TTR np Flashcards by Nathan Maassel

local neurotransmitters?

diffuse neurotransmitters?

local: GABA, GLU, endocannabinoids, gases
diffuse: monoamines(DA, 5HT,NE), acetylcholine, opioids, histamine

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ionic vs GPCR for acetylcholine

ionic - nicotinic

GPCR - muscarinic

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primary origin of NE in CNS

primary role?

locus coeruleus

attencion, vigilance, mood, emotion

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primary origin of 5HT in the brain?

primary roles in the brain?

ionotropic receptor?

raphe nuclei

arousal, mood, motion, migraine

5HT3 are ionic

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where are endorphins found?

hypothalamus exclusively

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where are enkephalins and dynorphins found?

periaqueductal gray and dorsal horn of spinal cord

these are endogenous opioids

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endogenous opioids

endorphins

enkephalins and dynorphins

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donepezil

rivastigmine

galantamine

cholinesterase inhibitors approved for treating alzheimers

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maintenance drugs for headaches causing trouble with daily life

amitriptyline - TCA

cyproheptadine - antihistamine(increases appetite)

divalproex sodium(valproate)

gabapentin - anticonvulsant, analgesic

topiramate - anticonvulsant, decreases weight

propanolol - lowers BP

verapamil

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ketorolac

non-selective COX inhibitor

powerful analgesic; NSAID

used to reduce the amount of morphine needed to be used

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effects of opioid agonists on the body

analgesia, sedation

RESPIRATORY DEPRESSION
antitussive - dextromethorphan

muscle rigidity

miosis

mostly CV stable but some bradycardia

GI constipation and urinary retention

can cross into placenta

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What is the blood gas partition coefficient and what does it mean?

Measure of solubility of the gas in blood (trends are generally applicable to tissues as well)

Lower Number = Less soluble

N2O < Des < Sev < Iso

Iso is most soluble - therefore takes the longest for emergence

Nitrous and DES are least soluble in all tissues

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general effects of inhaled anesthetics

CV depression

respiratory depression; bronchodilation

nausea/emesis

increased CBF; decreased metabolic demand

unconscious, amnesia, immobility

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adverse effects of etomidate

adrenocortical suppression

pain on injection

myoclonic movements

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mechanism of action for the iv anesthetics

propofol, etomidate - gaba block

ketamine - NMDA block

dexmedetomidine - a2AR agonist

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when is succinylcholine used

emergency surgery

full stomach

acute abdomen

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what are rosenthal fibers

alpha-beta crystalline inclusions in astrocytes adjacent to lesions

found in alexander disease and pilocytic astrocytoma

what is corpora amylacea

age related starch inclusions in astrocytes

alzheimers type 2 astrocytosis is seen in what

hepatic encephalopathy

wilson’s disease

NOT associated witha alzheimers

pathological and clinical presentation of corticobasal degeneration

path - ballooned neurons; tau inclusions

clinical - parkinsonism, alien limb, asymmetrical motor signs, dementia

pathological and clinical presentation of multiple system atrophy

path - olivopontocerebellar degen, nigrostriatal degen, shy-drager

clinical - ataxia, parkinsonism, autonomic dysfunction

bunina bodies are seen in

ALS

temozolomide

alkylating agent used in glioblastoma

more effective on methylated tumors; MGMT

positive prognostic markers for oligodendrogliomas

IDH-1 and 1p19q mutations

splitting of spinal cord

diastematomyelia

lacosamide mechanism, fxn

change Na channel shape partial seizure; add-on for poor control

contraindicated in AIP

barbiturates

buspirone mechanism, use

5HT1A agonist anxiolytic

trazodone mechanism use

serotonin uptake inhibition 5HT2A antagonism to prevent negative symptoms

bupropion mechanism use

NE/DA reuptake inhibitor antidepressant smoking cessation

mirtazapine mechanism use

a2AR antagonist 5HT2A, 3 AR, Histamine

difference between BPAD I and II

I has full manic episodes II only ever gets hypomanic; more depressive focused

what to watch for w/pt on clozapine

agranulocytosis gotta get WBC count

neuroleptic malignant syndrome

FEVER fever encephalopaty vitals unstable enzymes increased rigidity of muscles can get after staring antipsychotics

serotonin syndrome

• Hyperthermia, confusion, myoclonus, CV instability, flushing, diarrhea, seizures **Treatment**: cyproheptadine SSRI + MAOI

adverse effects of bupropion

- Stimulant effects: tachycardia, insomnia condarindicated in anorexics/bulemics -- will cause HA, seizures in

memantine

NMDA antagonist used to prevent excitotoxicity used in alzheimers

donepizine, galantamine, rivastigmine

AChE inhibitors used in alzheimers

selegiline

MAO-B selective inhibitor reduces DA breakdown adjunct to parkinsons

bromocriptine

DA agonist used in parkinsons AND neuroleptic malignant syndrome(induced by antipsychotics which are inhibiting DA)

synesthesia

mixing perceptions hearing color seeing sound