Psychopharmacology Exam 2 (part 4)

通報

問題一覧

Discuss pathology and clinical features of Alzheimer's Disease

Pathology: Amyloid/tau Clinical Features: Memory deficit, Aphasia, Apraxia, Agnosia

Discuss the pathology and clinical features of Dementia with Lewy Bodies and Parkinson's

Pathology: Alpha-synuclein Clinical features: Lewy bodies- memory deficits, fluctuating attention, EPS, Psychosis (hallucinations); PD - shuffling gait, Psychosis (hallucinations), facial apices, pin-rolling

Discuss the pathology and clinical features of Frontotemproal Dementia

Pathology: Tau Clinical Features: Memory deficits, Speech/language disorders, Disinhibition, Hyperorality

Discuss the pathology and clinical features of Huntington's Disease

Pathology: Trinucleotide repeat Clinical features: Memory deficit, Executive dysfunction, Chorea

Discuss the pathology of Wilson's Disease

Toxic/metabolic (copper)

Discuss the pathology of Metachromatic Leukodystrophy

Leukodystrophy

Discuss the pathology and clincial features of Creutzfeldt-Jakob Disease

Pathoogy: Prion-related pathology Clinical features: Memory deficits, Ataxia, Myoclonus, Language Disturbance

How do you differentiate Vascular Dementia from other Dementias?

It is associated with a stroke (CVA)

What peptide is associated with Alzheimers pathology?

AB 42

What is the greatest risk factor for Alzheimer's Disease?

Age

Name the genetic polymorphism of Alzheimer's Disease

Apolipoprotein E4

ACh's action can be terminated by two different enzymes:

Acetylcholinesterase (AChE) and Butyrylcholinesterase (BuChE)

What Cholinesterase Inhibitor is available in a patch, no drug-to-drug interactions in its class r/t bypaass 1st pass metabolism, and has the most severe S/E of N/V and diarrhea in its class?

Rivastigmine

While all Cholinesterase Inhibitors have GI S/E, which one is the only one that is hepatotoxic?

Tacrine

Treats mild-moderate Alzheimer's Disease

Cholinesterase Inhibitors (Donepezil, Rivastigmine, and Galantamine)

What drug class treats moderate-to-severe Alzheimer's Disease

N-methyl-D-aspartate Receptor Antagonist & Combo Drug (Memantine and Donepezil + Memantine)

Work by reducing the breakdown of acetylcholine in the brain, a chemical which helps neurons to communicate.

Cholinesterase Inhibitors

Preferentially blocks excessive extrasynaptic activity of the N-methyl-D-aspertate (NMDA) glutamate receptors in the brain, which is thought to be associated with AD. However, transmission associated with normal cell functioning is spared.

Memantine

A 2nd Gen, piperidine-class, selective and reversible AChE inhibitor, and is structurally dissimilar to others in its class. It inhibits AChE activity in human erythrocytes and increases extracellular ACh levels in the cerebral cortex and the hippocampus of the rat. Its 1/2 life is approximately 70h allowing for daily dosing.

Donepezil

This drug a pseudoirreversible inhibitor (it reverses itself over hours) of the enzymes acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), which are present both in the central nervous system (CNS) and peripherally. Central cholinergic neurons are important for regulation of memory; thus, in the CNS, the boost of acetylcholine caused by AChE blockade contributes to improved cognitive functioning. In particular, this drug appears to be somewhat selective for AChE in the cortex and hippocampus – two regions important for memory – over other areas of the brain. Peripheral cholinergic neurons in the gut are involved in gastrointestinal effects; thus the boost in peripheral acetylcholine caused by AChE and BuChE blockade may contribute major gastrointestinal side effects.

Rivastigmine

This drug is unique among cholinesterase inhibitors in that it is also a positive allosteric modulator (PAM) at nicotinic cholinergic receptors, which means it can boost the effects of acetylcholine at these receptors. This drug's second action as a PAM at nicotinic receptors could theoretically enhance its primary action as a cholinesterase inhibitor.

Galantamine

This drug is a noncompetitive, low-affinity NMDA (N-methyl-D- aspartate) receptor antagonist that binds to the magnesium site when the channel is open. Thus, blocks the downstream effects of excessive tonic glutamate release by “plugging” the NMDA ion channel, which may improve memory and prevent neuronal death due to glutamate excitotoxicity.

Memantine

Patho Renal

Patho Renal

Pathophysiology

Pathophysiology

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Patho Immunology

Patho Immunology

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Patho Hematology

Patho Hematology

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Patho Hematology 2

Patho Hematology 2

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Patho Respiratory

Patho Respiratory

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Patho Respiratory 2

Patho Respiratory 2

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Patho Cardiovascular

Patho Cardiovascular

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Patho Cardiovascular 2

Patho Cardiovascular 2

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Patho MSK

Patho MSK

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Patho Acid Base

Patho Acid Base

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Renal 2

Renal 2

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Fluid Balance

Fluid Balance

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Patho Endocrine

Patho Endocrine

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Patho Endocrine 2

Patho Endocrine 2

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Infections

Infections

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Patho Shock

Patho Shock

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GI 2

GI 2

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Cancer

Cancer

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