Imported: Neuro Test 2: Schriefer_Cns Stimulants

Front 1

a child presents to the ER with tightness of the neck and jaw muscles, hyperreflexia, tonic extensor thrusts...they parents thing he may have found some type of poison in their tool shed. What got him, moa, and how do you tx?

Back 1

strychnine

Produces CNS excitation by blocking glycine-mediated postsynaptic inhibition


tx:
IV diazepam, lorazepam, or anesthetic dose of short acting barbiturate
Respiratory support
Quiet surroundings
Gastric lavage

Front 2

MOA of caffeine?

Back 2

– act as antagonists at adenosine receptors.

Adenosine receptors are located on presynaptic terminals of noradrenergic neurons and blocks NE release. So caffeine increases NE release.

Front 3

adverse effects of caffeine?

Back 3

At 1 g dose of caffeine (12 cups coffee)
Insomnia, excitement, mild delirium, sensory disturbances
Increased heart rate
Increased respiration

At higher doses (10 g)
Clonic convulsions → death

Chronic use in pregnant women may increase rate of spontaneous abortion
Tolerance and physical dependence can occur.

Withdrawal symptoms include lethargy, irritability, and headache

Front 4

Therapeutic uses of caffeine?

Back 4

combination with aspirin or ergot alkaloids (cafergot..tx of headaches)

Front 5

Methylphenidate is what kind of drug?

Back 5

amphetamine

Ritalin

Front 6

how do amphetamines work?

Back 6

release NE, DA, and 5HT from nerve terminals

elevation of mood, euphoria, increased alertness
Reduced feeling of fatigue
Restlessness, increased motor activity
Reduced appetite
At very large doses, convulsions may occur

Front 7

adverse effects of amphetamines?

Back 7

Peripheral sympathomimetic effects (e.g., increased blood pressure). Avoid in patients with uncontrolled hypertension and coronary artery disease.

CNS irritability → depression
Abuse potential

Concern about long-term safety of stimulant treatment in children

Recent concern about deaths in patients with structural cardiac defects taking methylphenidate and Adderall. FDA reviewing psychiatric (hallucinations) and CV effects of all ADHD drugs

Front 8

therapeutic uses of Amphetamines?

Back 8

Narcolepsy – amphetamines/methylphenidate

Attention deficit-hyperactivity disorder – methylphenidate and d-amphetamine most commonly used. Long acting forms of both are now available and make once daily dosing possible (also transdermal). Clonidine may be effective in some children.

Front 9

phentermine is what kind of drug? moa? use?

Back 9

Amphetamine

release NE, DA, and 5HT from nerve terminals

Appetite suppression

Front 10

how does cocaine produce its CNS effects? what kind of drug was it again?

Back 10

Cocaine produces its CNS effects (and peripheral side effects) by inhibiting re-uptake of catecholamines, particularly DA. It acts primarily on centers controlling alertness and responsiveness, and on the brain’s reward center.

local anesthetic (ester)

Front 11

adverse effects of cocaine?

Back 11

similar to amphetamine. Vasoconstriction and ↑ BP; cardiac arrhythmias

Front 12

What kind of drug is modafinil? moa? use?

Back 12

Non-amphetamine stimulants used to treat excessive sleepiness due to narcolepsy, sleep apnea and shift work sleep disorder.

Stimulate cells in sleep/wake centers which release the neurotransmitters hypocretin 1 and 2. Results in increased wakefulness.

help get your fil of sleep

Front 13

What kind of drug is armodafinil? moa? use?

Back 13

Non-amphetamine stimulants used to treat excessive sleepiness due to narcolepsy, sleep apnea and shift work sleep disorder.

Stimulate cells in sleep/wake centers which release the neurotransmitters hypocretin 1 and 2. Results in increased wakefulness.

help get your fil of sleep

Front 14

what are the drug interactions of Modafinil and armodafinil

Back 14

induces some CYPs and inhibits others

Front 15

adverse effects of this drug include:

Headache, nausea, diarrhea, dry mouth, anorexia are common.
Nervousness, anxiety, and insomnia have been reported, but less than amphetamine, or methylphenidate.
Psychiatric problems (hallucinations, suicidal ideation) and serious allergic rxns.
Less abuse potential than amphetamine or methylphenidate

Back 15

Modafinil and armodafinil

Front 16

what kind of drug is Atomoxetine? use? moa?

Back 16

NOT a stimulant; included here because it is used to treat ADHD

Selectively inhibits NE transporter, blocking NE reuptake and resulting in increased attention and decreased impulsivity and hyperactivity. Since it doesn’t block DA reuptake, it’s not likely to be abused

Front 17

how do stimulants help tx ADHD

Back 17

increase attention span

Front 18

black box for Atomoxetine

Back 18

suicidal behavior in children and liver injury.

