robbypowell's version from 2016-10-01 20:16

CNS Pharmacology

Question Answer
the CNS is made up of the _____ and ______ ______Brain & Spinal Cord
Benzodiazepines (such as diazepam) affect the _____ system/cerebral cortex via _____Limbic System; via GABA
Antihypertensives such as Clonidine affect the _____ via ________ stimulation... resulting in (increased/decreased?) sympathetic activityMedulla; via A2-Adrenoceptor stimulation; Decreased
How are endothelial cells modified to create the blood brain barrier? What non-endothelial cells play a role as well?Tight Junctions (of endothelial cells); Astrocytes ((
T/F: The actions or side effects of many drugs are manifested by altered CNS activity.True
T/F: Few drugs actions or side effects are manifested by altered CNS activityFalse (many)
______ have podocyte processes that impinge on BV and provide barrier to influx of substances from circulation to brainAstrocytes (cell type)
T/F: Lipophilic drugs don't cross the blood brain barrierFalse (Hydrophilic)
T/F: Hydrophilic drugs don't cross the blood brain barrierTrue
T/F: Lipophilic drugs are allowed into the brain and CNS and have rapid onsetTrue (thiopental, diazepam, heroin)
T/F: Hydrophilic drugs are allowed into the brain and CNS and have rapid onsetFalse (dopamine, some AB... don't cross BBB)
T/F: Blood-Brain Barrier is NOT completely developed at birthTrue ("incompletely developed"... higher brain concentration of drugs in neonates)
T/F: Blood-Brain Barrier is completely developed at birthFalse ("incompletely developed"... higher brain concentration of drugs in neonates)
When the Area _____ is affected by drugs that pass through BBB it mainly causes nausea and vomitingArea Postrema
_____ encoding is the MAIN method of communication between neurons; it occurs at synapse via chemical neurotransmissionANALOG encoding

types of communication between neurons & chemical neurotransmission

Question Answer
Main method of comm between neuronsAnalog encoding (occurs at synapse via chemical neurotransmission)
Minor method of comm between neurons... occurs via gap junctionsDirect Signaling
____ encoding... frequency of action potential depolarizationDigital encoding
Local anesthetics block sodium channels and _____ encodingDigital encoding (affect frequency of AP depolarization)
LA toxicity/overdose causes sedation/convulsion due to decreased depolarization... this is caused by their effect on _____ encodingDigital encoding (affect frequency of AP depolarization)
Variable response due to variable amount of NT released is best describes ______ (analog/digital) encodingAnalog Encoding (chemical neurotransmission)
(Proximal/Terminal) _______ portion of neuronal cell body has all the substances the neuron needs to communicate with an adjacent neuron, neuroinformation gets sent to nerve terminalTerminal
Once Nuerotransmitter vesicles reach the synaptic terminal, they burst due to ____ release and cause release of neurotransmitter into the synaptic cleftCalcium
_________ is an irreversible inhibitor used in biologic warfare and insecticides, by breaking down their target neurotransmitterAcetylcholinesterase (AchE)
Post-synaptic drug used to treat ParkinsonsCathecol-O-Methyl Transferase (COMT)
_____ is the main Neurotransmitter for cholinergic pathwaysAcetylcholine (biogenic amines = NorEpi, Epi, Serotonin, Dopamine)
Which NT has these Functions: mediates arousal/sleep, respiration, motor activity, pain, vertigo, and memoryAcetylcholine
Drug that improves memory in Alzheimer's disease patientsTacrine/cognex
This NT 50% of all CNS CatecholaminesDopamine
Dopamine, Norepi, epi, 5HT and histamine are all _____ aminesBiogenic Amines
This NT Functions in areas of motor control, behavior, mood and perceptionDopamine
This NT causes Parkinson's syndrome when decreased and may also be associated with Huntington’s disease and schizophreniaDopamine
NT of brainstem neurons in locus ceruleusNorepinephrine
NT that is 5-17% of NE content; mainly in bodies of reticular formationEpinephrine
NT that Modulates sleep, pain, and affective states... acts in midline raphe nuclei of brainstem (projects into cortex, cerebellum, and spinal cord)5HT
This NT acts in the hypothalamus and other areas... and its blockade causes drowsinessHistamine
Glutamic acid is an ______ (excitatory/inhibitory) amino acid... and acts by depolarizing neuronsExcitatory
GABA and Glycine are _____ (excitatory/inhibitory) amino acids... and act by hyper polarizing neuronsInhibitory
______ (drug) inhibits glycine receptors and causes convulsionsStrychnine
Strychnine inhibits _____ receptors and causes convulsionsGlycine


