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Location of NA nerves "pons and medulla, locus ceruleus, discrete cluster"

Pathways of NA Ventral and dorsal bundles
What happens to the nerve endings of NA "terminate diffusely to cortex, hippocam
pus, hypothalamus, cerebelum and spinal cord"
Excitatory/inhibitory (a+B receptors) "B adrenoceptors are both, a adrenocepto
rs are excitatory only "
CNS functions of NA (3) "Control of mood, arousal, blood pressure regulation"
Psychotropic drugs (4) "Antidepressants, cocaine, amphetamine, antihypertensive
drugs"
Where are 5-HT neurone cell bodies found?
"pons and medulla, raphe nuclei"
Pathway of 5-HT neurone Median forebrain bundle
Ehere nerve endings of 5-HT go "diffuse into cortex, hippocampus, limbic system
, hypothalamus "
Number of subtypes and classes of subtypes of 5-HT
"14, 1- inhibitory, 2 ex
citatory postsynaptic, 3-vomiting"
CNS functions of 5-HT (3)
"Hallucinations - (5-HT neurones exhibit inhibit
ory effect on cortex), Sleep, wakefulness and mood - (Depletion of 5-HT abolishe
s sleep), Sensory transmission - (reduces sensory input)"
Other functions of 5-HT "Control of food, regulation of body temp/pressure/sexua
l function, vomiting, pain perception"
Types of serotonin drugs and name one for each "Antidepressant -fluoxetine, mig
raine - sumatriptan, anxiolytic - busopirone, antiemetic - odansetron, antipsych
otic - clozapine"
What takes up dopamine DA transporter
What metabolises dopamine
MAO and COMT
4 main systems of dopaminergic nerves "Nigrostriatal, Mesolimbic, Mesocortical
, tuberohypophyseal"
Where do cell nodies lie in each pathway
"Nigostriatal - substantia nigra
and terminate in corpus striatum, Mesolimbic - midbrain and terminate in limbic
system, mesocortical - Ventral tegmental area and terminate in front cortex, tu
berohypophyseal - arcuate nucleus in hypothalamus and project to median eminance
and pituitary"
Which dopamine receptors with what family
"D1 (1,5), D2 (2,3+4)"
D1 receptor causes what "Renal vasodilation, incr myocardial contractility"
Motor control is under which dopamine system
nigrostriatal system
How does dopamine affect endocrine control
"inhibit prolactin secretion, GH
release"
Parkinsons disease caused by
Deficiency of nigrostriatal dopaminergic neurons
Excess dopamine causes Schizophrenia
Name excitatory and inhibitory amino acid transmitters "Excitatory (Glutamate,
aspartate) Inhibitory (glycine, GABA)"
GABA stands for GAMMA aminobutyric acid
GABA A causes what abd how
"Postsynaptic inhibition by decr Cl- permeabilit
y, reduces depolarisation"
GABA Modulator Benzodiazapiene
GABA inhibitor bicuculline
GABA B found at
both pre and post synaptic terminals
What does GABA do at GABA B receptor
"incr K+ conductance, membrane hyperpola
risation, decr Ca2+ channels opening"
GABA B receptor agonist Baclofen
L glutamate derived from
Glucose via krebs cycle or glutamine synthesised
by glial cells and taken up by neurons
How is it stored and released Stored in synaptic vesicles and released by calc
ium dependent exocytosis
What carrier proteins allow for uptake Astrocytes
What happens to glutamate in astrocytes Converted to glutamine
3 types of ionotropic Glutamate receptors
"NMDA, AMPA and Kainate"
"NMDA permeable to ___, blocked by __, requires both" "Ca2+, Mg2+, glycine and
glutamate."