Front 19

Guanfacine use? moa?

Back 19

Also not a stimulant, but used as an adjunct in the treatment of ADHD.

It is an α2 –adrenergic agonist that decreases central sympathetic activity.

Front 20

Describe the potential adverse effects of ephedra.

Back 20

) have been associated with heart attacks, sudden cardiac death, stroke, brain hemorrhage, seizures, and deaths

Front 21

moa of ephedra?

Back 21

herbal product containing ephedrine, an indirect and direct acting sympathomimetic amine.

Ephedrine acts indirectly by releasing Norepinephrine and directly by stimulation of a, b1, and b2 adrenergic receptors.

Front 22

moa of LSD?

effects?

Back 22

agonist at presynaptic serotonin receptors (5HT2a) in the midbrain

Major effects
Heightened awareness of sensory input; synesthesia
Passive observer state
Inward attention
Diminished ability to determine boundaries

Front 23

Psilocybin and psilocin
mescaline

all similar to what? so moa?

Back 23

LSD

agonist at presynaptic serotonin receptors (5HT2a) in the midbrain

Front 24

moa of marijuana?

Back 24

Bind to specific cannabinoid (CB) receptors located in various brain areas. Endogenous ligands (endocannabinoids, EC) have also been identified.

Stimulation of CB receptors leads to activation of brain’s reward center (pleasurable effects) and also activates centers involved with eating.

Front 25

as increased heart rate, dry mouth, increased appetite, and reddening of conjunctiva =

Back 25

stoner

probably wearing tie dye listwning to phish with a necklace that has a little mushroom in it

weeeeeeeeeeeeed

Front 26

adverse effects of weed

Back 26

Decreased testosterone levels
Bronchitis
Airway obstruction
“Amotivational” syndrome (?)

Front 27

Therapeutic use of marijuana

Back 27

Glaucoma

Antiemetic (dronabinol [Marinol] and nabilone [Cesamet]) approved for use)

Front 28

moa of PCP

Back 28

Acts by binding to high affinity sites in cortex and limbic system, resulting in blocking of NMDA-type glutamate receptors

http://www.youtube.com/watch?v=LzB03c6Dc10

Front 29

effects of PCP?

Back 29

hallucinations (desired effect), detachment, disorientation, ataxia, violent behavior, distortion of body image, loss of proprioception, numbness, nystagmus, sweating, rapid heart rate, hypertension, acute psychotic reactions, and seizures. Can be fatal in overdose

Front 30

3,4 methylenedioxymethamphetamine is what kind of drug? moa?

Back 30

An amphetamine analog which produces central stimulation, euphoria, and hallucinations. MDMA causes DA release like amphetamine, but its major effect is on 5HT neurons. It causes 5HT release and blocks 5HT synthesis and reuptake. The net effect is more 5HT in the synapse and depletion of 5HT in the neuron.

this MDMA / Ecstasy

Front 31

pt comes in with in overheating and dehydration. Also causes involuntary grinding of the teeth. What drug were they on?

Back 31

3,4 methylenedioxymethamphetamine (MDMA or Ecstasy)

Front 32

is reported to cause feelings of empathy, closeness to others and facilitates interpersonal relationships

Back 32

3,4 methylenedioxymethamphetamine (MDMA or Ecstasy)

Front 33

How do CNS Stimulants (Analeptics) effect the CNS?

(Don't say stimulate, asshole)

Back 33

Remove inhibition from CNS
neurons, increase synaptic excitation or alter axonal membrane properties. Net result is CNS stimulation

Front 34

What is the most significant short-term risk associated with MDMA (ecstasy)?

**obj**

Back 34

impairment of the body’s ability to regulate temperature, resulting in overheating and dehydration.

Also causes involuntary grinding of the teeth.

Front 35

MOA of Bath Salts? Main ingredients?

Back 35

MOA: Inhibit NE/DA reuptake

Ingredients: methylenedioxypyrovalerone or 4-methylmethcathinone

Front 36

Adverse Effects of bath salts?

Back 36

Physical: Tachycardia, hyperthermia. seizures

Behavior: paranoia, anxiety, agressive behavior, suicide

Front 37

What are the "subjective" affects of LSD?

Back 37

Heightened awareness of sensory input; synesthesia

Passive observer state

Inward attention

Diminished ability to determine boundaries

Front 38

Adverse effects of ephedera?

Back 38

heart attacks, sudden cardiac
death, stroke, brain hemorrhage, seizures, and deaths

Front 39

What is the treatment for strychnine poisoning?

Back 39

IV diazepam, lorazepam, or anesthetic dose of short acting barbiturate

Respiratory support

Quiet surroundings

Gastric lavage