Quiz One Material Flashcards
What are the two methods of action in neurotransmitters?
Direct and indirect
What is it called when a drug or other neurotransmitter opens a channel?
Ionotrophic
What is it called when differences in membrane potential cause a channel to open?
Voltage-gated channels
What is the receptor called that, when a cellular signal, cause a cell to release secondary messengers?
Metabotrophic receptor
What are the three neurotransmitters that are catecholamines?
- Epinephrine, 2. Norepinephrine and 3. Dopamine
Which amino acid is used to create Dopamine?
Tyrosine
What is the name of the enzyme that transforms Tyr into DOPA?
Tyrosine Hydrolase
What is the name of the enzyme that transforms DOPA into DA?
Aromatic Amino Acid Decarboxylase
What transporter allows DA to be transferred into vesicles?
VMAT
What enzyme breaks down DA?
MAO
What transforms DA into NE?
Dopamine Beta Hydroxylase
What type of receptor is the autoreceptor for NE?
Alpha 2
What is the main type of cell that creates and releases Epinephrine?
Adrenal Medullary Cells
What is the second most likely culprit to release Epinephrine?
Some CNS Neurons
What catalyzes the change from NE to Epinephrine?
PNMT
What are three common maladies that 5 HT is used to treat?
- Sleeping disorder, 2. Depression and 3. Migraines
Which AA is used as a back bone to create 5 HT?
Tryptophan
Once the AA is taken up for the creation of 5 HT, what is the first enzyme that modifies it?
Tryptophan Hydroxylase
What is the AA for the creation of 5 HT turned into first?
5 HTP
What two autoreceptors exist for 5 HT?
5 HT alpha 1 and 5 HT beta
What is the AA that is used to start construction of ACh?
Choline
What is combined to form ACh?
Acetyl CoA and Choline
What is the name of the enzyme that creates ACh?
Choline Acetyl Transferase
What does the ACh signaling use instead of VMAT?
Vesicular Acetylcholine Transferase
What type of receptor is the ACh autoreceptor?
Maxurinic receptor (Muscarinic?)
What type of signals receive ACh signals?
Muscarinic or Nicotinic
What happens to free ACh floating around extracellularly?
It is degraded via Acetylcholinesterase to Choline
What type of receptor does NE interact with postsynaptically?
Alpha or Beta receptor
Which AA is used to create GABA?
Glutamine
What enzyme transforms an AA to make GABA?
Glutamate Decarboxylase
What transporter moves GABA into vesicles?
Vesicular GABA Transporter
What two receptors exist for the post-synaptic reception of GABA?
GABA alpha and GABA beta receptors
What type of receptor is the autoreceptor for GABA?
GABA beta
What brings GABA back into the cell?
GABA transporter
What enzyme transforms GABA in astrocytes?
GABA transaminase
What pathway is always excitatory?
Glutamate signaling
What is the starting AA in the glutamate signaling pathway?
Glutamine
Glutamine tranforms into _?
Alpah Keto glutarate
What transforms alpha keto glutarate into glutamate?
Aminotransferase
What packages glutamate?
Vesicular glutamate transporter
What two types of post-synaptic receptors exist for glutamate?
- NMDA and 2. AMPA
What do Astrocytes do with Glutamate?
They transform it into glutamine and ship it back to the pre-synaptic neuron
What enzyme is used to transform Glutamate into glutamine?
Glutamine synthase
What affect do endorphins have on neurotranmitters?
GABA decreases
What type of receptor do endorphins target?
Mew opioids
How does Histamine act?
On the H3 receptor as an inhibitory heteroreceptor
What does neurotensin do?
Regulates DA system - inhibitory feedback
Where is neurotensin found?
GI tract - inhibits motility and circulation
How does amphetamine work?
Increases DA release
How does cocaine work?
Blocks DA reuptake
How does methylpenidate work?
Blocks DA reuptake
How does Tricyclic work?
Blocks reuptake of NE and 5 HT
What do endocannabinoids target?
Anandamides
What type of receptor turns off DA release?
D2
What do kainate receptors respond to?
Glutamate
What transforms Alpha-keto-glutarate into Glutamate?
Glutamate dehydrogenase
What four structures tend to be targeted by parasympathetic innervation?
- Smooth muscles, 2. Gland cells, 3. Cardiac muscles and 4. Nerve terminals
Name the neurotransmitter route for parasympathetic innervation?
Medulla -> ACh to Nicotinic receptor -> ACh Muscarinic receptor
Name the neurotransmitter route for sympathetic sweat gland innervation?
