Pharm Test 3 Central Nervous System Iii And Iv

Front 1

Phenylpropionic Derivatives
- type of drug
- mechanism
- adverse effects

Back 1

- largest group of aspirin alternatives
- inhibit cyclo-oxygenase and prostaglandin synthesis
- cause fewer GI side effects than aspirin so are being used in place of aspirin

Front 2

Celecoxib
- type of drug
- mechanism
- what do they treat
- adverse effects

Back 2

- new NSAIDs
- inhibit COX-2
- rheumatoid arthritis and osteoarthritis
- could cause cardiovascular damage

Front 3

Combination Preparations
- what are the 3 combinations

Back 3

- aspirin + Acetaminophen
- NSAIDs + caffeine
- NSAIDs + Opioid

Front 4

what drug is used to treat migraine headaches

Back 4

Sumatriptan

Front 5

what happens in the brain that leads to Parkinson's disease

Back 5

progressive and selective loss of neurons from specific brain regions

Front 6

what are some other neurodegenerative disorders

Back 6

ALS
Alzheimer's disease
Huntington' disease

Front 7

what are the 4 symptoms of Parkinson's disease

Back 7

muscular rigidity
tremor
bradykinesia
postural instability

Front 8

Parkinsons is an idiopathic disease that if left untreated will do what

Back 8

progress to a rigid, akinetic state in which patients can no longer care for themselves

Front 9

the therapy of Parkinson's is to enhance action of what

Back 9

dopamine in the CNS

Front 10

what is the first mechanism to enhance action of dopamine

Back 10

replacement of CNS dopamine by giving the dopamine precursor L-DOPA

Front 11

what is the immediate precursor of dopamine

Back 11

Levodopa

Front 12

Levodopa
- what does it do

Back 12

- increases dopamine production within the basal ganglia
usually combined with a peripheral dopa-decarboxylase inhibitor to decrease side effects

Front 13

the combination of Levodopa combined with peripheral dopa-decarboxylase inhibitor is called what

Back 13

sinemet

Front 14

what is the 2nd mechanism to enhance action of dopamine

Back 14

administration of direct acting dopamine agonists

Front 15

what are the 2 dopamine receptor agonists

Back 15

bromocriptine
pramipexole

Front 16

what do bromocriptine and pramipexole do

Back 16

directly stimulate CNS post synaptic dopamine receptors

Front 17

what is the 3rd mechanism to enhance action of dopamine

Back 17

use of agents that alter dopamine metabolsim or synaptic concentration

Front 18

what is the MAO-B inhibitor (i have no idea what this means)

Back 18

selegiline
(oh of course)

Front 19

what does the MAO-B inhibitor, selegiline do

Back 19

blocks major pathway in dopamine metabolism thus increasing the duraction of action of dopamine

Front 20

what is the 4th and final mechanism to enhance the action of dopamine

Back 20

a depression of unopposed CNS cholinergic systems

Front 21

what does benztropine do to enhance dopamine

Back 21

blocks the increased excitatory activity of cholinergic interneurons on outflow pathways from basal ganglia, secondary to the loss of dopamine inhibition of these neurons

Front 22

a primary therapy for Parkinson's is dopamine replacement via the use of what

Back 22

levodopa (L-DOPA)

Front 23

does dopamine cross the blood brain barrier

Back 23

no

Front 24

b/c dopamine does not cross the blood brain barrier, what does this mean

Back 24

large doses of the immediate metabolic precursor which does enter the brain where its converted to dopamine

Front 25

what % of administered L-DOPA enters the brain with the majority converted to dopamine

Back 25

1%
so high doses must be given which gives a lot of side effects

Front 26

b/c of the side effects of large doses, L-DOPA is given with what

Back 26

carbidopa
- a peripheral DOPA sinemet

Front 27

carbidopa will greatly reduce the peripheral side effects but will not reduce what

Back 27

CNS untoward effects

Front 28

what are the 2 dopamine agonists

Back 28

Bromocriptine
Pramipexole

Front 29

Dopamine Agonists
- duration of action
- mechanism

Back 29

- longer duration of action
- provide direct stimulation of CNS dopamine receptors and do not require enzymatic conversion to dopamine

Front 30

Bromocriptine
- type of drug
- mechanism

Back 30

- non-selective dopamine agonist
- stimulates both D1 and D2- like dopamine receptors

Front 31

Pramipexole
- type of drug
- mechanism

Back 31

- dopamine agonist
- selective stimulants of D2 dopamine receptor
produce fewer side effects

Front 32

Selegiline
- type of drug
- mechanism

Back 32

- monoamine oxidase (MAO) inhibitor
- inhibitor of MAO that increases dopamine levels by reducing its metabolic inactivation

Front 33

Benztropine
- type of drug
- mechanism
- adverse effects

Back 33

- muscarinic receptor antagonists
- block cholinergic mechanisms in the striatum that are normally opposed by tonic release of dopamine
- cycloplegia, dry mouth, urinary retention
- with high doses, CNS effects (confusion, hallucinations) may occur
may improve tremor and rigidity