Pharmacology Week 10

Question 1

What are some examples of therapeutic uses for CNS drugs?

Answer 1

• depression
• migraine
• anxiety
• insomnia

Question 2

What are example of drugs used socially that affect the CNS?

Answer 2

• caffeine
• alcohol
• nicotine

Question 3

endogenous chemicals that transmit signals from a neuron to a target cell across a synapse

Answer 3

central neurotransmitters

Question 4

what are some examples of fast point-to-point signaling?

Answer 4

• amino acids: glutamate, aspartate, GABA, glycine

- Ach

Question 5

What are some examples of slow regulatory signaling?

Answer 5

-neuropeptides
-monoamines
others (histamine 1 receptors, nitric oxide

Question 6

say whether the amino acid is excitatory or inhibitory:

• Glutamate:
• aspartate:
• GABA:
• glycine:

Answer 6

• Glutamate: excitatory
• aspartate: excitatory
• GABA: inhibitory
• glycine: inhibitory

Question 7

used to render patients unaware of and unresponsive to painful stimulation

Answer 7

general anaesthetic agents (GA)

Question 8

What are some examples of GA…

• IV:
• inhaled:

Answer 8

• IV: ketamine, midazolam, propofol

- inhaled: methoxyflurane and nitrous oxide

Question 9

What are indications for IV general anesthetics?

Answer 9

• conscious sedation (midazolam, propofol)
• sedation during ventilation
• pain relief (ketamine)

Question 10

potent IV analgesic

• dissociative anesthesia (patient appears awake but in unconscious)
• safer profile

Answer 10

ketamine

Question 11

what are adverse effects of ketamine?

Answer 11

• raised BP and pulse rate

- increased muscle tone

Question 12

What are adverse effects of propofol?

Answer 12

• involuntary movements
• bradycardia/ hypotension
• apnea

Question 13

• IV anaesthetic that is used as first line
• unconsciousness occurs about 30 sec after injection
• short half life

Answer 13

propofol

Question 14

what are indications for nitrous oxide and hydrocarbons?

Answer 14

• introduction and maintenance of anesthesia

- analgesia (green whistle)

Question 15

widely used analgesics for moderate to severe pain. act on opiod receptors in the brain and spinal cord to control pain

Answer 15

opioid analgesics

Question 16

What do opioid analgesics produce?

Answer 16

euphoria, reduce anxiety, promote sleep, inhibit coughing and may be used to treat diarrhea

Question 17

most important in modulating pain. Its a GPCR receptors that affect the dorsal horn by inhibiting potassium channels and decreasing the messaging going through

Answer 17

mu-opioid receptor

Question 18

from a plant, prototype drug, potent analgesic

Answer 18

morphine (ordine)

Question 19

synthetic opioid, very potent

Answer 19

fentanyl (durogesic)

Question 20

more lipid soluble, rapidly crosses BBB (when first used, believed to not be addictive)

Answer 20

heroine

Question 21

long acting, treatment of narcotic addiction

Answer 21

methadone (physeptone)

Question 22

most used strong opioid (outpatients)

Answer 22

oxycodone (endone)

Question 23

pro-drug. mild to moderate pain. cough

Answer 23

codeine (actacode)

Question 24

indications for opioid analgesics

Answer 24

• acute or chronic pain
• cough suppression (codeine)
• diarrhea (codeine)
• opioid dependence (methadone)
• opioid adjunct during general anesthesia (fentanyl, morphine)

Question 25

adverse effects of analgesics

Answer 25

- tolerance and physical dependence - withdrawal syndrome (dilated pupils, muscle aches, extreme anxiety) - constipation - nausea - dizziness - headaches

Question 26

What is used to reverse overdose and decrease GI adverse effects?

Answer 26

- Naloxone (opioid antagonist) | - acupuncture (release endogenous opioids)

Question 27

there is conclusive or substantial evidence that cannabis are effective.....

