Pharmacology for the Nervous System Flashcards

1
Q

What is the main focus of CNS pharmacology?

A

To modify synaptic transmissions in the central nervous system.

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2
Q

What are the functions of the cerebrum?

A
  • thinking
  • sensory perception
  • voluntary motor actions
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3
Q

What disorders are associated with the basal ganglia?

A

Disorders such as Parkinson’s and Huntington’s disease are associated with the basal ganglia.

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4
Q

What are the functions of the diencephalon?

A
  • The diencephalon includes the thalamus and hypothalamus.
  • Controlling sensations, temperature, appetite, water balance, and emotional reactions.
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5
Q

What are the functions of the mesencephalon and brainstem?

A

Controls respiration, cardiovascular function, arousal, and alertness.

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6
Q

What role does the cerebellum play?

A

The cerebellum helps plan and coordinate motor activity and maintain balance and posture.

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7
Q

What is the function of the limbic system?

A

The limbic system regulates emotional and behavioral activities (motivation, aggression, and sexual activity).

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8
Q

What are the functions of the spinal cord?

A

The spinal cord connects neurons and transmits signals between the brain and specific body levels.

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9
Q

What is the blood-brain barrier?

A

A selective filter that limits substances entering the CNS, allowing nonpolar lipid-soluble drugs to pass through.

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10
Q

What are neurotransmitters?

A

Chemicals that transmit signals between neurons, producing excitatory or inhibitory effects.

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11
Q

What is the role of acetylcholine in the CNS?

A

Acetylcholine is helpful in cognition and memory, generally producing excitatory effects.

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12
Q

What is dopamine associated with in the CNS?

A

Dopamine regulates motor control, mood, and emotions, and is commonly associated with Parkinson’s disease.

  • Inhibition
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13
Q

What effects does norepinephrine have in the CNS?

A

Norepinephrine increases alertness, arousal, and attention by causing excitation through inhibition.

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14
Q

What is serotonin’s primary role in the CNS?

A
  • Serotonin acts as a strong inhibitor
  • Affecting mood, behavior, and inhibiting painful stimuli.
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15
Q

What are the functions of GABA and glycine?

A

GABA and glycine are inhibitory neurotransmitters, causing inhibition at presynaptic and postsynaptic neurons.

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16
Q

What are the roles of aspartate and glutamate?

A

Aspartate and glutamate cause CNS excitation and may produce neurotoxic effects during CNS injury.

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17
Q

What are the functions of substance P?

A

Substance P is an excitatory transmitter in the spinal cord, mediating the transmission of painful sensations.

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18
Q

How do drugs affect presynaptic action potential?

A

Certain drugs block propagation along neural axons, eliminating activity at the synapse by preventing action potential from reaching the presynaptic terminal.

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19
Q

What happens when neurotransmitter synthesis is inhibited?

A

Blocking synthesis depletes the presynaptic terminal and impairs transmission.

20
Q

What is the effect of inhibiting neurotransmitter storage?

A

Impairing storage decreases the synapse’s ability to transmit information for extended periods.

21
Q

How do drugs that affect neurotransmitter release work?

A

Some drugs increase synaptic activity by increasing neurotransmitter release, while others decrease activity by reducing release.

22
Q

What is the result of inhibiting neurotransmitter reuptake?

A

Impairing reuptake allows more neurotransmitter to remain in the synaptic cleft, increasing synaptic activity.

23
Q

How does inhibiting neurotransmitter degradation affect synaptic activity?

A

Inhibition prevents breakdown of the transmitter, allowing more active neurotransmitter to remain in the cleft and increasing activity.

24
Q

What is the role of postsynaptic receptor modulation?

A

Drugs can block or enhance receptor activity, affecting neurotransmitter binding and synaptic transmission.

25
Q

How do presynaptic autoreceptors affect neurotransmitter release?

A

Autoreceptors serve as negative feedback, limiting further neurotransmitter release when high levels of activity occur.

26
Q

What are membrane effects on synaptic transmission?

A

Drugs alter membrane organization and fluidity, affecting vesicle fusion and neurotransmitter release.

27
Q

What are antispasticity medications used for?

A

To manage spastic muscles resulting from CNS dysfunction.

28
Q

What are the primary uses of benzodiazepines?

A

Used for hypnotic effects, anxiety treatment, seizure reduction, general anesthesia, and muscle relaxation.

29
Q

What are common nonbenzodiazepine sedatives?

A

Zolpidem (Ambien), Zaleplon (Sonata), and Eszopiclone (Lunesta).

30
Q

What are the risks associated with barbiturates?

A

High addiction potential, strong sedative effects, and a small therapeutic index.

31
Q

How are sedative-hypnotics typically administered?

A

Primarily orally, easily absorbed in the GI tract, and reach the CNS through the blood-brain barrier.

32
Q

What are common adverse effects of sedative-hypnotics?

A

Residual drowsiness, decreased motor performance, tolerance, dependence, and withdrawal effects.

33
Q

What are rehab considerations for patients on sedative-hypnotics?

A

Schedule visits to avoid peak sedative effects, consider fall risk, and promote non-pharmacological interventions.

34
Q

What is psychosis?

A

A severe form of mental illness marked by thought disturbances and impaired perception of reality.

35
Q

What are traditional antipsychotic medications?

A

Dopamine receptor antagonists in the mesolimbic pathway, with side effects including movement disorders.

36
Q

What are atypical antipsychotic medications?

A

Weak D2 dopamine antagonists, strong serotonin receptor antagonists, with lower side effect risks.

37
Q

How are antipsychotics metabolized?

A

Primarily in the liver, with prolonged use increasing metabolism rate, reducing drug effects.

38
Q

What are drug-induced movement disorders (DIMD)?

A

Abnormal movement patterns due to dopamine blocking, including tardive dyskinesia, pseudoparkinsonism, and akathisia.

39
Q

What is neuroleptic malignant syndrome?

A

A potentially fatal condition from high doses of dopamine receptor-blocking drugs, characterized by hyperthermia, rigidity, and altered mental status.

40
Q

What are nonmotor adverse effects of antipsychotics?

A

Metabolic effects, sedation, anticholinergic effects, and orthostatic hypotension.

41
Q

What are rehab considerations for patients on antipsychotics?

A

Monitor motor control changes, ensure patient cooperation, and be aware of sedation and orthostatic hypotension risks.

42
Q

What is epilepsy?

A

A neurological disorder with recurrent seizures due to sudden disturbances in cerebral excitation.

43
Q

What are first-generation antiepileptic drugs?

A

Barbiturates, benzodiazepines, hydantoins, iminostilbenes, succinimides, and valproates, each with specific mechanisms and adverse effects.

44
Q

What are second-generation antiepileptic drugs?

A

Newer medications such as felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, pregabalin, rufinamide, tiagabine, topiramate, vigabatrin, and zonisamide, with varied mechanisms and side effects.

45
Q

How are antiepileptic drugs metabolized?

A

Primarily in the liver, with most drugs administered orally and exerting effects on the brain.

46
Q

What are rehab considerations for patients on antiepileptic drugs?

A

Be aware of seizure risk, educate patients on medication timing, and reduce adverse effects affecting therapy.