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PHM 114
Chapter 7
| Question | Answer |
|---|---|
| Nervous System | senses and interprets our surroundings and controls vital bodily functions |
| Central Nervous System | Includes the brain and spinal cord. It's responsible for processing information received from the body |
| Peripheral Nervous System | Is made up of all nerves outside the brain and spinal cord. It's responsible for bringing signals to the CNS for interpretation |
| Somatic Nervous System | controls intentional, voluntary movement |
| Autonomic Nervous System | controls involuntary and automatic body functions such as heart rate, respiration, and digestion. Divided into Sympathetic and Parasympathetic Nervous System |
| Sympathetic Nervous System | Uses adrenergic receptros and some cholinergic receptors |
| Parasympathetic Nervous System | uses only cholinergic receptors |
| Cerebrum and Cerebral Cortex | performs higher cognitive functions such as thinking and memory |
| Cerebellum | coordinates movement and balance |
| Pons and Medulla | In the brain stem. Regulate automatic and reflex functions of the body |
| Thalamus and Hypothalamus | control various functions such as hormone regulation and body temperature |
| Pituitary Gland | also helps regulate hormones and controls the growth cycle throughout life |
| Blood Brain Barrier | protects this delicate tissue from potentially harmful chemicals. It must be overcome when drug therapy should enter the CNS to exert its action |
| Neurotransmitters | Chemicals that carry signals from one nerve cell to the next |
| Dendrites | Bring signals into the cell body |
| Axons | carry signals away from the nucleus to neighboring cells |
| Schwann Cells | In peripheral nervous system and Oligodendrocytes in the CNS form a myelin sheath that surrounds and protects axons |
| Autonomic Nervous is responsible for what? | A set of responses to stressful stimuli which are called the "fight and flight" response |
| What nerves release norepinephrine? | Sympathetic |
| Adrenergic | Term given because epinephrine is often referred to as adrenaline |
| Parasympathetic Nerves | regulate restful body functions. Also called Cholinergic |
| Why are parasympathetic nerves called cholinergic? | Because of their type of receptor and their primary neurotransmitter is acetylcholine |
| Alpha Receptors | Found in the blood vessels. When stimulated they constrict blood vessels, raising blood pressure. When they are blocked by drugs, blood pressure lowers |
| Beta One Receptors | Found mostly within the heart. When stimulated they increase heart rate and contraction force |
| Beta Two Receptors | Found in the smooth muscle of arteries and bronchioles in the lungs and also in other tissues. When stimulated these receptors cause blood vessels and bronchioles to dilate |
| What happens when beta receptors are blocked with drug therapy? | heart rate slows and the demand for ocygen within heart decreases. Lower blood pressure |
| Seizures | Convulsions. Uncoordinated bursts of neuronal activity that result in brain dysfunction |
| Epilepsy | Chronic seizure disorder that causes a variety of different types of seizures. All patients with epilepsy have seizures but not all patients with seizures have epilepsy |
| Common causes for seizures? | alcohol or drug withdrawal.high fever.stroke.electric shock.low or high blood sugar.low sodium in the blood.low calcium in the blood.infection.brain tumors or scar tissue.head injury or trauma |
| What is the most common type of seizure? | partial seizure |
| Partial Seizure | A localized area of the brain is affected. Do not lose consciousness. Defined area of body is affected. Twitching or muscle tightness in specific areas of body. Visual disturbances. Can usually communicate |
| Generalized Seizures | Loss of consciousness. Afterward patient experiences period of memory loss,confusion,and tiredness that may last for a few minutes to hours |
| What are drugs used to treat seizure disorders called? | Anticonvulsants |
| Antiepileptic Drugs | affect the influx of sodium,calcium,or chloride ions across the nerve cell membrane in some way |
| Glutamate | Excitatory neurotransmitter that affects sodium and calcium influx |
| GABA | inhibitory neurotransmitter that affects chloride influx |
| What is treatment for status epilepticus? | diazepam.lorazepam.phenytoin.fosphenytoin.phenobarbital |
| Parkinsons Disease | Charactorized by tremors,muscle rigidiity,difficulty moving,and balance problems. Most common amount elderly patients |