Answer 27

- for the tx for chronic pain in adults - antiemetics in treatment of chemotherapy-induced nausea and vomiting - for improving patient reported multiple sclerosis spasticity symptoms

Question 28

plant derived cannabis compound

Answer 28

THC

Question 29

explain the difference b/w the 2 CB receptors

Answer 29

CB1: mainly localized in the brain (THC) CB2: mainly in the periphery (in blood) leukocytes

Question 30

CBD name: | was used to treat?

Answer 30

cannabidiol (CBD) | -epilepsy

Question 31

neurological drugs

Answer 31

- antiepileptics - drugs for Parkinsonism - drugs for migraine - drugs for alzheimers - drugs for stroke - drugs for multiple sclerosis - drugs for myasthenia gravis

Question 32

psychotropic drugs

Answer 32

- antidepressants - antipsychotics - drugs for bipolar disorder - anxiolytics and hypnotics - drugs for ADHD - drugs for alcohol, nicotine, and opioid dependence

Question 33

chronic disease in which seizures result from abnormal discharge of cerebral neurons

Answer 33

epilepsy

Question 34

anti epileptics mechanism of action

Answer 34

- inhibition of sodium channels - enhancement of GABA action - inhibition of calcium channels - inhibition of the action of glutamate

Question 35

anti epileptics indications

Answer 35

- epilepsy - bipolar disorder - prevention of migraine - neuropatic pain - status epilepticus

Question 36

adverse effects of gabapentin (Neurontin)

Answer 36

- drowsiness/dizziness/ataxia - tremor, amnesia - peripheral edema - movement disorders

Question 37

adverse effects of valproate (epilim)

Answer 37

- drowsiness/ataxia - tremor - paraesthesia - increased appetite/ weight gain

Question 38

anti epileptic medications

Answer 38

- gabapentin (Neurontin) - valproate (epilim) - pregabalin (Lyrica) - benzodiazepines

Question 39

adverse effects of pregabalin (Lyrica)

Answer 39

- drowsiness, dizziness, ataxia - tremor, impaired balance - peripheral edema - dysartria

Question 40

progressive degenerative disease of the basal ganglia in CNS causing poverty of movement, rigidity and tremor

Answer 40

Parkinsons disease

Question 41

what is the main pathology in parkinsons disease?

Answer 41

extensive degeneration of the dopaminergic nigrostriatal tract, associated with DECREASED levels of dopamine

Question 42

examples of Parkinson's disease drugs

Answer 42

- anticholinergics - dopamine agonist - levodopa - amantadine - MAI inhibitors

Question 43

alteration in cerebral blood flow that leads to changes in intracranial pressure, fluctuating levels of serotonin

Answer 43

migraine

Question 44

for acute migraines what is the first line treatment? | second line?

Answer 44

1: analgesic drugs (NSAIDs and paracetamol), antiemetic drugs 2: triptans

Question 45

constricts cranial vessels by acting selectively at 5HT1 receptors

Answer 45

Triptans

Question 46

adverse effects of triptains

Answer 46

- transient paraesthesia - drowsiness/ fatigue - transient increase in BP - weakness - myalgia

Question 47

2 or 3 severe attacks of migraines a month would warrant ?

Answer 47

migraine prophylaxis | beta blockers, amitriptyline, valproate, botulinum toxin

Question 48

prophylaxis of headaches in adults with chronic migraine

Answer 48

botox

Question 49

a form of dementia characterized by profound brain shrinkage, enlarges ventricles and significant change to brain tissue

Answer 49

Alzheimer's Disease

Question 50

What drugs are used to treat Alzheimers disease?

Answer 50

anticholinesterases

Question 51

drug that increases acetylcholine effect

Answer 51

anticholinesterase

Question 52

what are adverse effects for anticholinesterases?

Answer 52

- vomiting/ nausea/ dyspepsia - dizziness - myalgia - muscle cramps