Maryville NURS660
Psychopharmacology Exam 4-
Questions and Answers-
Guaranteed Pass
Cortico-striatal-thalamic loop in ADHD - --Impulsivity and hyperactivity
are modulated here.
-Motor activity, such as hyperactivity and psychomotor agitation or
retardation, can be modulated by CSTC loop from the prefrontal motor
cortex to the putamen (lateral striatum) to the thalamus and back to the
prefrontal motor cortex.
-Common symptoms of hyperactivity in children with ADHD include
fidgeting, leaving one's seat, running/climbing, being constantly on the
go and having trouble playing quietly.
-Mesolimbic dopamine pathway in ADHD - --Too little of norepi or
dopamine-have issues with being distracted, organized, forgetful, or
fatigued. (norepi and dopamine are the two key neurotransmitters in
ADHD)
-Pathophysiology of ADHD - -Inefficient tuning of prefrontal cortex by
dysregulation of dopamine and norepinephrine.
Symptoms: inattention, hyperactivity, and impulsivity.
-Atomexetine (Strattera) - --ADHD Non-Stimulant
-Inhibits NET in the prefrontal cortex increases both DA and NE. As only
a few NET exist in the nucleus accumbens, atomoxetine does not induce
an increase in DA and NE in the nucleus accumbens, the reward center
of the brain, thus atomoxetine does not have abuse potential.
-Requires build-up over time, not short acting, no concern for
abuse/misuse.
-Can't be taken with Paxil or Wellbutrin
-Adverse effects: priapism, liver injury
-Methlyphenidate - -Ritalin, Concerta, ADHD stimulant.
-Methylphenidate binds to the dopamine transporter and to the
norepinephrine transporter, in both cases acting as an allosteric
modulator. Stops the action of the transporters, preventing reuptake
and thus allowing dopamine and norepinephrine to accumulate in the
synapse.
-Amphetamine - -Adderall, ADHD
-Competitively inhibits dopamine transporter and VMAT transporter.
-Blocks the transporter for dopamine and norepinephrine.
-Increases dopamine at synaptic cleft.
-High risk for abuse
, -Guanfacine - -Intuniv, nonstimulant for ADHD.
Selective agonist for alpha 2A.
Better tolerated than clonidine.
-Clonidine - -Alpha 2 agonist ADHD.
Less selective than guanfacine, binds to alpha 2A, 2B, & 2C.
Can reduce signs of autonomic hyperactivity during withdrawal.
-Lisdexamfetamine - -Vyvanse ADHD
Stimulant
Longer-acting, less risk for abuse
Pro-drug
Can't be snorted
-Impulsivity - -oribitofrontal cortex
-Hyperactive symptoms - -Prefrontal motor cortex
-Declines notably by adolescence
-Selective attention - -Dorsal ACC
-Inattention - -inefficient information processing in DLPFC
-Acetylcholine in Dementia - -Acetylcholine is an important
neurotransmitter and is thought to be involved in memory.
Major acetylcholine neurotransmitter projections originating in the basal
forebrain project to the prefrontal cortex, amygdala, and hippocampus,
the primary brain structure involved in short-term memory and most
greatly affected in Alzheimer's disease.
-Donepezil (Aricept) - --Reversible, long-acting selective inhibitor of
acetylcholinesterase (AChE),
-transient gastrointestinal side effects
-Taken once daily
-Galantamine - -AChE inhibition and positive allosteric modulation (PAM)
of nicotinic cholinergic receptors.
-Cholinesterase inhibitor, enhances actions of acetylcholine
-Contraindicated in patients with renal or hepatic impairment
-Rivastigmine - -Cholinesterase inhibitor
Available as oral and transdermal
The oral formulation may result in more gastrointestinal side effects
than donepezil,
-inhibition of both AChE and butyrylcholinesterase (BuChE) in the
periphery.
