post-midterm neuro drugs

  1. Reserpine
    • deplete dopamine stores within nerve endings 
    • may diminish striatal dopaminergic transmission to affect both direct and indirect pathways of basal ganglia --> producing parkinsonism
  2. Carbidopa and I-dopa
    • reduces peripheral metabolism of I-dopa
    • administer together with I-dopa to treat Parkinson's disease
  3. a metabolite of MPTP
    • contaminant produced during improper preparation of synthetic narcotic 
    • causes parkinsonism by damage in nigral Mtc
  4. cocaine, amphetamine, benztropine
    • inhibition of dopamine reuptake 
    • increase dopamine level at the synaptic cleft
  5. what are prophylactic (preventive) treatments for depression? (name 5)
    lithium, carbamacepines, lamotrigine, valproate, anitepileptics (mood stablizers)
  6. Tricyclics, Fluoxetine (prozac)
    • selective seratonine reuptake inhibitors 
    • used for treatment of anti-depression 

    could also use MAO inhibitors, ECT...
  7. cocaine, amphetamine, benztropine
    • treatment for anti-psychotic 
    • blocks reuptake of Dopamine 

    • short-term SE: tremor, rigidity (parkinson like symptom) 
    • Long-term SE: tardive dyskinesia
  8. what would you substitute for opiate addiction?
    methadone
  9. what is common treatment for alcohol withdrawal?
    • Benzodiazepine 
    • (GABA enhancer)
  10. Haldrol, haloperiodol, perphenazine
    • typical antipsychotic drugs 
    • treatment for schizophrenics 
    • block D1 and D2 receptors
    • side effect as parkinson like movements ie. tremor, rigidity,

    also, if haloperidol were applied to ppl with addictions, it would reduce euphoric/rewarding effect
  11. Clozapine, olanzapine
    • atypical antipsychotic medications 
    • block D3 and D4 receptors 
    • no side effects 
    • treatment for schizophrenics
  12. Levetiracetam
    • aka KEPPRA
    • treatment for epilepsy 
    • decrease the voltage-operated delayed rectifier K+ current without affecting Na+ and A-type K+ current --> reduced repetitive action potential generation  
    • reduction of N-type and P/Q type Ca currents ==> decreased NT release 
    • binds to synaptic vesicle protein, SV2A (= believed to impede conduction across synapses)
  13. Benzodiazepines, barbiturates (Gabanergic)
    • treatment of epilepsy 
    • potentiate inhibitory GABA A receptors and inhibit AMPA receptors 
    • Enhance inhibition
  14. Phenytoin, carbamazepine, lamotriginum
    • treatment for epilepsy 
    • reduce the flow of Na+ and Ca+ ions into the neurons
    • increase the level of GABA 
    • suppress the release of NT (glutamate) 
    • less excitability
  15. Thiazide (from physio)
    blocks NCCT at distal convoluted tubule (mutation in this channel: Gittelman's syndrome)
  16. Bumetanides, furosemide (from physio)
    • blocks NKCC2 at TAL. 
    • diuretics
    • mutation in NKCC2 or ROMK, or CLC-kb = Bartter's syndrome
  17. Phenothiazine
    • block D2 receptor in the forebrain
    • used in the treatment of psychosis
    • may cause parkinsonism by limiting dopamine -mediated inhibition of striatal neurons contributing to the indirect pathway
  18. acetazolamide (from physio)
    • inhibits carbanic anhydrase 
    • turns H2CO3 --> CO2 and H2O 

    Carbanic anhydrase is considered diuretics because it excretes out H+ in urine
  19. PTU
    • inhibit iodine oxidation  
    • inhibit organification (formation of MIT or DIT by iodine and thyroglobulin)
    • inhibit coupling between MIT and DIT
  20. Thyocyanate
    inhibit Na/I cotransporter in thyroid gland
  21. Perchlorate
    inhibit Na+/I Cotransporter in thyroid gland
  22. what are the drugs that induce fetal gamma globulin formation to avoid HbS formation to express AR sickle cell? name 3
    • 5-azacytidine, (decitabine, demethylating agent)
    • hydroxyurea, (demethylating agent?)
    • butyrate compounds (histone deacetylation)
  23. Bromocriptine (from physio)
    • treatment for prolactinoma 
    • tumor on prolactin secreting anterior pituitary --> causes excessive release of prolactin 
    • treat with dopamine agonist
  24. sodium benzoate (genetics)
    • trap excess ammonia made from protein degradation when urea cycle is defect 
    • chemical diversion
  25. sulfonamides, animaralials, chloramphenicol 
    -->what disease is associated?
    • G6PD 
    • cannot produce NADPH oxidase
    • oxidative drug will cause hemolytic anemia 
    • example of idiosyncratic drug effects
  26. Warfarin --> explain pharmakokinetic and pharmakodynamic dual polymorphism
    warfarin --> anticoaggulant drug by inhibiting vitamin K-expoxide reducatse (VKORC1 gene) 

    • warfarin is racemic -->S-warfarin is more potent since it follows single pathway with CYP2C9 
    • pharmakokinetic effect
    • expression of CYP2C9 is polymorphic-->individual has different alleles 

    • Pharmakodynamic effect 
    • VKROC1 is also polymorphic --> requires different effective dosage of warfarin
  27. Butyrylcholinesterase (BChE)-->what does it metabolize?
    succinylcholine 

    AR ppl with BChE will experience prolonged muscle paralysis due to succinylchoine
  28. N-acetyltransferase (NAT2) -->what does it metabolize?
    isoniazid 

    slow acetylaters(AR)-->adverse effects --> more prone to drug toxicity ie. hepatotoxicity, neuropathy 

    fast acetylaters
  29. Codeine and metoprolol --> what metabolizes them?
    metabolized by CYP2D6 

    • codeine: convered to morphine by CYP2D6 
    • -ultrarapid metabolizers have extra copy of CYP2D6 --> codeine gets covereted to morphine too fast --> leads to respiratory arrest 
    • -opposite affect for poor metabolizers; too slow conversion, thus codeine is ineffective drugs for them 

    • metroprolol 
    • -poor metabolizers take time to detoxify--> increased adverse effects 
    • -ultrarapid metabolizers need higher dosage
  30. 6-marcaptopurine and azathiopurine --> what metabolizes them?
    • anti-cancer drug 
    • metabolized by thiopurine-methyltransferase 
    • autosomal recessive ppl with TPMT will suffer from myelosuppresion due to prolonged presence of these drugs
  31. amiloride (from physio)
    blocks ENac at collecting duct
Author
marika
ID
243816
Card Set
post-midterm neuro drugs
Description
drugs
Updated