Chapter 21 Intro To CNS Pharma
Chapter 21 Intro To CNS Pharma
Chapter 21 Intro To CNS Pharma
CNS PHARMACOLOGY
• Nearly ALL drugs with CNS effects act on a specific receptor that modulates transmission
• CNS DRUGS are among the most important tools for studying all aspects of CNS physiology
• Unraveling the actions of drugs with known clinical efficacy led to the hypotheses regarding the
mechanism of disease
NEURONS
• Electrically excitable cells that process and transmit information via an electrochemical process
NEUROGLIA
• Large number of nonneuronal support cells
• Astrocytes
o Most abundant cell in the brain
o Provides metabolic nutrients to neurons and maintaining extracellular ion concentrations
• Oligodendrocytes
o Wrap around the axons of projection neurons in the CNS forming the myelin sheath
o Similar to the Schwann cells in peripheral neurons
o Myelin sheath insulates the axons and increases the speed of signal propagation
• Microglia
o Specialized macrophages derived from the bone marrow that settle in the CNS
o Major immune defense system in the brain
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THE SYNAPSE AND SYNAPTIC POTENTIALS
SYNAPSE
Communication between neurons in the CNS occurs through chemical synapses in the majority of cases
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SITES AND MECHANISMS OF DRUG ACTION
• Some drugs exert their effect through direct interactions with molecular components of ion
channels on axons
• Carbamazepine
• Phenytoin
• Local anesthetics and some drugs used for general anesthesia
• Most drugs exert their effect mainly at the synapses
• May act presynaptically to alter
• Synthesis
• Storage
• Release
• Reuptake
• Metabolism of transmitter chemicals
• Activate or block
• Pre- and postsynaptic receptors for specific transmitters
• Interfere with the action of second messengers
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• Reserpine
• Inhibits storage of catecholamines
• Amphetamine
• Induces release of catecholamines
• Cocaine
• Blocks the uptake of catecholamines
• Anticholinesterase
• Inhibits degradation of acetylcholine
CNS ORGANIZATION
2 TYPES OF NEURONAL SYSTEM
A. HIERARCHICAL SYSTEM
• Contain large myelinated, rapidly conducting fibers
• Control major sensory and motor functions
• Excitability of the CNS
• Major excitatory transmitters
• Aspartate
• Glutamate
• Also include numerous small inhibitory interneurons transmitter
• Gamma amino butyric acid (GABA)
• Glycine
B. DIFFUSED/NON-SPECIFIC NEURONAL
SYSTEM
• Broadly distributed, with single cells frequently sending processes to many different parts of the
brain-tangential
• Varicosities
• Periodic enlargements that contain transmitter vesicles
• Located in the axons
• Transmitters
• Noradrenergic amines (NE, dopamine and serotonin)
• Peptides that act on metabotropic receptors
• Found primarily in a compact cell group called locus caeruleus in the caudal pontine
central gray matter
• Marked effects on CNS functions
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• Attention
• Appetite
• Emotional states
Please take note of the different neurotransmitters enumerated on Table 21.1 below and their
receptor subtypes and mechanisms.
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