepinephrine and/or serotonin combats depression
When are tricyclic antidepressants prescribed?
Depression, panic disorders and neuropathic pain
What are side effects of tricyclic antidepressants?
Sedation (anti-histaminergic effects)
Postural hypotension, tachycardia (anti-adrenergic effects)
Urinary retention, dry mouth, blurred vision / diplopia (anti-cholinergic effects)
Give examples of SSRIs:
Citalopram Fluoxetine Paroxetine Escitalopram Sertraline
What is the mechanism of action of SSRIs?
Inhibition of reuptake of serotonin at the serotonin reuptake pump of the synaptic cleft (in the central
nervous system)
Increases serotonin stimulation of somatodendritic5-HT1A and terminal autoreceptors
When are SSRIs prescribed?
Depression, bulimia, OCD
What are side effects of SSRIs?
Dry mouth Nausea Insomnia Anxiety Decreased libido Seizures (rare) Dyskinesia (rare)
Give an example of a catechol-o-methyl transferase inhibitor:
Entacapone
What is the mechanism of action of entacapone?
Prevents the peripheral breakdown of levodopa by inhibiting COMT (COMT converts L-DOPA into 3-
methoxy-4-hydroxy-L-phenylalanine (3-OMD). 3-OMD doesn’t cross the blood brain barrier).
Therefore more levodopa reaches the brain.
When is entacapone prescribed?
In Parkinsons disease alongside L-dopa and dopamine decarboxylase inhibitor
What are the side effects of entacapone?
Dyskinesia (common, up to 27%) Nausea (11%) Abdominal pain Vomiting Dry mouth Dizziness
Give examples of dopamine agonists:
Apomorphine Pramipexole Bromocriptine Pergolide Rotigotine
What is the mechanism of action of dopamine agonists?
Stimulate post synaptic dopamine receptors
Apomorphine: non selective D1 and D2 dopamine subfamily of receptors
Pramipexole: selective D3 receptor
When are dopamine agonists administered?
Parkinsons disease
What are side effects of dopamine agonists?
Apomorphine: pain at site of injection, nausea, vomiting
Pramipexole: hallucinations, nausea, drowsiness, involuntary movements
