TTR np Flashcards
local neurotransmitters?
diffuse neurotransmitters?
local: GABA, GLU, endocannabinoids, gases
diffuse: monoamines(DA, 5HT,NE), acetylcholine, opioids, histamine
ionic vs GPCR for acetylcholine
ionic - nicotinic
GPCR - muscarinic
primary origin of NE in CNS
primary role?
locus coeruleus
attencion, vigilance, mood, emotion
primary origin of 5HT in the brain?
primary roles in the brain?
ionotropic receptor?
raphe nuclei
arousal, mood, motion, migraine
5HT3 are ionic
where are endorphins found?
hypothalamus exclusively
where are enkephalins and dynorphins found?
periaqueductal gray and dorsal horn of spinal cord
these are endogenous opioids
endogenous opioids
endorphins
enkephalins and dynorphins
donepezil
rivastigmine
galantamine
cholinesterase inhibitors approved for treating alzheimers
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
ketorolac
non-selective COX inhibitor
powerful analgesic; NSAID
used to reduce the amount of morphine needed to be used
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
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
general effects of inhaled anesthetics
CV depression
respiratory depression; bronchodilation
nausea/emesis
increased CBF; decreased metabolic demand
unconscious, amnesia, immobility
adverse effects of etomidate
adrenocortical suppression
pain on injection
myoclonic movements
mechanism of action for the iv anesthetics
propofol, etomidate - gaba block
ketamine - NMDA block
dexmedetomidine - a2AR agonist
when is succinylcholine used
emergency surgery
full stomach
acute abdomen
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
