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neuro pathophys Flashcards

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1
Q

drugs that act as direct agonists or antagonists at NT receptors

A
  • FGAs
  • SGAs
  • ropinerole
  • benztropine
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2
Q
  • partially blocks muscarinic cholinergic receptors in the caudate/putamen; also has ability to block dopamine reuptake
  • used in combination with other agents to treat symptoms of Parkinson’s disease
A

benztropine

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3
Q
  • agonist at D2 dopamine receptors
  • used in combination with other agents to treat symptoms of Parkinson’s disease
A

ropinerole

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4
Q
  • decrease serotonin and dopamine activity by blocking 5-HT2A receptors, and to a lesser degree D2 dopamine receptors.
A

SGAs (second generation antipsychotics)

  • clozapine
  • risperidone
  • ziprasidone
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5
Q

decrease dopamine activity by blocking D2 dopamine receptors

A

first generation antipsychotics (FGAs)

  • chlorpromazine
  • thiothixine
  • haloperidol
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6
Q
  • Contains L-DOPA and carbidopa
  • L-DOPA is converted to dopamine (see metabolic pathway for production of dopamine); Carbidopa prevents conversion in the periphery so that L-DOPA can enter the brain.
  • Used to treat Parkinson’s disease.
  • Enhances dopamine production in the brain
A

sinemet

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7
Q

what drugs increase NT production

A

sinemet

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8
Q

what drugs act by blocking NT degradation

A
  • monoamine oxidase inhibitors (MAOIs)
  • cholinesterase inhibitors (ChEIs)
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9
Q

enhance cholinergic effects by inhibiting acetylcholinesterase (AChE)

A

cholinesterase inhibitors (ChEIs)

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10
Q

cholinesterase inhibitors used in the tx of alzheimer’s disease; increases cholinergic activity in the hippocampus and cerebral cortex

A

donezipil, galantimine, rivastigmine

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11
Q

cholinesterase inhibitor used in the tx of myasthenia gravis; increases cholinergic activity at NMJ

A

pyridostigmine

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12
Q
  • used to treat MDD
  • MAOIs that enhance activity of DA, NE, and 5-HT by inhibiting monoamine oxidase (MAO), thereby preventing degradation of the NTs
A
  • clorgyline
  • seleiline (L-deprenyl)
  • iproniazid
  • moclobemide
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13
Q

MAOI used either alone or in combination w/ other meds to treat sx of parkinson’s

A

rasagiline

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14
Q

enhance activity of DA, NE, and 5-HT by inhibiting monoamine oxidase (MAO), thereby preventing degradation of the NTs

A

monoamine oxidase inhibitors (MAOIs)

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15
Q

drugs that act by blocking NT reuptake

A
  • SSRIs (fluoxetine, paroxetine, sertraline)
  • tricyclic antidepressants (desipramine, imipramine, clomipramine)
  • NDRIs (bupropion)
  • SNRIs
  • adderall, methylphenidate
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16
Q
  • used to treat ADD and ADHD
  • increases dopamine and norepinephrine activity by blocking uptake into presynaptic vesicles and increasing NT release (adderall), or by blocking dopamine reuptake (MPH)
A
  • adderall
  • methylphenidate
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17
Q
  • used to treat MDD
  • venlafaxine, duloxetine, etc
A

serotonin/norepinephrine reuptake inhibitors (SNRIs)

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18
Q
  • bupropion
  • used to treat MDD
A

norepinephrine/dopamine reuptake inhibitors (NDRIs)

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19
Q
  • desipramine, imipramine, clonipramine
  • effective at treating MDD, but have many side effects
  • enhance activity of monoamines by inhibiting reuptake of norepinephrine and in some cases serotonin; also effects ACh and other biogenic amines
A

tricyclic antidepressants (TCAs)

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20
Q
  • fluoxetine, paroxetine, sertraline
  • 1st line tx for MDD
  • also used for tx of many anxiety disorders
  • enhance serotonin activity at receptors by blocking serotonin reuptake
A

selective serotonin reuptake inhibitors (SSRIs)