| What happens during Parkinsons? | Its a CNS disorder. Cells are lost in the substantia nigra, a region in the midbrain. These cells produce dopamine, used in initiating and coordinating muscle movement. |
| How do patients act with PD? | walk with shuffling gait,lean forward,and are somewhat off balance |
| What is the mainstay of treatment for PD? | dopaminergic agents. LOVODOPA which is the most effective because it improves movement and restores normal function |
| What treatment agents are used for early PD for mild symptoms such as tremors? | Anticholinergics and Amantadine |
| Anticholinergics | work by blocking muscarinic receptors in the brain which helps balance cholinergic activity and reduces tremors |
| Amantadine | antiviral drug used for influenza that inhibits the reuptake of dopamine into presynaptic nerve endings. The inhibition allows reduced dopamine to accumulate in the synaptic cleft and stimulate more dopamine receptors |
| Catechol-o-methyltrans-ferase inhibitors | COMT. Help when levodopa starts to wear off at end of each dosing interval. One of these agents is given with each does of levodopa to increase amount of on time by 1 to 2 hrs each day. Levodopa is decreased by 100 mg a day |
| How do COMT's work? | Block and enzyme that metabolizes dopamine.Boost the effects of levodopa and dopamine by allowing dopamine to remain present longer |
| Monoamine Oxidase Inhibitors | MAOIs. Mild dopamine boosting drugs that are used early on in disease progression or as adjunct therapy in advanced PD |
| What is Rasagiline often used for? | Mild PD symptoms |
| What is Selegiline usually used for? | Adjunct therapy when levodopa begins wearing off |
| What do MAOIs do? | Block MAO, and enzyme that breaks down dopamine in neurons |
| Alzheimer's Disease | Form of dementia. degenerative brain disorder leading to loss of memory,intellect,judgement,orientation,and speech |
| What is the goal of drug therapy with Alzheimer's Disease? | to maintain cognitive function and alertness for as long as possible. |
| How do drug agents for Alzheimer's work? | inhibit enzymes that break down acetylcholine, a neurotransmitter thought to be deficient in early alzheimers. |
| What drug can be used later in the disease of Alzheimers? | antidepressants for depression. Benzodiazepines for anxiety and sleep problems. Antipsychotic meds such as haloperidol for hallucinations |
| Attention deficit Hyperactivity Disorder | ADHD. Characterized by inattention,impulsivity, and hyperactivity |
| What has to occur before a patient can be diagnosed with ADHD? | must have 6 or more symptoms of inattention and 6 or more hyperactivity symptoms that impair daily life in at lease 2 settings for at lease 6 months |
| What is the first line drug therapy for ADHD? | CNS stimulants. Most are Controlled Substances. Dosing starts low and is increased until improvement in symptoms is seen without side effects |
| What drug therapy is tried first for ADHD? | immediate release products |
| How do CNS stimulants work? | Enhance the release and blocking the reuptake of dopamine and norepinephrine in presynaptic nerve cells |
| What is an alternative to CNS stimulants? | atomoxetine which is not a controlled substance and can help with behavioral management |
| What are most drugs that affect the autonomic nervous system used for? | to control blood pressure and heart rate |
| Adrenergic Inhibitors | block alpha and beta receptors |
| Adrenergic Agonists | Stimulate alpha and beta receptors |
| Alpha Blockers | Used to treat hypertension. Useful in men with benign prostatic hyperplasia |
| Beta Blockers | used for hypertension,angina,and arrhythmias. Make up Class II of antiarrhythmic agents. low cost. Also recommended for heart attack patients |
| cardioselective Beta Blockers | inhibit only beta-one receptors in the heart. Useful in treating angiina and certain arrhythmias without causing bronchoconstriction |
| Antichonlinergic Side Effects | dry mouth.dry eyes.constipation.urinary retention.blood pressure rises |
| What patients shouldnt use drugs with antichonlinergic side effects? | Patients with urinary difficulty or bowel problems |
| Ginkgo Biloba | May have modest benefit for patients with early alzheimers disease, but serious side effects |
| Side effects of Ginkgo Biloba | Bleeding.Seizures.Coma |
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Tara3184
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