CNS meds - CentralNervousSystem Medications NURS324Fall2010...

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Central Nervous System  Medications NURS 324 Fall 2010 Dr. Smith
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CNS Physiology CNS is vastly more complicated than the  peripheral nervous system Protected by the blood-brain barrier Includes highly specialized neurons and  tissue in the brain and spinal cord 21 identified neurotransmitters, more exist -monoamines and amino acids  The difficulty of researching CNS activity  means that we hypothesize on drug 
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CNS Adaptation to Drugs The CNS is able to adapt when exposed  to drugs for a long time Effects of adaptation: -increased therapeutic effects -decreased side effects
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CNS Adaptation to Drugs -tolerance: decreased response occurring  after prolonged drug use -physical dependence: a state in which  abrupt discontinuation of a drug will cause  withdrawal signs/symptoms
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Studying CNS Drugs Less systematic than the peripheral  nervous system drugs we just learned We will learn (and be expected to know)  the CNS neurotransmitters (NTs) as they  arise in the discussion of a drug The CNS complexity and uncertainty  about MOAs leads to great individual  variation in responses and adverse  reactions
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Voluntary Motor Control The extrapyramidal system (EPS) is a  large network of brain areas that, together,  control voluntary movement The basal ganglia (or nuclei) are one  component of the EPS GABA is the NT that ultimately controls  voluntary movement GABA is inhibitory (slows motor function)
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Voluntary Motor Control The basal ganglia needs a balance of two  NTs, dopamine and Ach, to achieve the  correct amount of GABA DA reduces GABA levels Ach increases GABA levels
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Parkinson’s Disease Neurons of the basal ganglia that produce  DA slowly degenerate Less DA is delivered, leading to increased  levels of GABA Symptoms: muscle tremors, rigidity,  bradykinesia
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Lack of Dopamine in Basal  Ganglia
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Treatment of Parkinson’s Dopamine replacement (levodopa) Dopamine agonists (pramipexole) COMT inhibitors (entacapone) MAO-B inhibitors (selegiline)
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CNS meds - CentralNervousSystem Medications NURS324Fall2010...

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