PHAR 672: CNS Drugs Overview

Questions and Answers

Which neurotransmitter is primarily associated with inhibition in the central nervous system?

Gamma-aminobutyric acid (GABA) (correct)

Norepinephrine

Glutamate

Acetylcholine

What role does histamine primarily play in the central nervous system?

Learning facilitation

Pain reduction

Memory enhancement

Arousal and wakefulness (correct)

Which neurotransmitter is involved in both learning and memory as well as psychosis?

Acetylcholine

Norepinephrine

Serotonin

Glutamate (correct)

Which type of drug produces a partial response when engaging a receptor?

Partial agonist Signup and view all the answers

Which of the following neurotransmitters is considered stimulatory (excitatory)?

Acetylcholine Signup and view all the answers

What is the primary physiological response associated with endorphins?

Inducing pleasure and reducing pain Signup and view all the answers

What is the effect of neurotransmitters like norepinephrine in the central nervous system?

Promotion of arousal and alertness Signup and view all the answers

Which neurotransmitter directly influences pain perception and pleasure?

Endorphins Signup and view all the answers

Which neurotransmitter's function depends on the receptors it engages with?

Acetylcholine Signup and view all the answers

What is the maximum daily dose of Bupropion?

450 mg Signup and view all the answers

What is a key risk associated with Mirtazapine?

QTc prolongation Signup and view all the answers

Which of the following must be done when discontinuing an antidepressant?

Gradually taper the dose Signup and view all the answers

Which medication is classified as a mood stabilizer used for bipolar disorder?

Carbamazepine Signup and view all the answers

What should be monitored when using Lithium as a mood stabilizer?

Drug levels in blood for toxicities Signup and view all the answers

What counseling point is important for patients taking Lithium?

Consume sodium and drink 2-3 liters of water daily Signup and view all the answers

What is a significant warning associated with Bupropion?

Increased risk of seizures Signup and view all the answers

When should Zyban be initiated for smoking cessation?

One week before quit day Signup and view all the answers

Which of the following is NOT a mood stabilizer for bipolar disorder?

Fluoxetine Signup and view all the answers

What should patients be counseled about regarding the use of antidepressants in children and adolescents?

They must be monitored for increased risk of suicide Signup and view all the answers

When is it appropriate to use a partial agonist?

The body exhibits both insufficient and excessive response from the receptor. Signup and view all the answers

What characterizes the role of an antagonist?

It works to decrease the body's excessive receptor response. Signup and view all the answers

Which of the following is a psychiatric disorder associated with 'mood' disorders?

Major Depressive Disorder Signup and view all the answers

What is a common characteristic of bipolar disorders?

Extreme fluctuations in mood Signup and view all the answers

Which neurotransmitter dysfunction is primarily associated with schizophrenia?

Increased dopamine levels Signup and view all the answers

Which condition is classified under anxiety disorders?

Separation Anxiety Disorder Signup and view all the answers

Which disorder involves thought disturbances such as incoherence and paranoia?

Schizophrenia Signup and view all the answers

What defines a major depressive disorder?

A persistent feeling of sadness and loss of interest. Signup and view all the answers

What is the primary focus of treatment for patients experiencing a coverage of excessive responses to receptors?

Administering antagonists to reduce receptor activity. Signup and view all the answers

Which of the following is a substance-related disorder?

Alcohol Use Disorder Signup and view all the answers

What is a common side effect associated with the use of Sertraline?

Sexual dysfunction Signup and view all the answers

What important warning is associated with the use of Venlafaxine?

Increased risk of suicide in younger populations Signup and view all the answers

Which medication is associated with a risk of QTc prolongation?

Duloxetine Signup and view all the answers

What should be done if discontinuing Vilazodone treatment?

Taper the dose over time Signup and view all the answers

What is a potential effect of Nortriptyline usage?

Hyponatremia Signup and view all the answers

Which medication must be taken with food?

