Spring 2013 Pharm review for Reddy Flashcards
Name the Excitatory NT in the CNS
Glutamate, Substance P
- dopamine, serotonin, NE, Ach depending on the receptor involved
Name the Inhibitory NT in the CNS
GABA, Enkephalins, Glycine (SC)
- dopamine, serotonin, NE, Ach depending on the receptor involved
What are the four dopaminergic pathways in the brain
- Nigrostriatal System
- Mesolimbic System
- Mesocortical System
- Tuberinfidibulum System
The Nigrostriatal system regulates
movement
The Mesolimbic system regulates
emotion, love
The Mesocortical system regulates
cognition, motivation
The Tuberinfindibulum system regulates
pituitary
Dopamine, NE are both released at nerve terminals, How is the action of these NT terminated
- Reuptake (about 90%)
- MAO-metabolism
- COMT-metabolism
Name three drug strategies to increase the amount of NT
- Inhibit reuptake
- Inhibit MAO
- Inhibit COMT
Name two examples of drugs used to inhibit NT reuptake
cocaine
TCA- Imipramine
Name a drug used to inhibit MAO
Selegiline
*used in alzheimer’s dx to inhibit MAO B
Alzheimer’s is characterized by loss of many neurons, especially
cholinergic
*Too little Ach
Alzheimer’s results in impairment of
memory and cognitive functions
Name a drug used to increase AcH in the brain
Donepezil
What NT is implicated in destruction of cholinergic nerve death
Glutamate
What drug is used to address glutamates effect on patient’s with alzheimers
Memantine
Attention-deficit/Hyperactivity disorder is characterized by
Persistent pattern of frequent, severe inattention and/or hyperactivity
What drugs are most frequently used to tx ADHD
stimulants
What secondary drug is used to tx ADHD
nonstimulant
- Atomoxetine- given to patient’s refractory to stimulant therapy
Atomoxetine is a
selective NE reuptake inhibitor
Name two stimulants used to tx ADHD
methylphenidate (ritalin)
amphetamine (adderrall)
- both work in RAS
methylphenidate’s MOA includes
blocking reuptake of dopamine in CNS
amphetamine’s MOA includes
increases release of dopamine & NE
Name the three main drug categories used to tx anxiety
- Benzodiazepine
- Non-Benzo Benzos
- Buspirone
Benzos agonize what receptor
GABA
- opens chloride channels
Non-Benzo benzos agonize what receptor
GABA
Name some benzos
“zepam” or “zolam”
Diazepam, Lorazepam, Midazolam
Buspirone partially agonizes what serotonin subtype
5-HT 1A
What is the difference b/t Buspirone and Benzos
Benzos onset immediate
Buspirone onset takes weeks
Buspirone increases risk for seizures, increased HR (stimulant)
Non-Benzo benzo’s major difference from Benzos is that
it is less addictive
Name three major non-benzo benzos
Zolpidem
Zaleplon
Eszopiclone
What is the GABA antagonist used to treat overdose of benzos and non-benzo benzos
Flumazemil
Name a drug used to inhibit COMT
**capone
What two drugs help with insomnia
Melatonin (released by pineal gland)
RaMELTeon
Parkinson’s is characterized by
too little dopamine in the nigrostriatial pathway
What 1st line drug combination is used to tx parkinsons
levadopa and carbidopa
Why is carbidopa added to L-dopa therapy
to inhibit L-aa carboxylase from converting L-dopa to Dopamine in the periphery
What is the on-off phenomenon seen with parkinson treatment with L-dopa/carbidopa
normal movement followed by resting tremors, rigidity, bradykinesia, etc
- caused by continued loss of dopamine neurons
Name three other strategies besides replacing dopamine used to tx parkinsons
block metabolism of dopamine
dopamine agonism
anti-Ach drugs
name two drugs used to block dopamine metabolism via inhibition of COMT
talCAPONE
entaCAPONE
name a drug used to block dopamine metabolism via inhibition of MAO
selegiline (MAO B)
Name a dopamine agonist used to tx parkinsons
Bromocriptine
Name an anti-cholinergic drug used to tx parkinsons
benztropine
Huntington’s disease is characterized by loss of
GABA neurons- loss of inhibition
*Too much movement (chorea)
What is the tx strategy for Huntington’s disease
control symptoms, support therapy
List the four primary drugs used to tx epilepsy
Valproic acid
Ethosuximide
Phenytoin
Carbamazepine
Name the generalized seizures
Generalized tonic-clonic (grandMal)
Absence (PetitMal)-originating in occipital area
Myoclonic (muscle involvement)
Name two drugs used to treat generalized tonic-clonic seizures
carbamazepine
valproic acid
Name two drugs used to tx absence seizures
Ethosuximide-blocks ca2+ current in thalmus
valproic acid
Name the three partial seizures
simple partial - No LOC
complex partial - LOC
partial seizures with secondary generalization
Name a drug used to tx all three partial seizures
carbamazepine
What is the MOA of most antiepileptic drugs
blocking or hyperpolarizing ion channels
What two antiepileptics work by blocking sodium channels
Carbamazepine
Phenytoin
What two antiepileptics work by blocking calcium channels
Ethosuximide
Valproic acid
What four antiepileptics work by hyperpolorizing neurons
Carbamazepine
Benozs
Phenobarbital
Valproic Acid
Name two other strategies used to tx epilepsy
enhancement of GABA
reduction of excitatory NT