Neuropharm extras (do last) Flashcards
glutamate originates in the __________
cortex
norepinephrine originates in the __________
locus coeruleus
serotonin originates in the ____________
raphe nucleus
dopamine originates in the ______________ and ____________
ventral tegmental area
substantia nigra
acetylcholine originates in the ___________ and ___________
septal nuclei
nucleus basalis
histamine originates in the______________
tuberomamillary nucleus of hypothalamus
the biochemical amines have _________ pathways
ascending
glutamate terminates in the __________
hippocampus
norepinephrine and serotonin both terminate in the __________, __________, and _________
cortex
hippocampus
cerebellum
____________ terminates in the ____________ which is involved in addiction
dopamine
nucleus accumbens
which NT terminates in the striatum?
dopamine
which NT are involved in epilepsy and how?
glutamate - overactive
GABA - underactive
which NT are involved in depression and how?
serotonin and norepinephrine - underactive
which NT play a role in anxiety and how?
GABA and serotonin – underactive
which NT are involved in Parkinson’s disease and how?
acetylcholine - overactive
dopamine - underactive
which NT is involved in schizophrenia and how?
dopamine - hyperactive
which NT is involved in Alzheimers and how?
acetylcholine - underactive
which NT are excitatory in the CNS?
glutamate
acetylcholine
which is the major inhibitory NT in the CNS?
GABA
which NT is involved in migraine and how?
serotonin - too low
List 4 peptide neurotransmitters: ODEE
Opiods
Dynorphin
Endorphin
Enkephalin
List 4 amino acid neurotransmitters: GGGA
GABA
Glutamate
Glycine
Aspartate
List 5 biogenic amine neurotransmitters: SADEN
Serotonin Acetylcholine Dopamine Epinephrine Norepinephrine
Increased synaptic 5-HT in the CNS causes what side effects?
insomnia
agitation
Increased synaptic 5-HT in the GI causes what side effects?
nausea
diarrhea
bleed (platelet function)
Besides depression, what are other indications for SSRIs?
anxiety d/o
eating d/o
PMDD
ADHD
“Discontinuation syndrome” is more likely to occur with a drug that has a _______(shorter/longer) half life.
shorter
SNRIs have all the side effects of SSRIs plus what?
increase blood pressure
Besides depression, what are other indications for duloxetine?
neuropathic pain
fibromyalgia
anxiety d/o
SSRIs or SNRIs combined with ___________ (name 3) can cause serotonin syndrome.
MOAIs
St John’s Wort
methadone
The efficacy of SSRIs and SNRIs is the same. However, which one is less reliant on dietary tryptophan?
SNRI
Name 2 drugs that block SERT, NET plus some muscarinic, histamine, and alpha adrenergic receptors.
amitriptyline
desipramine
What are side effects of anticholinergics?
dry mouth
constipation
vision loss
conduction block
People taking TCAs might complain of what side effects upon starting therapy?
drowsiness
increased appetite and wt gain
sexual dysfunction
autonomic sx (dry mouth, constipation)
Why are people taking TCAs at high risk of toxicity?
low TI half life >24 hours metabolites also have long half life metabolized by CYPs 10 day supply is enough to kill
Besides depression, what are other indications for TCAs?
anxiety
enuresis
neuropathic pain
migraine
Unique adverse effect of MAOI
postural hypotension
What are the symptoms of serotonin syndrome?
akathisia tremor altered mental status clonus muscle rigidity hyperthermia death
Definitely avoid in pregnancy:
tranylcypromine (MAOI)
“Risk cannot be ruled out” in pregnancy:
fluoxetine
sertraline
(SSRI)
Possible risk of fetal limb malformation in some studies:
amitryptiline (TCA)
Tolerance does not develop for which adverse effects of antidepressants?
sexual dysfunction cardiac toxicity (TCAs)
Activation of _____________ is a key step in the inflammatory response, it catalyzes production of EPA and AA from membrane phospholipids.
Phospholipase A2
P.S. the type of fat in our diet influences what type of fatty acids comprise our membrane phospholipids
Prostaglandins, thromboxanes, and leukotrienes are _______________, derivatives of AA and EPA via cyclooxygenase and lipooxygenase enzymes.
eicosanoids
arachidonic acid & EPA
Eicosanoids specifically produced via cyclooxygenase are called___________.
prostanoids
these act uniquely on different tissue
Inhibition of COX ______(1 or 2) leads to GI-related side effects.
1
COX-1 is expressed in most tissues for “housekeeping” functions.
Expression of COX _____(1 or 2) is induced by stress, growth factors, cytokines, and inflammatory mediators.
2
Inhibition of COX ______ (1 or 2) causes the antipyretic, analgesic, and anti-inflammatory actions of _______(drug class).
2
NSAIDS
EPA is metabolized into omega ____ (3 or 6) eicosanoids.
omega 3
Arachidonic acid is metabolized into omega _____ (3 or 6) eicosanoids.
omega 6
Which eicosanoid family stimulates bronchoconstriction?
leukotrienes
Which has more potent inflammatory activity? Omega 6 (AA) or omega 3 (EPA) fatty acids?
Omega 6 (AA)
What enzymes do AA (omega 6) and EPA (omega 3) compete for ?
cyclooxygenase
lipooxygenase
Which eicosanoid family stimulates platelet aggregation?
thromboxanes
The primary biologic effect of NSAIDS is inhibition of _________ synthesis from COX-1 & 2.
prostaglandin
You need ________(higher/lower) doses of NSAIDS to have anti-inflammatory benefit.
higher
