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Year 2 Revision > Pharmacology in the CNS > Flashcards

Pharmacology in the CNS Flashcards

1
Q

What is the function of the blood brain barrier?

A

Maintain constant environment
Protect brain from foreign substances
Protect brain from peripheral transmitters

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2
Q

Why is drug entry to the CNS severely restricted?

A

Blood brain barrier (BBB)

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3
Q

Name a structure that lies functionally outwith the BBB.

A

Area postrema - vomit reflex

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4
Q

Name some problems associated with disease of the blood brain barrier.

A

Hypertension, infection, trauma, substances which can enter the CNS and cause toxicity.

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5
Q

Name some routes of drug administration into the CNS.

A

Enteral - i.e. lipophylic drugs
Perenteral (not enterally)
i.e. intrathecal - meningitis antibiotics, opiate analgesics, regional anaesthesia (epidural)

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6
Q

Name some different approaches to aid entry of drugs into the CNS.

A

Prodrugs i.e. L-DOPA
Carrier molecules
Transient BBB disruption (e.g. mannitol)

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7
Q

How does a partial agonist work?

A

partially activates a receptor, producing a functional response in the cell.

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8
Q

Define general anaesthetic agents and list some examples.

A

Drugs used to produce surgical anaesthesia.
Halothane, isoflurane (inhalational)
Propofol (intravenous)

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9
Q

Define anxiolytics and sedatives.

A

Drugs that cause sleep and reduce anxiety. AKA hypnotics, minor tranquilisers.
Barbiturates
Benzodiazepines (diazepam)

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10
Q

Define antischizophenia (antipsychotic) drugs and list some examples.

A

Drugs that are effective in relieving the symptoms of schizophrenic illness AKA neuroleptics, major tranquilisers.
Typical - chlorpromazine, haloperidol.
Atypical - clozapine, olanzapine.

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11
Q

Give some examples of antidepressant drugs.

A

monoamine oxidase inhibitors (phenelzine)
tricyclic antidepressants (imipramine)
SSRIs (fluoxitine)

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12
Q

What is the normal therapeutic onset of antidepressant drugs?

A

2-4 weeks.

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13
Q

What are analgesics? Name some.

A

drugs used clinically for controlling pain.
opiates (e.g. morphine, buprenorphine)
baclofen (gabba B receptor agonists)
NSAIDs (ibuprofen, aspirin)

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14
Q

What are psychomotor stimulants? Name some.

A

Drugs that cause wakefulness and europhia.
Cocaine, amphetamine
methylphenidate (ritalin)
caffeine

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15
Q

What are psychotomimetic drugs? Name some.

A

Drugs that cause disturbances of perception and of behaviour , that cannot be simply characterised as having sedative or stimulant effects.
LSD, ketamine.

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16
Q

What are cognition enhancers? Name some.

A

Drugs that improve memory and cognition performance.

Galantamine, donepezil (AChE inhibitors - Alzheimer’s disease)

17
Q

Gabapentin is a drug specific for what disease?

A

Epilepsy

18
Q

L-DOPA is a drug for what specific disease?

A

Parkinson’s

19
Q

Lithium is a drug used to treat what disorder?

A

Bipolar disorder.

20
Q

Why does most CNS drug treatment need improving?

A

Delayed therapeutic onset
Inadequate therapeutic efficacy
Side effects

21
Q

Where is dopamine produced in the brain?

A

Hypothalamus, substantia nigra.

22
Q

Degeneration of the nigrostriatal pathway (required for fine motor control) occurs in what disease?

A

Parkinson’s disease.

23
Q

Name 3 of the major characteristics of Parkinson’s disease.

A

Tremor, hypokinesia, rigidity.

24
Q

What are some of the causes of parkinson’s disease?

A 
Aging
Genetic factors (synuclein, parkin and other risk genes)
Environmental factors (toxins, herbicides, pesticides)
25
Q

Describe three therapies which aim to treat Parkinson’s disease.

A
  1. Replace dopamine (L-DOPA)
  2. Mimic dopamine action (D2/3 agonists - bromocriptine)
  3. Reduce dopamine breakdown (MAOIs - selegiline)
26
Q

What are some side-effects of dopamine agonists?

A
  1. Hallucinations

2. Pathological gambling/shopping

27
Q

List some of the symptoms of schizophrenia.

A

Hallucinations, delusions, sustained depression, anhedonia (inability to feel pleasure), avolition (lack of drive), impaired attention.

28
Q

How does schizophrenia treatment work?

A

Reduce dopaminergic signalling at D2 dopamine receptors (D2 agonists).

29
Q

What are some of the side effects of D2 agonists?

A

akinesia, prolactin hypersecretion, postural hypotension, sedation, dry mouth, weight gain.

30
Q

Dopamine travels to the anterior pituitary gland where it binds to prolactin secreting cells. How does it get there?

A

It is secreted into the portal blood vessels.

31
Q

What effect does dopamine have on prolactin secretion?

A

dopamine decreases prolactin secretion.

32
Q

Describe the tuberohypophyseal system.

A

Group of short dopamine neurons that projects from the arcurate nucleus in the hypothalamus to the median eminence.

33
Q

What effect does dopamine have on growth hormone?

A

Growth hormone is increased by dopamine.

Year 2 Revision (15 decks)

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