Vilazodone Signup and view all the answers

What is the consequence of abruptly stopping Duloxetine?

Withdrawal symptoms Signup and view all the answers

What risk is associated with both Warfarin and Venlafaxine?

Increased risk of bleeding Signup and view all the answers

Which medication can cause anticholinergic side effects?

Amitriptyline Signup and view all the answers

What is a known action of Paroxetine?

Increasing blood pressure Signup and view all the answers

What is a common adverse drug reaction (ADR) associated with Valproic acid?

Abdominal pain Signup and view all the answers

Which black box warning is NOT associated with Valproic acid?

Skin reactions Signup and view all the answers

Which of the following counseling points should be emphasized for patients taking Lamotrigene?

Start with a low dose Signup and view all the answers

What adverse effect is commonly reported with Lamotrigene?

Ataxia Signup and view all the answers

How often should drug levels be monitored for patients taking mood stabilizers?

For toxicities Signup and view all the answers

What is an important consideration when prescribing Valproate to women of reproductive age?

Delayed periods Signup and view all the answers

Study Notes

Central Nervous System (CNS) Overview

CNS drugs are essential for treating psychiatric and neurological disorders.
Neurons generate action potentials through opening sodium (Na+) channels and subsequently potassium (K+) and calcium (Ca2+) channels.

Neurotransmitter Functions

Excitatory Neurotransmitters: Glutamate, Aspartate, Norepinephrine, Histamine, and Acetylcholine (Ach) contribute to stimulating brain activity.
Inhibitory Neurotransmitter: Gamma-aminobutyric acid (GABA) reduces neuronal excitability.
Neurotransmitters have various roles:
- Histamine: Arousal, movement
- Glutamate: Learning and memory, involved in psychosis
- Acetylcholine: Thought processes, memory, and learning
- Endorphins: Pain relief and pleasure responses.

Drug Types and Their Uses

Agonists: Used when there is insufficient receptor activity.
Partial Agonists: Address imbalances in receptor response, serving as antagonists when necessary.
Antagonists: Used when there is excessive receptor activation.

Common Psychiatric Disorders

Major Depressive Disorder (MDD)
Autism Spectrum Disorder (ASD)
Post-Traumatic Stress Disorder (PTSD)
Affective, thought, and anxiety disorders, including:
- Dysthymia
- Bipolar Disorder
- Schizophrenia

Schizophrenia Insights

Associated with excessive dopamine and serotonin dysfunction.
Numerous neurotransmitters influence schizophrenia's development and symptoms.

Antidepressant Medications

Common antidepressants:
- SSRIs: Paroxetine (Paxil), Sertraline (Zoloft), Venlafaxine (Effexor).
- Side Effects: Risk of suicidal thoughts, especially in youth; potential sexual dysfunction and QTc prolongation risk.

Bipolar Disorder Management

Treatment typically involves mood stabilizers, which may include:
- Lithium
- Valproate (Depakote)
- Carbamazepine
- Lamotrigine (Lamictal)
Antidepressants should not be administered without a mood stabilizer already in use.

Mood Stabilizers

Lithium: Monitored for blood levels; side effects include nausea, dehydration, and hypotension.
Valproate: Monitored for liver toxicity and pancreatitis; side effects like weight gain and drowsiness need consideration.
Lamotrigine: Risk of Stevens-Johnson syndrome; requires monitoring for toxicities and drug interactions.

Counseling Points for Patients

Ensure fluid intake (2-3 liters of water) for lithium users.
Gradually taper antidepressants to avoid withdrawal symptoms.
Report any suicidal thoughts to healthcare professionals immediately.

Studying That Suits You

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Description

Explore the essential features of the Central Nervous System (CNS) and understand the mechanisms of neuron firing, including action potentials. This quiz is tailored for Dr. Lee's PHAR 672 class in Fall 2024, focusing on CNS drugs and their interactions with neuronal activity.