Spinal cord -> ACh to Nicotinic receptor in Sympathetic chain -> ACh on Muscarinic receptors in sweat glands
Name the neurotransmitter route for sympathetic cardiac, smooth muscle, gland cells, and nerve terminal innervation?
Spinal cord -> ACh to Nicotinic receptor in Sympathetic chain -> NE on alpha and beta receptors in target cells
Name the neurotransmitter route for sympathetic renal vascular smooth muscle innervation?
Spinal cord -> ACh to Nicotinic receptor in Sympathetic chain -> DA on D1 receptors in target cells
Name the neurotransmitter route for sympathetic release of Epinephrine and NE?
Spinal cord -> ACh to Nicotinic receptor in adrenal medulla -> releases Epi and NE
Name the neurotransmitter route for somatic innervation?
Ach to Nicotinic receptor in skeletal muscle
What four structures tend to be targeted by parasympathetic innervation?
- Smooth muscles, 2. Gland cells, 3. Cardiac muscles and 4. Nerve terminals
Name the neurotransmitter route for parasympathetic innervation?
Medulla -> ACh to Nicotinic receptor -> ACh Muscarinic receptor
Name the neurotransmitter route for sympathetic sweat gland innervation?
Spinal cord -> ACh to Nicotinic receptor in Sympathetic chain -> ACh on Muscarinic receptors in sweat glands
Name the neurotransmitter route for sympathetic cardiac, smooth muscle, gland cells, and nerve terminal innervation?
Spinal cord -> ACh to Nicotinic receptor in Sympathetic chain -> NE on alpha and beta receptors in target cells
Name the neurotransmitter route for sympathetic renal vascular smooth muscle innervation?
Spinal cord -> ACh to Nicotinic receptor in Sympathetic chain -> DA on D1 receptors in target cells
Name the neurotransmitter route for sympathetic release of Epinephrine and NE?
Spinal cord -> ACh to Nicotinic receptor in adrenal medulla -> releases Epi and NE
Name the neurotransmitter route for somatic innervation?
Ach to Nicotinic receptor in skeletal muscle
Cell bodies located in the thoracolumbar region with axons that extend to para- and pre-vertebral ganglia that, in the ganglia, have synapses with post-ganglionic neurons all describes which type of nervous system?
Pre-ganglionic Sympathetic System
Cell bodies are in para- and pre-vertebral ganglia, axons/fibers extend to effector tissues/organs, and pre-ganglionic nerves also innervate adrenal medulla all describe what nervous system?
Post-ganglionic Sympathetic nervous system
Cell bodies are craniosacral, axons extend to ganglia located near or in effector tissues/organs, and in the ganglia, axon terminals synapse ont other neurons all describes which nervous system?
Pre-ganglionic Parasympathetic Nervous System
Cell bodies are near effector tissues/organs and axons innervate effector tissue both describe which nervous system?
Post-ganglionic Parasympathetic Nervous System
What signaling is used in pre-ganglionic signaling?
ACh to nicotinic receptors
What is the most common post-ganglionic sympathetic receptor?
NE
Which receptors are activated by DA?
D1, (other D’s as well), Alpha and Beta
What neurotransmitter is used on post-ganglionic parasympathetic neurons?
ACh on muscarinic receptors in effector tissues or nicotinic receptors in somatic muscles
What percentage of people in the US develop epilepsy? How about in the world?
1:26 in US, 1:100 in the world
What percentage of epileptic patients are therapy-resistant?
25-40%
What is epileptogenesis?
A sequence of events that converts a normal neuronal network into a hyperexcitable network
What is the lifetime prevalence of seizures?
9-10% of the population
What is the largest cause of epilepsy?
Ion Channel mutations
What are the four criteria of a simple partial seizure?
- Localized focus, 2. Minimal spread, 3. Normal awareness/memory/conciousness and 4. Short duration
What are the three signs of a complex partial seizure?
- Localized, 2. Awareness/memory/conciousness are lost, and 3. duration is short
What is an “aura” in regards to seizures?
When there is a disturbance of higher cerebral function
What are the three characteristics of a secondary generalized seizure?
- Begin as simple/complex partial, 2. phases of tonic and clonic phases and 3. postictal phase - confusion afterwards
What type of seizure is an absence seizure?
A generalized seizure
What tends to make new ASDs safer than old ones?
Fewer drug-drug interactions
What are the three primary MOA for ASDs?
- Enhancement of GABA inhibition, 2. Reduction of excitatory (usually glutamate) and 3. Modification of ionic conductances
What is currently the only ASD for Absence seizures?
Ethosuximide
What is the drug of choice for partial and generalized T/C seizures?
Carbamazepine
What is the MOA for carbamazepine?
Blocks Na channels
What disease can result from medication, causes severe rashes, and is most common in Chinese?
