Pharmacology CNS 2 Flashcards
What genetic factor goes behind alzheimers?
On chromosome 19 there is APOE gene that everyone has
APOE ε2 is rare and lowers the risk of Alzheimer’s.
APOE ε3 is the most common and has no effect on risk.
APOE ε4 raises the risk of getting Alzheimer’s, and the more copies a person has, the higher the risk.
What are the proteins that cause alzhimers
Beta-amyloid plaques build up in the brain and disrupt cell communication, contributing to Alzheimer’s.
Tau protein tangles mess up the brain’s transport system, causing brain cells to die.
What are problems with APOE4 gene
makes a person more likely to develop atherosclerosis, which is the clogging of arteries, and increases the risk of stroke and weakens synaptic connections, lowers glucose metabolism, and decreases the brain’s ability to repair itself through neurogenesis.
What is the role of APOE genes
They clear beta-amyloid
Function of acetylcholine
a neurotransmitter important for memory and learning
What receptors respond to glutamte
NMDA receptors
Discuss the mechanism in the brains of people with alzhimers
1)Lower dopamine, serotonin, and norepinephrine in Alzheimer’s patients can lead to mood problems like depression
2)People with Alzheimer’s have lower acetylcholine levels, which contributes to their cognitive decline
3)NMDA receptors are overactivated, leading to excitotoxicity
What medications increase amount of acetylcholine
Donepezil and Tacrine
What is effected if we increase acetylcholine
parasympathetic nervous system is affects
How does Donepezil and Tacrine work
Anticholinesterase inhibitors work by blocking the enzyme acetylcholinesterase, not acetylcholine itself.
how does Memantine drug work/what does it do
Memantine is an NMDA receptor antagonist, which means it blocks NMDA receptors in the brain.
List the 3 drugs to treat alzhumers
-Donepezil
-Tacrine
-Memantine
you should know these FOUR primary symptoms of parkinsons disease
TRAP
T=Tremor
R=Rigidity
A=Bradykinesia
P=Postural instability
What is the relation of Dopamine to acetylcholine
Dopamine helps balance out acetylcholine, without enough dopamine, this balance is disrupted, leading to the motor symptoms we see in PD.
Why does PD happen
The substantia nigra, a part of the brain responsible for starting and controlling movement, doesn’t work properly in people with PD because they lack enough dopamine. Dopamine is necessary for the substantia nigra to function properly. Normally, dopamine helps balance out acetylcholine, another neurotransmitter. Without enough dopamine, not only do motor symptoms like tremors and rigidity occur, but the person also loses the ability to experience things like motivation, reward.
what mechanism can we do to treat symptoms of PD
1)Blocking enzymes that break down dopamine
2)Adding synthetic dopamine
3)Decreasing muscarinic activity to reduce the overactive effects of acetylcholine, helping to restore the balance between dopamine and acetylcholine
List the 6 types of medications we can use on people with PD
1)Carbidopa-levodopa.: chemical converted into dopamine
2)Dopamine agonist: mimic dopamine effects in your brain.
3)MAO-B inhibitors.They help prevent the breakdown of brain dopamine
4) Anticholinergics may help control tremor and rigidity.
5)(COMT) inhibitors.
6)Deep brain stimulation.
Example of Anticholinergics and how they work
-benztropine (Cogentin) and trihexyphenidyl (Artane)
-work by blocking muscarinic receptors, which reduces the effects of acetylcholine in the brain. This is important because in Parkinson’s, there is an imbalance between dopamine and acetylcholine, and by limiting acetylcholine, anticholinergics help restore some balance, easing symptoms like tremors and rigidity.
Dopaminergics use and adverse effects
-precursors of dopamine
Most commonly used is levodopa (Larodopa)
-dyskinesia, hallucination and mental confusion
how does Amantadine work
it acts as a nicotinic antagonist (blocking certain receptors), a dopamine agonist (helping to stimulate dopamine receptors), and a noncompetitive NMDA antagonist (blocking receptors involved in cell damage)
Explain the mechanism behind how schizophrenia is caused
dopamine overactivity and glutamate underactivity both play important roles in schizophrenia, with the subcortex being a key area where dopamine dysfunction occurs.
What is the issue with clozapine (Clozaril)
agranulocytosis=severely low levels of white blood cells
Explain typical and atypical Antipsychotic
Second generation:atypical
older types: typical
List the Typical Antipsychotic
chlorpromazine (Thorazine), haloperidol (Haldol)
List the Atypical
clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal)
How do haloperidol work
blocking postsynaptic dopaminergic receptors.
Antipsychotics: Adverse Effects
sedation, dry mouth, sexual dysfunction, akathisia, bradykinesia, tardive dyskinesia, drowsiness, dizziness when changing positions, blurred vision, rapid heartbeat, sensitivity to the sun, skin rashes, menstrual problems for women.
How does lithium work
stabilizes mood.. decreases norepinephrine release and increases serotonin synthesis, both of which contribute to mood regulation.
Mechanism behind depression
Depression results from hypoactivity and hyperactivity in different brain areas.
Neurotransmitter imbalances, including low serotonin, dopamine, and norepinephrine, are key factors contributing to depression, rather than high serotonin levels.
What part of the brain is lacking in depression
hypoactivity in the dorsolateral PFC, superior temporal cortex, insula, and cerebellum, and hyperactivity in the thalamus, caudate, visual cortex, and ventrolateral and anterior PFC
5 diffrent types of antidepressants cures
Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Atypical antidepressants
For Antidepressents TCAs are used how do they help
Increase effects of norepinephrine and serotonin in the CNS by blocking reuptake by neurons and block the action of acetylcholine.