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21
Q

how are neurotransmitters inactivated/reuptaken

A
  • in some cases intact NT is taken up and re-packaged (DA, 5-HT, NE)
  • in some cases NT is broken down and specific by-products are taken up for re-use (choline)
  • in some cases NT is taken by glial cells, converted, and then re-used (glutamate)
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22
Q

how are the actions of neurotransmitters terminated

A
  • uptake
  • degradation
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23
Q
  • type: Gi/Go-protein coupled
  • cellular mechanism: decreasing cellular levels of cAMP
  • effect: inhibitory
A

5-HT1 serotonin receptors

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24
Q
  • type: Gq/G11-protein coupled
  • cellular mechanism: increasing cellular levels of IP3 and DAG
  • effect: excitatory
A

5-HT2 serotonin receptors

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25
* **type:** ligand-gated Na+ and K+ cation channel * **cellular mechanism:** depolarizing plasma membrane * **effect:** excitatory
5-HT3 serotonin receptors
26
how do 5-HT3 receptors receptor from the others
they represent a subfamily of the ligand-gated ion channel superfamily (i.e. they are ionotropic receptors instead of metabotropic)
27
* 5-HT1, 5-HT2, 5-HT4-7 * all receptors in this family are G-protein coupled receptors (metabotropic)
serotonin receptors
28
* metabotropic * D1-like (D1 and D5) * D2-like (D2, D3, and D4)
dopamine receptors
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major types of neurotransmitter receptors
* ionotropic receptors * metabotropic receptors
30
* form an ion channel * activation alters membrane conductance
ionotropic receptors
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* act through G-proteins * can activate or inhibit second messenger systems * can also be associated w/ an ion channel
metabotropic receptors
32
primary excitatory NT in the brain
glutamate
33
primary inhibitory NT in the brain
GABA
34
what is the rate-limiting step in ACh production
reuptake of choline at synapse
35
* primary NT of alpha motor neurons * in brain, plays a role in wakefulness, attention, learning, and memory * levels in brain are decreased n association w/ AZ, PD, down's syndrome, and even w/ normal aging
acetylcholine (ACh)
36
* involved in the regulation of mood, depression, obsessions and compulsions, social interactions/aggressiveness * derived from the amino acid tryptophan * an indolamine
serotonin
37
* derived from the amino acid tyrosine * catecholamines
dopamine and norepinephrine
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* is part of the reticular activating system * projections prduce excitation and arousal * receives input from limbic structure, allowing emotions to trigger noradrenergic responses
norepinephrine
39
what are the four dopaminergic pathways
* nigrostriatial * mesolimbic * mesocortical * tuberoinfundibular
40
* substantia nigra to caudate-putamen (striatum) * extrapyramidal motor system (EPS); movement
nigrostriatal dopaminergic pathway
41
* ventral tegmental area to limbic structures (nucleus accumbens, hippocampus, amygdala, anterior cingulate cortex) * responsible for arousal, memory, motivational behavior
mesolimbic dopaminergic pathway
42
* ventral tegmental area to cerebral cortex (particularly prefrontal cortex) * cognition, executive function, stress
mesocortical dopaminergic pathway
43
* arcuate nucleus of hypothalamus to pituitary * prolactin secretion
tuberoinfundibular dopaminergic pathway
44
types of neurotransmitters
* biogenic amines * amino acids * neuropeptides
45
* dopamine * norepinephrine * epinephrine * serotonin * acetylcholine
biogenic amines
46
* glutamate * GABA * glycine * aspartate
amino acids
47
* somatostatin * substance P * oxytocin * vasopressin * prolactin * TRH * GnRH * CGRP
neuropeptides
48
what type of transmission is neuronal communication
electrochemical
49
* Located ventral to the thalamus and just rostral to the brainstem. It forms the ventral part of the diencephalon * **Links the nervous system to the endocrine system via the pituitary gland** (hypophysis) * Helps to **regulate metabolic homeostasis** and other activities of the autonomic nervous system. * Controls **body temperature, hunger & thirst** (consummatory behaviors), important aspects of parenting and attachment behaviors, **social recognition, fatigue, sleep, arousal, and circadian rhythms** * Synthesizes peptides & hormones that in turn stimulate or inhibit the release or pituitary hormones. * **Damage can severely affect homeostatic functions and hormone regulation**