-Memantine - --NMDA receptor antagonist
Psychopharmacology Exam 4-
Questions and Answers-
Guaranteed Pass
Cortico-striatal-thalamic loop in ADHD - --Impulsivity and hyperactivity
are modulated here.
-Motor activity, such as hyperactivity and psychomotor agitation or
retardation, can be modulated by CSTC loop from the prefrontal motor
cortex to the putamen (lateral striatum) to the thalamus and back to the
prefrontal motor cortex.
-Common symptoms of hyperactivity in children with ADHD include
fidgeting, leaving one's seat, running/climbing, being constantly on the
go and having trouble playing quietly.
-Mesolimbic dopamine pathway in ADHD - --Too little of norepi or
dopamine-have issues with being distracted, organized, forgetful, or
fatigued. (norepi and dopamine are the two key neurotransmitters in
ADHD)
-Pathophysiology of ADHD - -Inefficient tuning of prefrontal cortex by
dysregulation of dopamine and norepinephrine.
Symptoms: inattention, hyperactivity, and impulsivity.
-Atomexetine (Strattera) - --ADHD Non-Stimulant
-Inhibits NET in the prefrontal cortex increases both DA and NE. As only
a few NET exist in the nucleus accumbens, atomoxetine does not induce
an increase in DA and NE in the nucleus accumbens, the reward center
of the brain, thus atomoxetine does not have abuse potential.
-Requires build-up over time, not short acting, no concern for
abuse/misuse.
-Can't be taken with Paxil or Wellbutrin
-Adverse effects: priapism, liver injury
-Methlyphenidate - -Ritalin, Concerta, ADHD stimulant.
-Methylphenidate binds to the dopamine transporter and to the
norepinephrine transporter, in both cases acting as an allosteric
modulator. Stops the action of the transporters, preventing reuptake
and thus allowing dopamine and norepinephrine to accumulate in the
synapse.
-Amphetamine - -Adderall, ADHD
-Competitively inhibits dopamine transporter and VMAT transporter.
-Blocks the transporter for dopamine and norepinephrine.
-Increases dopamine at synaptic cleft.
-High risk for abuse
, -Guanfacine - -Intuniv, nonstimulant for ADHD.
Selective agonist for alpha 2A.
Better tolerated than clonidine.
-Clonidine - -Alpha 2 agonist ADHD.
Less selective than guanfacine, binds to alpha 2A, 2B, & 2C.
Can reduce signs of autonomic hyperactivity during withdrawal.
-Lisdexamfetamine - -Vyvanse ADHD
Stimulant
Longer-acting, less risk for abuse
Pro-drug
Can't be snorted
-Impulsivity - -oribitofrontal cortex
-Hyperactive symptoms - -Prefrontal motor cortex
-Declines notably by adolescence
-Selective attention - -Dorsal ACC
-Inattention - -inefficient information processing in DLPFC
-Acetylcholine in Dementia - -Acetylcholine is an important
neurotransmitter and is thought to be involved in memory.
Major acetylcholine neurotransmitter projections originating in the basal
forebrain project to the prefrontal cortex, amygdala, and hippocampus,
the primary brain structure involved in short-term memory and most
greatly affected in Alzheimer's disease.
-Donepezil (Aricept) - --Reversible, long-acting selective inhibitor of
acetylcholinesterase (AChE),
-transient gastrointestinal side effects
-Taken once daily
-Galantamine - -AChE inhibition and positive allosteric modulation (PAM)
of nicotinic cholinergic receptors.
-Cholinesterase inhibitor, enhances actions of acetylcholine
-Contraindicated in patients with renal or hepatic impairment
-Rivastigmine - -Cholinesterase inhibitor
Available as oral and transdermal
The oral formulation may result in more gastrointestinal side effects
than donepezil,
-inhibition of both AChE and butyrylcholinesterase (BuChE) in the
periphery.
-Memantine - --NMDA receptor antagonist