What blocks NMDA

Ketamine and phenylcycladine
Metabotropic receptor GPCR
GPCR which groups excitatory and inhibitory
"1-postsynaptic excitatory, 2+3
- presynaptic and inhibitory"
GPCR responsible for
Long term potentiation and depression of memory
2 psychotomimetic drugs Ketamine and phenylcycladine
Glycine is what type of transmitter and where inhibitory transmitter in the sp
inal cord
Glycine associated with what kinds of channels Multimeric ligand gated chloride
channel
Glycine antagonist
Strychnine
Effect of tetanus on glycine
"Inhibit glycine release, excessive reflex hyper
excitability"
Where are cholinergic pathways found
"Forebrain, midbrain and brainstem"
What is damaged in alzheimers diseases The nucleus basalis of Meyneryt that pro
jects to the cortex
what provides cholinergic input to hippocampus Septohippocampal nucleus
Cholinergic interneurons are found in the
corpus striatum
Acetylcholine receptors are predominantly ___ receptors and __ Class
Nicotini
c receptors and M1
4 functions of acetylcholine
"Memory, Arousal, Motor Control, Learning"
What are positive symptoms
Symptoms that are treatable
What are some positive symptoms of Schizophrenia
"Delusions, hallucinatio
ns, abnormal behaviour, catatonia"
What are some negative symptoms of Schizophrenia
"Withdrawl from social c
ontacts, decr emotional response, anhedonia (can't feel pleasure from pleasurabl
e activities), relucatance to perform everyday tasks"
What causes schizophrenia
"Incr dopaminergic mesolimbic pathway, incr D2 r
eceptor activity, decr NMDA receptor function"
4 structural changes in CNS due to Schizophrenia
"Cortical atrophy, enlar
gement of cerebral ventricles, neurodegeneration and dementia development"
3 neurochemical theories of schizophrenia
"Dopamine theory, glutamate theo
ry, serotoni theory (switches off inhibitory neurons leading to sensory overload
)"
Goals of drug therapy for schizophrenia (3)
"Reduce psychotic signs and symp
toms, reduce hallucinations and delusion, reduce paranoia"
Name 3 neuroleptics
"Antipsychotic drugs, antischizophrenic, major tranquili
ser"
Dtypical and atypical antipsychotics differ in what 4 areas
"Receptor profil
e, extrapyramidal effects, treatment of resistan groups, efficacy against negati
ve symptoms"
Classical neuroleptics target what receptors
D2 receptor antagonists
Classes and examples of classical neuroleptics "Phenothiazines - chloropromazin
e, Thoxanthenes - droperidol, Butyrophenones - zuclopenthixol"
Behavioural effects of classic neuroleptics
"Inhibit motor activity of anima
ls - decr spontaneous activity and catalepsy. Humans - few emotions, decr respon
se to external stimulo, reduced agression"
Idiosyncratic eand hypersensitivity reaction
"Jaundice with phenothiazines, l
eucopenia and agranulocytosis, sensitivity to UV light, mental confusion, rapid
rise in body temperature "
Half life of neuroleptics
15-30 hours
How iare classic neuroleptics cleared hepatic
How are classic neuroleptics applied
Oral or intramuscular
Name 3 atypical neuroleptics
"Amisulpiride, respiridone, clozapine"
"Amisulpiride: what receptor, incr release of, positive, negative"
"Selecti
ve for D2, incr release of prolactin, reduced side effects, many drug interactio
ns"
"Respiridone: what receptors, positive, negative"
"high affinity 5-HT 2A a
nd D2, none for muscarinic, hyperprolactinaemia, decreased extrapyramidal effect
s"

"Clozapine, what receptors, positive and negative"

"5HT2A, muscarinic, hist
amine, D1 and D2 antagonists, useful if fail other treatments, myocarditis and n
eutropenia "
Side effects of neuroleptic blocks
"a - hypotension, H1 - sedation, M block
- dry mouth, blurred vision and urinary retention, 5HT - hypothermia and weight
gain"
Side effects of D2/1 block
"Catalepsy, prolactin release, extrapyramidal m
otor disturbances - parkisonian symptims, dystonic reactions, motor restlessness
, oculogyric crisis, tardive dyskinesia, opisthotonos (rigid posture)"
What is tardive dyskinesia
"Involuntary movement of face, tongue, trunk or
limbs. "
What is tardive dyskinesia caused by
Increased number of D2 receptors
What is neuroleptic malignant syndrome "Fever, muscle rigidity and altered cons
ciousness. Treat hyperkalemia and paralysis. May require mechanical ventilation"
3 causes of metabolic syndrom Increased insulin resistance or decreased insuli
n secretion from pancreatic B cell or inhibition of serotonin 5HT1A receptor
Precautions of using antipsychotics
"Epilepsy, parkinsonism, hyperthyroidism
, blood dyscrasias and diabetes"
Neuroleptics should not be taken with Other CNS depressants and antimuscarinic
drugs
Symptoms of parksinsons syndrome
"Tremor at rest, muscle rigidity, cognit
ive impairment"
Causes of Parkinsons
"Age, Cerebral ischaemia, viral encephalitis, drugs and
pathological damage"
Neurochemical changes in parkinsons
"Disorder of basal ganglia, loss of dopa
minergic cell bodies, substantia nigra (increased dopamine receptors and hyperac
tivity of remain receptors)"
Effect of parkinsons on cholinergic neurons
"Normally dopamine inhibits ACh
release. But less dopamine, hyperactivity of cholinergic neurons -> hypokinesia
and tremor"
Four types of treatment for parkinsons "Replace dopamine, mimic dopamine at rec
eptors, incr dopamine release, ACh antagonists"
"Replacement of dopamine: Drug, where absorbed, how it is broken down, given wit
h, why is it less effective over time" "Levodopa, absorbed from intestine, brok
en down by MAO in GIT, given with dopa decarboxylase inhibitor (stops breakdown)
, less effective over time as neurons continually degenerate"
Side effects of L-Dopa "Dyskinesia, nausea and anorexia, hypotension (dopamine
in periphery causes vasodilation), psychological effects, schizophrenia like sym
ptoms, insomnia"
How is dopamine breakdown in CNS reduced
"MAO-B inhibitor - selegiline, C
OMT inhibitor entacapone, block dopa receptors in periphery - Domperidone"
Drugs that mimic dopamine at D2 or D3 and side effects "Bromocriptine, pramipex
ole - confusion and hallucination"
Drugs that increase dopamine release
Amantadine
Advantages and disadvantages to drugs that increase dopamine release
"Less ef
fective than L-Dopa and bromocriptine, less side effects, action declines over t
ime"
Acetylcholine antagonist drugs Benztropine
Predominant use of actylcholine antagonists
Reduce tremor
Advantages and disadvantages to acetylcholine antagonists
"Reduce tremor,
severe side effects, avoid in elderly with cognitive impairment"