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30 Cards in this Set
- Front
- Back
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Diazepam is preferred to barbiturates as an anti-anxiety agent because diazpam because
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Has less addiction potential
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A patient with grand mal epilepsy would likely be under treatment with
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Phenytoin
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Monoamines include
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Seratonin (5-HT
Dopamine Norepinepherine |
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Condition in which Dopamine receptors misfire
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Schizophrenia
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Condition in which Dopamine generating cells are damaged or have died
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Parkinsons Disease-cells died in substantia Nigra
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Dopamine Receptor Family D1
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High cAMP
High PIP2 hydrolysis-Ca mobilization PKC activation Located in the Stratium neocortex |
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D2
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Low in cAMP
High Potassium currents Low Voltage gated Ca currents |
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D3
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Hypothalmus
Nucleus accumbens Olfactory tubercle |
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D4
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Frontal cortex
Medulla Midbrain |
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D5
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Hippocampus
Hypothalamus |
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Schizophrenia is diagnosed by 2 of the following in a 1 month period
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Dellusions
Hallucinations Disorgainzed Speech Catatonic behavior Negative symptoms |
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Positive symptoms of Schizophrenia
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Delusions--false beliefs
Hallucinations-false percep Agitation |
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Negative symptoms of Schizophrenia
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Interpersonal withdrawl
Loss of drive flattened affect |
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Major therapeutic target for schizophrenia
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Mesolimbic and mesocortical
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Typical Antipsychotic Rx used to treat schizophrenia
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Haloperidol (Haldol)-Binds to receptors in all central dopamine pathways
Effect: Alleviate positive symptoms. No effect on negative effects |
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Adverse effects of conventional antipsychotic
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Binds to D2 receptors in the basal ganglia
Extrapyramidal-Dystonia-dyskinetic movements due to disordered tonicity of muscle Akinesia-Absence of movement Tardive dyskinesia |
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Adverse effects of Conventional Antipsychotics on the pituitary gland
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Low prolactin secretion
Amenorrhea False + pregnancy test Gynecomastia Low libido |
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Adverse effects of Conventional Antipsychotics on the PNS
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Antagonism of muscarinic receptors in the PNS-
Dry mouth Orthostatic hypotension Difficulty urinating Constipation |
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Atypical Antipsychotic
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Clozapine (Clozaril)-MOA-Binds to the receptors in the mesolimbic and mesocoritcal dopaminergic pathways-more selective for D3 and D4-Fewer extrapyramidal side effects. Also binds to seratonin receptors which helps alleviate positive and negative effects
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Adverse effects of Clozapine
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Weight gain
Anticholinergic effects Hypersalivation 1% of patients develop agranulocytosis CBC needed every two weeks |
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Atypical Antipsycholitcs
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Olanzapine (zyprexa)
Risperidone (Risperdal) Quetiapine (seroquel) Adverse effects same as Clozapine except for the agranulocytosis and hypersalivation |
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Aripiprazole (Abilify)
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Partial agonist activity at dopamine and seratonin 5HT1a receptors and antagonist activity at 5HT2a receptor
Indicated for schizophrenia, bi polar and depression |
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Atypical Antipsychotics
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Interact with any drugs that cause CNS depression-benzos, opiates, ethanol, and antihistamines
Olanzapine (zyprexa): 10 times more likely to develop diabetes Prolonged QT interval |
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Symptoms of Parkinson's Dx
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Resting tumor
Postural Instability Rigidity Cholinergic hyperactivity Dementia |
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Extrapyramidal systems controls
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involuntary movement
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Effects of Parkinson's Dx on pathways that regulate movement
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Direct pathway inhibited and indirect pathway activated. Understimulation of D1 receptors (direct pathway) and overstimulation of D2 receptors (indirect pathway)
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Goals of therapy for Parkinson's Dx
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Increase supply of dopamine and supress acetylcholine actions
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In what form can a pt receive dopamine
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Levadopa/Carbidopa-Sinemet
Carbidopa inhibits dopa decarboxylase and does not cross the BBB |
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Levodopa is metabolized
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by dopa decarboxylate to dopamine in the CNS. Levadopa is also metabolized in the GI and the peripheral tissue before it reaches the brain.
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Adverse effects of Sinemet
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Abnormal involuntary muscle movement of the orofacial muscles (tardive dyskinesia. Oral inflammation, movements of anterior teeth and difficulty wearing dentures. Dry mouth.
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