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Questions and Answers
What percentage of total prescriptions are CNS drugs in England?
What percentage of total prescriptions are CNS drugs in England?
- 19% (correct)
- 10%
- 20%
- 15%
What is the estimated cost of CNS drugs to the NHS?
What is the estimated cost of CNS drugs to the NHS?
- £1.2 billion
- £2.1 billion
- £1.59 billion (correct)
- £1.8 billion
What is the definition of CNS drugs according to the British National Formulary (BNF)?
What is the definition of CNS drugs according to the British National Formulary (BNF)?
- Includes analgesics, excludes anaesthetics (correct)
- Excludes both analgesics and anaesthetics
- Includes analgesics and anaesthetics
- Excludes analgesics and includes anaesthetics
What is the ranking of CNS drugs in terms of prescription items in England?
What is the ranking of CNS drugs in terms of prescription items in England?
How many prescription items of CNS drugs were there in England in 2022/3?
How many prescription items of CNS drugs were there in England in 2022/3?
What is the approximate number of CNS drug prescriptions per person in England?
What is the approximate number of CNS drug prescriptions per person in England?
What is the primary function of the basal ganglia in the brain?
What is the primary function of the basal ganglia in the brain?
What is the main function of the hypothalamus and pituitary gland in the brain?
What is the main function of the hypothalamus and pituitary gland in the brain?
What is the primary function of the thalamus in the brain?
What is the primary function of the thalamus in the brain?
What is the function of the amygdala and cingulate gyrus in the brain?
What is the function of the amygdala and cingulate gyrus in the brain?
What is the primary function of the cerebellum in the brain?
What is the primary function of the cerebellum in the brain?
What is the term for the chemical messengers released by neurons in the CNS?
What is the term for the chemical messengers released by neurons in the CNS?
What is the primary inhibitory neurotransmitter in the brain?
What is the primary inhibitory neurotransmitter in the brain?
What enzyme is responsible for synthesizing GABA from glutamate?
What enzyme is responsible for synthesizing GABA from glutamate?
What is the mechanism of GABA deactivation?
What is the mechanism of GABA deactivation?
Which cell type is responsible for synthesizing GABA?
Which cell type is responsible for synthesizing GABA?
What is the location of GABA transaminase (GABA-T)?
What is the location of GABA transaminase (GABA-T)?
What is the function of GABA transporters?
What is the function of GABA transporters?
Which of the following G-protein coupled receptors is associated with presynaptic inhibition?
Which of the following G-protein coupled receptors is associated with presynaptic inhibition?
Which neurotransmitter is involved in motor control and is affected in Parkinson's disease?
Which neurotransmitter is involved in motor control and is affected in Parkinson's disease?
What is the effect of the Gs protein on cAMP levels?
What is the effect of the Gs protein on cAMP levels?
Which of the following is a function of the M3 muscarinic receptor?
Which of the following is a function of the M3 muscarinic receptor?
Which neurotransmitter is primarily involved in the regulation of arousal, attention, and memory?
Which neurotransmitter is primarily involved in the regulation of arousal, attention, and memory?
What is the primary function of the GABAergic neuron in the brain?
What is the primary function of the GABAergic neuron in the brain?
Which receptor is responsible for the sedative and analgesic effects of adrenoceptor agonists?
Which receptor is responsible for the sedative and analgesic effects of adrenoceptor agonists?
What is the primary function of the dopamine receptor D2 in the brain?
What is the primary function of the dopamine receptor D2 in the brain?
Which enzyme is involved in the conversion of L-tyrosine to L-dopa in the synthesis of dopamine?
Which enzyme is involved in the conversion of L-tyrosine to L-dopa in the synthesis of dopamine?
Which neurotransmitter is primarily involved in the regulation of cognitive control and emotions?
Which neurotransmitter is primarily involved in the regulation of cognitive control and emotions?
What is the primary function of the GABA-T enzyme in the brain?
What is the primary function of the GABA-T enzyme in the brain?
Which receptor is primarily involved in the regulation of neuronal excitability and behaviour?
Which receptor is primarily involved in the regulation of neuronal excitability and behaviour?
What is the primary function of the serotonin transporter SERT in the brain?
What is the primary function of the serotonin transporter SERT in the brain?
The hippocampus is responsible for emotion and memory.
The hippocampus is responsible for emotion and memory.
The hypothalamus is responsible for sensory neurotransmission.
The hypothalamus is responsible for sensory neurotransmission.
The brain is a purely electrical machine.
The brain is a purely electrical machine.
The cerebellum is responsible for higher brain functions.
The cerebellum is responsible for higher brain functions.
Neurotransmitters are released postsynaptically and generate rapid excitatory/inhibitory responses presynaptically.
Neurotransmitters are released postsynaptically and generate rapid excitatory/inhibitory responses presynaptically.
Neuromodulators can generate faster responses postsynaptically mainly by G protein-coupled receptors.
Neuromodulators can generate faster responses postsynaptically mainly by G protein-coupled receptors.
During an action potential, potassium channels open during the depolarisation phase.
During an action potential, potassium channels open during the depolarisation phase.
Glial cells are a type of neuronal cell that provides metabolic support for neurons.
Glial cells are a type of neuronal cell that provides metabolic support for neurons.
The ATP-Na+/K+ pump is responsible for generating the resting potential in neurons.
The ATP-Na+/K+ pump is responsible for generating the resting potential in neurons.
Neurotransmitters can act only via ligand-gated ion channels.
Neurotransmitters can act only via ligand-gated ion channels.
Some chemicals, such as ACh, dopamine, and 5-HT, can only act as neurotransmitters or neuromodulators.