hypothalamus
50
* Two almond-shaped masses of neurons on either side of the thalamus at the lower end of the hippocampus * Involved in perceptions of **fear and anxiety, defensive behaviors, emotional learning, and in social functions such as mating.** * Heavily interconnected with hippocampus, hypothalamus, sensory nerves, and with insular cortex * Damage causes dysregulation of emotions and is associated with **depression, aggression, anxiety**, etc..
amygdala
51
* Located in **medial temporal lobe** * Required for **declarative memory consolidation** and the **formation of long-term declarative memories** * Implicated in **maintenance of cognitive maps** for navigation * Damage is associated with a profound a**nterograde amnesia** (inability to learn new information)
hippocampus
52
Supports a variety of functions, including emotion, behavior, motivation, long-term memory, and olfaction
limbic system * olfactory bulbs, **hippocampus, amygdala,** anterior thalamic nucleus, septum, fornix, cingulate cortex, **hypothalamus**
53
what are extrapyramidal symptoms
* tremors * rigidity * loss of gait * uncontrolled movements (dyskinesias) * inability to make postural adjustments * disruption of autonomic functions
54
* memory for how to do things - i.e. motor memory * referred to as implicit or unconscious memory because it **does not require conscious awareness**
procedural memory
55
* Involves multiple structures. * Responsible for: -**Modulating voluntary and involuntary movements**. -**Postural adjustments.** -**Fine-tuning** motor movements. -**Motor learning** (i.e., **procedural memory**). * Some projections are crossed and some are uncrossed
extrapyramidal motor system (EMS) functions
56
* Part of the **Pyramidal Motor System**. * **Provides direct innervation of motor neurons** in spinal cord, brainstem, and cranial nerve nuclei. * Is responsible for **initiation of voluntary movements**. * **Is a crossed system**– cells on the right side of the brain control muscles on the left side of the body. * Damage causes **paresis or paralysis on the opposite side of the body**
precentral gyrus
57
what happens when the prefrontal cortex is damaged?
* The PFCx is very susceptible to damage * **Personality can change drastically** * Can **negatively impact someone’s ability to assess situations or perform tasks**, especially if they have a moral or ethical aspect to them. * Can be **unable to discern appropriate behavior, may experience reduced inhibitions**, or may experience **extreme emotional distress**, such as paranoia, anxiety, euphoria, and irritability * Can produce impairments of **working memory** (i.e., ability to hold information online and use in decision-making).
58
principle relay structure of the brain
thalamus
59
dopaminergic cells that project to striatum
substantia nigra
60
what structures make up the extrapyramidal motor system
* caudate and putamen (striatum) * globus pallidus * midbrain (substantia nigra) * cerebellum | caudate, putamen, and globus pallidus make up **BASAL GANGLIA**
61
* consists of primary motor cortex * innervates spinal cord * controlling voluntary movement by carrying motor impulses from the brain to the spinal cord
pyramidal motor system
62
cell bodies located in the brainstem (locus coeruleus) and project to cortical membrane
norepinephrine neuron cell bodies
63
* cell bodies located in brainstem in raphe nuclei * dorsal (rostral) project to brain * ventral (caudal) project to spinal cord
serotonin neuron cell bodies
64
what is the immediate precursor of dopamine
L-Dopa
65
* cell bodies located in basal forebrain * projects to cortical mantle and subcortical membrane * septal nuclei: contain cholinergic cell bodies that project primarily to the hippocampus * nucleus basalis: contains a large population of cholinergic cell bodies, collectively known as the Ch4 complex, which produce acetylcholine for the cerebral cortex and amygdala
acetylcholine neuron cell bodies
66
* **type:** Gs-protein coupled * **cellular mechanism:** activates adenylyl cyclase, increases cellular levels of cAMP * **effect:** excitatory
D1 like dopaminergic receptors | D1 and D5
67
what is the primary source of GABA precursor and glutamate
glutamine
68
* **type:** Gi/Go-protein coupled * **cellular mechanism:** inhibits adenylyl cyclase, decreases cellular levels of cAMP * **effect:** inhibitory
D2-like dopaminergic receptors | D2, D3, D4
69
remove from synaptic cleft back into a neuron or glial cell after they have been released to transmit a signal
uptake
70
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