Term
| how is serotonin made and broken down |
|
Definition
L tryptophan ingested >
facillitated transport into brain (concentration in blood relation to other AA)>
RATE LIMITING: tryptophan hydroxylase + O2 + pteridine >
serotonin >
MAO >
5-hydroxyindole acetic acid >
transport out of brain (inhibited by probenecid) >
small amt in urine (unless malignant carcinoid) |
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|
Term
| what are the 4 serotonin receptors how do they work, where are they located |
|
Definition
all 16 in brain, not all in body
1: Gi: inc K, hyperpolarize, inhibit
2: Gq: dec K, depolarize, excite
3: ion: dec K, inc Na, depolarize (fast)
4: dec K, hyperpolarize, excite |
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|
Term
| functions of serotnin in blood and vessels 2 |
|
Definition
platelets contact endothelium which releases 5HT which goes to 5HT2 on platelets causing aggregation and vasoconstriction
vasoconstriction in eplanchnic, renal, pulmonary, cerebral) |
|
|
Term
| functions of serotonin in lungs 2 |
|
Definition
pulmonary vessel constriction
constriction of bronchioles |
|
|
Term
| functions of serotonin in GI |
|
Definition
enterochromaffin cells make it, store it, and use it.
released bia vagal stimulation to cause emesis |
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|
Term
| functions of serotonin in CNS 9 |
|
Definition
| sleep, cognotion, sensory, motor, temp, pain, appetite, sex, hormone secetion |
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|
Term
| is serotonin hydrophillic or phobic what does this mean about its distribution and function |
|
Definition
phillic
cannot cross BBB, must be made in brain
not all cells that use it make it so they need transporter |
|
|
Term
| why can serotonin be hallucinogenic |
|
Definition
| N and O methylated properities |
|
|
Term
| what is the chemical class of serotonin |
|
Definition
|
|
Term
| what compound is relative to serotonin, how is it foemed |
|
Definition
melatonin
N acetylation
O methylation
in pineal gland controlled by light |
|
|
Term
| ergot: where does it come from, what does it to (biochem and physio) |
|
Definition
fungus on rye and grain
interacts with 5HT, D, and a receptors different interaction in different systems
vasoconstriction, cerebral constriction, supress sensory neuropeptides |
|
|
Term
| complication of all ergots |
|
Definition
| vasoconstriction can cause gangrene and misscarriage |
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|
Term
| migraine: family hx, sex, onset, location, character, duration, associated symptoms |
|
Definition
hx: yes
sex: females
onset: variable
location: usually unilateral
character: pulse, throb
duration; 2-72h
symp: aura (15%), photosensitive, sound sensitive, pale, nausea, vomiting. aggrevated by physical activity |
|
|
Term
| cluster headache: family hx, sex, onset, location, character, duration, associated symptoms |
|
Definition
hx: no
sex: males
onset: in sleep
location: behind/around eye
character: sharp, steady
duration: 15-90min
symp: uni/bilateral sweating, flushing, congestion, ptosis, lacrimation, pupillary changes |
|
|
Term
| tension headahce: family hx, sex, onset, location, character, duration, associated symptoms |
|
Definition
hx: yes
sex: females
onset: stress
location: bilateral around head
character: dull, persistant, tight
duration: 30 mim - 7d
symp: mild photophobia, noise phobia, anorexia |
|
|
Term
| mild migraine: definition, tx |
|
Definition
occasional throbbing, no major impairment
mild analegesics combo analegesics, amiemetics |
|
|
Term
| moderate migraine: definition, tx |
|
Definition
some impairment in function, nausea
combination anaglesics, ergots, sumatriptan, amiemetics |
|
|
Term
| severe migraine: definition, tx |
|
Definition
>3/mo, functional impairment, nausea, vomiting
ergot, sumatriptan, animetics, prophylaxis |
|
|
Term
| what drugs are used in migraine prophylaxis 5, what is #1 |
|
Definition
#1 B blocker
Ca channel blocker
TCA
serotonergic agonist
MAOI |
|
|