Some chemicals, such as ACh, dopamine, and 5-HT, can only act as neurotransmitters or neuromodulators.
GABA is an excitatory neurotransmitter in the CNS.
GABA is an excitatory neurotransmitter in the CNS.
The 5-HT3 receptor is involved in the inhibition of behavior, including sleep, feeding, and thermoregulation.
The 5-HT3 receptor is involved in the inhibition of behavior, including sleep, feeding, and thermoregulation.
M4 and M5 muscarinic receptors are involved in glandular and smooth muscle function.
M4 and M5 muscarinic receptors are involved in glandular and smooth muscle function.
Adenosine receptors A1 and A2A are involved in excitatory neurotransmission.
Adenosine receptors A1 and A2A are involved in excitatory neurotransmission.
Nicotinic receptors are primarily involved in postsynaptic transmission.
Nicotinic receptors are primarily involved in postsynaptic transmission.
Histamine receptors H1-3 are primarily involved in motor control and are affected in Parkinson's disease.
Histamine receptors H1-3 are primarily involved in motor control and are affected in Parkinson's disease.
Glutamate is the primary inhibitory neurotransmitter in the brain.
Glutamate is the primary inhibitory neurotransmitter in the brain.
Ketamine is a medicinal drug that blocks AMPA receptors.
Ketamine is a medicinal drug that blocks AMPA receptors.
Glutamate is synthesized from glucose via the Kreb's cycle.
Glutamate is synthesized from glucose via the Kreb's cycle.
NMDA receptors are only found on postsynaptic neurons.
NMDA receptors are only found on postsynaptic neurons.
There are 3 metabotropic glutamate receptors.
There are 3 metabotropic glutamate receptors.
Glutamate is stored in synaptic vesicles and released in a Ca2+-independent manner.
Glutamate is stored in synaptic vesicles and released in a Ca2+-independent manner.
GABA is synthesised from aspartate by glutamic acid decarboxylase (GAD)
GABA is synthesised from aspartate by glutamic acid decarboxylase (GAD)
GABA transaminase (GABA-T) is found in the synapses of GABAergic neurons
GABA transaminase (GABA-T) is found in the synapses of GABAergic neurons
GAT1 is responsible for the re-uptake of GABA in astrocytes
GAT1 is responsible for the re-uptake of GABA in astrocytes
GABA is the primary excitatory neurotransmitter in the brain
GABA is the primary excitatory neurotransmitter in the brain
Glutaminase is involved in the synthesis of glutamate from glutamine
Glutaminase is involved in the synthesis of glutamate from glutamine
GABAergic neurons are responsible for the synthesis and release of glutamate
GABAergic neurons are responsible for the synthesis and release of glutamate
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Study Notes
Anatomy of the Brain
- The brain consists of the mid brain, cerebellum, pons, and medulla.
- The brain is a chemical machine that controls various functions of higher animals over wide timescales through fast and slow transmission, controlled by chemical mediators and molecular mechanisms.
Major Functions of the Brain
- Cerebellum: motor movement/co-ordination
- Basal ganglia (striatum, substantia nigra): motor movement
- Limbic system: amygdala and cingulate gyrus (emotion and memory), hippocampus (learning and memory)
- Thalamus: sensory neurotransmission
- Hypothalamus and pituitary gland: endocrine control
- Cerebral cortex: higher brain functions
Chemical Signalling in the CNS
- Neurotransmitters: released presynaptically and generate rapid excitatory/inhibitory responses postsynaptically.
Amino Acid Transmitters
Glutamate
- Main excitatory transmitter in the CNS
- Stored in synaptic vesicles and released by Ca2+-dependent exocytosis
- Synthesised from glucose (Krebs cycle) or glutamine (pharmacologically inactive) via glial cells
- Receptors: NMDA, AMPA, kainate, and 8 metabotropic receptors (GPCRs)
GABA (γ-Aminobutynic acid)
- Main inhibitory transmitter in the brain
- Widespread distribution in the brain, highest density in the nigrostriatal system
- Synthesised in GABAergic neurons (majority short interneurons)
- Re-uptake by specific transporters: GABA transporter 1 (GAT1) and GAT3
- Deactivation: GABA transaminase (GABA-T) found in mitochondria of astrocytes and neurons
Monoamines
Noradrenaline (NA)
- Function: arousal, attention/memory, stress, cognitive control, emotions, neuroplasticity, posture, and balance, blood pressure
- Receptors: adrenoceptors (α1, α2, β1, β2, β3)
Dopamine (DA)
- Function: endocrine control, motor control (Parkinson's disease), behaviour, emotion, memory, and learning
- Receptors: D1 type (Gs coupled, activates adenylate cyclase), D2 type (Gi/o coupled, inhibits adenylate cyclase)
5-Hydroxytryptamine/serotonin (5-HT)
- Function: mood, memory processing, sleep, cognition
- Receptors: 5-HT1A, 5-HT1B/D, 5-HT1E, 5-HT1F, 5-HT2A, 5-HT2B, 5-HT2C, 5-HT3, 5-HT4, 5-HT5, 5-HT6, and 5-HT7
Acetylcholine (ACh)
- Function: motor control (Parkinson's disease, Huntington's chorea), arousal (Alzheimer's disease), learning, and short-term memory
- Receptors: muscarinic (mAChR) and nicotinic (nAChR)
Other CNS Mediators
- Purines: adenosine (A1 and A2A), ATP (P2X)
- Histamine: H1-3, widespread in brain, anti-histamine used to control nausea/vomiting (motion sickness), induce sleep
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