NLM2 Neurotransmitters

Question 1

Name 2 drugs used in Parkinson’s and mode of action

Answer 1

Benztropine, hyoscine

Inhibits post synaptic muscarinic receptors

Question 2

Name 2 drugs used in Alzheimer’s and action

Answer 2

Physostigmine, donepezil

Inhibits AChE so more in cleft

Question 3

How is NA formed in the axon?

Answer 3

From tyrosine via dopamine-B-hydroxylase

Question 4

What enzyme degrades NA in the post synaptic membrane?

Answer 4

COMT

Question 5

How does amphetamine work?

Answer 5

Displaces NA and serotonin from vesicles so huge action potentials

Question 6

What is mirtazapine?

Answer 6

Antidepressant, inhibits alpha2 receptor which is inhibitory

therefore more NA in cleft

Question 7

What two antidepressants function like cocaine?

Answer 7

Imipramine, amitriptyline

Question 8

How does cocaine work?

Answer 8

By inhibiting the reuptake of NA from cleft via inhibition of NET

Question 9

How does lithium work and what is it?

Answer 9

Antidepressant, inhibits breakdown of NA and serotonin in axon by inhibition of MAO

Question 10

How is serotonin (5HT) formed in the axon?

Answer 10

From tryptophan via l-aromatic acid decarboxylase

Question 11

What are imipramine and amitriptaline + action?

Answer 11

Antidepressants that inhibit the reuptake of serotonin and NA from the synaptic cleft via inhibition of NET and SERT

Question 12

How does LSD work?

Answer 12

Works on postsynaptic 5HT2 receptor

Causes hallucinations

Question 13

What is ondansetron?

Answer 13

An antiemetic that works on postsynaptic 5HT3 receptor

Question 14

What is dopamine formed from?

Answer 14

Tyrosine via DOPA decarboxylase

Question 15

What breaks down dopamine in the synaptic cleft?

Answer 15

COMT

catechol-O-methyl transferase

Question 16

Name 3 drugs used in Parkinson’s

Answer 16

Levodopa, selegiline, amantadine

Question 17

What drug is used to treat pituitary tumours?

Answer 17

Bromocriptine

Question 18

How does amantadine work?

Answer 18

Increases release of neurotransmitter into cleft

Treats Parkinson’s

Question 19

How does levodopa work?

Answer 19

Increases production of dopamine in axon from tyrosine

Treats Parkinson’s

Question 20

What is the main excitatory neurotransmitter?

Answer 20

Glutamate

Question 21

How is glutamate broken down?

Answer 21

Transported into astrocyte by EAAT and broken down to glutamine by glutamine synthetase

Question 22

What drug improves memory? How?

Answer 22

Cyclothiazide. Acts at NMDA receptors, increases glutamate’s effect

Question 23

What alzheimer’s drug acts on NMDA glutamate receptors?

Answer 23

Memantine

Question 24

What anaesthetic works a NMDA receptors?

Answer 24

Ketamine, suppresses action

Question 25

What anti-epileptic drugs acts at NMDA glutamate receptors?

Answer 25

Felbamate and topiramate

Question 26

What is Ketamine?

Answer 26

Anaesthetic that inhibits glutamate NMDA channels

Question 27

What are felbamate and topiramate?

Answer 27

Anti-epileptic drugs that inhibit glutamate NMDA receptors

Question 28

What is the main inhibitory neurotransmitter?

Answer 28

GABA

Question 29

How is GABA formed?

Answer 29

From glutamate via glutamic acid decarboxylase

Question 30

Which sedative drugs act on GABAa ion channels?

Answer 30

``` Benzodiazipines (eg temazepam and diazepam) Steroid anaesthetics (alphaxolone) and alcohol ```

Question 31

What anti-epileptic drug acts on GABA transaminase to stop its breakdown?

Answer 31

Vigabatrin

Question 32

ACh is the neurotransmitter involved in what?

Answer 32

Movement, memory, nausea and vomiting

Question 33

NA and adrenaline are the neurotransmitters involved in what?

Answer 33

Mood, reward, pain and BP control

Question 34

Serotonin is the neurotransmitter involved in what?

Answer 34

Mood, appetite, pain, nausea and vomiting

Question 35

Dopamine is the neurotransmitter involved in what?

Answer 35

Reward, movement, nausea and vomiting

Question 36

Glutamate is the neurotransmitter involved in what?

Answer 36

Movement, excitatory

Question 37

GABA is the neurotransmitter involved in what?

Answer 37

Movement, inhibitory

Question 38

How do antiepileptic drugs work?

Answer 38

Glutamate Na+ channel blockers or GABA enhancement

Question 39

Name 4 antiepileptic glutamate Na+ blockers

Answer 39

Phenytoin, carbamazide, lamotrigine, valproate

Question 40

What are the actions and problems of phenytoin?

Answer 40

Anti-epileptic drug with many side effects Wide variation in rates of metabolism (cP450), CNS effects (double vision), gum hyperplasia, excessive hair growth and allergy

Question 41

What is phenytoin given as?

Answer 41

Fosphenytoin

Question 42

Describe uses and side effects of carbamazepine

Answer 42

Used for partial seizures and tonic-clonic seizures, little sedation at therapeutic dose SE: P450 induction, rash, nausea, ADH-like activity, jaundice

Question 43

What drug is first choice to treat petit mal seizures and myoclonic?

Answer 43

Valproate

Question 44

What is used in status epilepticus?

Answer 44

IV Diazepam | Others include clonazepam and chlomethiazole

Question 45

Describe uses and SE of lamotrigine

Answer 45

Used for tonic-clonic epilepsy Rare SE: skin eruptions, toxic epidermal necrolysis and angioedema Doesn't affect P450 :)

Question 46

Describe action and SE of phenobarbitone

Answer 46

Increases duration of GABAa channel opening SE: Don't use in petit-mal P450 induction and causes sedation Taken once daily

Question 47

Name GABA related drugs

Answer 47

GABA agonists= clonezepam, diazepam (benzodiazepines) | gabapentin and pregabalin

Question 48

How does valproate work?

Answer 48

Enhances GABA formation and inhibits GABA breakdown via transamination

Question 49

Name the antiepileptic that inhibits GABA reuptake

Answer 49

Tiagabine

Question 50

What is tiagabine?

Answer 50

Antiepileptic drug that inhibits GABA reuptake

Question 51

What antiepileptic acts by hyperpolarising neurones?

Answer 51

Retigabine, potassium channel opener

Question 52

Name the antiepileptic that acts by blocking calcium channels in neurones?

Answer 52

Ethosuximide