Stevens-Johnson Syndrome
What is concerning about grapefruit juice and carbamazepine?
It raises the amount of drug in the system
What is the MOA for ethosuximide?
Reduces T-type Ca2+ channel currents
What is the name of the ASD that was commonly used in the US, but was found to have risks outweighing the benefits and is still frequently used in other countries today?
Phenolbarbital
What type of patient should absolutely never use Phenolbarbital?
Those with Absence seizsures
What is the drug that causes gingival hyperplasia and has zero-order kinetics at high doses?
Phenytoin
What is the MOA for Phenytoin?
Blockade of Na channels
What drug has a nonlinear, dose-dependent kinetics?
Carbamazepine
Which ASD is being investigated for its weight-loss effect and can cause the metabolism of estrogen (ineffective birth control)?
Topiramate
What is topiramate’s MOA?
Blocks Na channels, inhibits Ca channels, inhibits AMPA/kainate receptors and potentiates GABA
What ASD is strictly contraindicated in hepatic disease or in pregnancy?
Valproic Acid
What are the three best drugs to prescribe for partial seizures?
- Carbamazepine, 2. Phenytoin and 3. Topiramate
What are the two best drugs to treat generalized tonic-clonic seizures?
- Valproate and 2. Topiramate
What are the two best ASD for treating Absence seizures?
- Ethosuximide and 2. Valproate
Which ASDs cause dizziness, fatigue, ataxia and diplopia?
All ASDs
Which ASD causes irritability?
Levetiracetam
Which ASD causes word-finding difficulty?
Topiramate
Which ASD causes weight loss?
Topiramate
Which ASDs cause weight gain?
Everything but Topiramate
What are the three agonists of the muscarinic receptors?
- ACh, 2. Bethanechol and 3. Pilocarpine
What are the two antagonists of the muscarinic receptors?
- Atropine and 2. Scopolamine
What is bathanechol typically used for?
GI motility
What is Pilocarpine used for?
Glaucomas
What is the agonist for Nicotinic receptors?
ACh
What are the two antagonists of nicotinic muscle receptors?
- Succinylcholine and 2. D-tubocurarine
What is the antagonist of nicotinic nerve receptors?
- Mecamylamine
How does Succinylcholine act?
It keeps cells depolarized
How does Tubocurare work?
It competes with ACh at Nicotinic receptors (non-depolarizing)
How does Sarin (nerve gas) affect the body?
Causes cholinesterase inhibition and death
What is the name of the anti-cholinesterase drug that has a short duration of action, is used for glaucomas and is an antidote for atropine?
Physostigmine
What is the anti-cholinesterase drug that has an extended duration of action and is used to treat Alzheimer’s?
Donepezil
What drug prevents the release of ACh and is used to treat muscle dystonia (spasms) and remove wrinkles?
Botulinim Toxin
What drug is used in dentistry to treat xerostomia in Sjogren’s syndrome?
Cevimeline
What drug is used to treat xerostomia after radiotherapy?
Pilocarpine
What are the two agonists of Alpha one receptors?
- Epi > NE and 2. Phenylephrine
What is the antagonist for Alpha one receptors?
Prazosin
What are the three agonists for Alpha two receptors?
- Epi > NE, 2. Clonidine and 3. Guanfacine
What are the two agonists for Beta one receptors?
- Epi = NE and 2. Isoproterenol
What is the antagonist for Beta one receptors?
Propranolol
What are the four agonists for Beta two receptors?
- Epi»_space; NE, 2. Isoproterenol, 3. albuterol and 4. terbutaline
What is the antagonist for Beta two receptors?
Propranolol
What are the two agonists of D1 receptors?
- DA and 2. Fenoldapam
What are three uses for Alpha one agonists?
- treat shock, .2 nasal decongestant and 3. mydriasis
What are two uses for Alpha two agonists?
- Treatment of hypertension and 2. treatment of ADHD patients
What are three uses for Beta one agonists?
- Asthma, 2. COPD and 3. relax muscles of uterus
What are the three drugs that release NE?
- Ephedrine, 2. Ephedra and 3. Pseudoephedrine
What are NE agonists used for?
Decongestants and Dietary supplements
What are the two non-selective Alpha antagonists?
- Phenoxybenzamine and 2. Phentolamine
What two reasons would you use a non-selective Alpha antagonist for?
- Pheocromocytoma and 2. hypertensive emergencies
What are the two alpha one antigonists?
- Prazosin and 2. terazosin
What is used to treat benign prostatic hypertrophy?
Tamsulosin
What are antimuscarinic drugs used for (2)?
- Parkinson’s and 2. motion sickness