Term
| what B blocker are used in migraine prophylaxis 5 |
|
Definition
propranolol
timolol
atenolol
nadolol
metoprolol |
|
|
Term
| what TCA are used in migraine prophylaxis 2 |
|
Definition
amitriptyline
nortryptyline |
|
|
Term
| what serotonergic agonist are used in migraine prophylaxis 2 |
|
Definition
methylserglide
cyproheptadine |
|
|
Term
| what MAOI are used in migraine prophylaxis 2 |
|
Definition
|
|
Term
| what are triggers someone can avoid for migraine |
|
Definition
| alcohol, foods, irregular sleep, stress, time zone shift, altitude, barometric pressure, menstural cycle |
|
|
Term
|
Definition
citalopram
paroxetine
sertaline
fluoxetine
fluboxamine
escitalopram
depression, PMDD, OCD, anxiety, migrane prophylaxis |
|
|
Term
| serotoniin agonists and their receptors (3) |
|
Definition
sumatriptan: 5HT-1D
LSD: 5HT-2A, 2C
buspirone: 5HT-1A |
|
|
Term
| serotonin antagonist and their receptors: |
|
Definition
odansteron: 5HT-3
risperidone: 5HT- 2A, 2C, D
cyproheptadine: 5HT-2A
methysergide: 5HT-2A, 2C |
|
|
Term
|
Definition
ergoloid methylate
ergonovine
ergotamine
bromocryptine
methysergide
dihydroergotamine |
|
|
Term
|
Definition
constrict vessels
supress release of neuropeptides |
|
|
Term
|
Definition
non selective
ergot derivative |
|
|
Term
|
Definition
| K channel open, hyperpolarization, inhibitory |
|
|
Term
|
Definition
| inhibit 5HT-2A on smooth muscle |
|
|
Term
|
Definition
LSD and methylergovine relative
inhibits vasoconstriction and vasopressin
inhibits 5HT-2A, 2C on smooth muscle |
|
|
Term
|
Definition
|
|
Term
|
Definition
psychic alterations
hallucinations |
|
|
Term
|
Definition
|
|
Term
|
Definition
| gynecomastia: D receptor inhibition allows activity of prolactin |
|
|
Term
|
Definition
| inflammatory fibrosis (esp heart) in prolonged tx |
|
|
Term
| administration sumatriptan 3 |
|
Definition
IV - NO causes coronary vasospasm
oral - poor absorption
SC
nasal |
|
|
Term
| administration odansteron 2 |
|
Definition
|
|
Term
| administration methysergide |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
nausea and vomiting (esp from chemo due to enterochromaffin release of 5HT in SI stimulation emesis
vagal afferents through 5HT-3 receptors initiate vomiting, this is stopped |
|
|
Term
|
Definition
migraine prophylaxis
counteract sex SE of SSRI |
|
|
Term
|
Definition
migraine prophylaxis
vascular headache prophylaxis
depression
schizophrenia |
|
|
Term
|
Definition
migraine
depression
schizophrenia |
|
|
Term
|
Definition
| increase brain metabolism |
|
|
Term
|
Definition
| increase strength, duration, and frequency of uterine contraction to decrease uterine bleeding |
|
|
Term
|
Definition
|
|
Term
|
Definition
post partum hemorrhage
abortion bleeding control |
|
|
Term
|
Definition
| caffiene + belladonna + phenobarbitol |
|
|
Term
|
Definition
|
|
Term
|
Definition
ergot derivative
inhibit vasoconstriction and vasopressin
inhibit 5HT action on smooth muscle |
|
|
Term
|
Definition
| caffiene + belladonna + phenobarbitol |
|
|
Term
| administration ergotamine |
|
Definition
PO, SL, retro rocks
should not exceede 6mg/d or 10mg/wk
take 1-2mh/0,5h until relief |
|
|
Term
| administration of dihydroergotamine |
|
Definition
|
|
Term
|
Definition
CP, coronary vasoconstriction, tachy, brady
numbness, tingling of fingers and toes
nausea, vomiting |
|
|
Term
| contraindications of ergotamine 4 |
|
Definition
| pregnancy, peripherial vascular disease, hepatic/renal impairment |
|
|
Term
| contraindications of dihydroergotamine 4 |
|
Definition
| pregnancy, peripherial vascular disease, hepatic/renal impairment |
|
|
Term
| interactions of ergotamine 4 |
|
Definition
| azithro, dirithro, clathro, erythromycin causes ergotism (HTN, ischemia) |
|
|
Term
| interactions of dihydroergotamine 4 |
|
Definition
| azithro, dirithro, clathro, erythromycin causes ergotism (HTN, ischemia) |
|
|
Term
|
Definition
| acute migraine or cluser headache |
|
|
Term
|
Definition
| migraine or cluster headache |
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|