Question Answer
T/F: Barbiturates such as Thiopental, pentobarbital and phenobarbital were used earlier but not commonly used nowTrue
What is the main cause of death from barbiturates?Respiratory depression (not breathing)
When barbiturates are given with _____ and then stopped... patients show exaggerated hemorrhageCoumadin
Replacement of H with organic groups at what position on barbiturate benzene ring causes CNS depressant property ?C5
The C2 oxygen on barbiturate ring is replaced with sulfur, making the drug very lipid soluble and with a shorter duration of action in what two IV drugs?thiopental and thiamylal
What is the longest acting Barbiturate?Phenobarbital*** (least lipophilic)... longer onset, longer duration
What was the 1st drug used for IV sedation... that isn't used anymore? (barbiturate)PENTObarbital ***
What is an ULTRA short acting barbiturate, sulfur replaces oxygen in C2 positionThiopental***
Mechanism of action for barbiturates is to enhance binding and duration of action of what Neurotransmitter?GABA
This class of drugs decrease REM sleepBarbiturates
____ _____: complex network of neurons, nuclei & neuronal pathways that extends throughout the brainstem; modulates arousal/sleepReticular Formation
Sedative drugs (do/not) affect cardiovascular system... Hypnotic drugs (do/not) affect cardiovascular systemSed Don't; Hypn Do
Meprobamate has serious risks of physical/psychological dependance... what are its hepatic effects?Induces hepatic microsomal enzyme activity (barbiturate-like)
This drug is an azaspirodecanedione, has anxiolytic effects, but doesn't create physical dependence ... but takes 1-3 weeks for onset of actionBusiprone (buspar)
selective anxiolytic (with no other effects), delayed onset of action, mode of action is different (works on serotonin and NOT GABA)Busiprone/Buspar
what type of drugs are used in pediatric sedation?Antihistamines (such as hydroxyzine)
2 benzodiazepines... _____ is used for treating static epilepsy; _____ used for treating (non-static?) epilepsyDiazepam-static; Clonazepam-nonstatic
Benzodiazepines with addition of NO3 at R7 have ____ activityanticonvulsant (Clonazepam)
Benzodiazepines with addition of Cl at R7 have ____ activityanxiolytic
Benzodiazepines with addition of H or CH3 at R7 have ___ activitydecreased activity (less effective)
Benzodiazepines act on the _____ receptorGABA receptor
2 Benzodiazepines used for sedative effectsDiazepam & Midazolam (*** used more than diazepam bc it is better for IV sedation ***)
Which sedative Benzodiazepine is used more than diazepam bc it is better for IV sedationMidazolam
Effects of _____ are believed to occur because of depression of RAS in the central core of brain ***Benzodiazepines
____ _____ should be done to monitor oxygen saturation when given IV benzodiazepinesPulse oximetry
Best drug class to decrease anxiety in Cardiac compromised patientsBenzodiazepines
_____ gets degraded to oxazepam and stays in system longer bc of this while _____ doesn't and so stays in system a short timeDiazepam; Midazolam
Diazepam contains ____ ____ in its IV administration which can cause Thrombophlebitis; Midazolam doesn'tPropylene Glycol

is this neurotransmitter excitatory or inhibitory?

Question Answer
Histamine on H1 receptorExcitatory
Serotonin (5HT)Excitatory
Substance PExcitatory
Histamine on H2 receptorInhibitory
Glycine (mainly in spinal cord)Inhibitory