Pharm Cram Flashcards
Anti-Emetic Drugs
Promethazine, mixed receptor antagonist. Fatigue, dizziness, sedation, antimuscarinic side effects.
Metoclopramide, a d2 antagonist, CNS, extrapyramidal side effects, drowsniess.
Hyoscine, muscarinic antagonist, anti-muscarinic effects.
Serotonin receptor antagonist, such as ondansetron. Headache, flushing, constipation.
Anti-Emetic Target
Block histamine, dopamine and muscarinic receptors to inhibit transmission of excitatory signals to the vomiting centre from the labyrinth, peripheral afferents, chemoreceptor trigger zone and emotional pathways.
Parkinsons Targets and drugs
L-DOPA with dopa decarboxylase inhibitor.
D2 Agonist.
MAOB/COMT Inhibitors.
Schizophrenia
Too much D2 activation in mesolimbic regions and too little D1 activation in the pre-frontal cortex.
Treat with D2 Antagonists. no effect on negative symptoms. Also bind with less affinity to serotonin and histamine, leading to anti-emetic, dyskinesias and extra-pyramidal side effects.
Alzheimer’s Pathophysiology
Amyloid - Amyloid precursor protein processing usually produces non-toxic products. In Alzheimers, it is cleaved by beta-secretase instead of alpha-secretase, leading to Abeta protein, which form toxic amyloid plaques.
Tau - hyperphosphorylated, insoluble, aggregates to form neurotoxic tangles of microtubules. Dissociation = instability
Inflammation - Microglial cells and astrocytes increase the production of inflammatory mediators in the area surrounding neurones, leading to chronic damage.
Alzheimer’s Treatment
Anticholinesterases.
Can be NMDA receptor antagonists
Anti-Convulsants.
Types include: tonic-clonic, partial, myoclonic, tonic-atonic, status epilepticus and absence.
Treatment tends to focus on VGSC blockers, CCBS, GABA enhancers (prevent metabolism and agonise receptors) and glutamate receptor blockers.
Key considerations should include drug-drug interactions, as these can be severe and common with treatment of epilepsy. May be tetarogenic. Can lso be used in the treatment of neuropathic pain.
