Chapter09:DrugTherapyforCentralNervousSystemProblems Visovsky:IntroductiontoClinicalPharmacology,9thEdition

1. Whichneurotransmitterhasaninhibitoryactionwithinthecentralnervoussystem? a. Epinephrine b. Acetylcholine c. Norepinephrine d. Gamma-aminobutyricacid ANS: D Neurotransmitterscanbeexcitatoryorinhibitory.Excitatoryneurotransmittersincludeacetylcholi ne(Ach),epinephrine,andnorepinephrine.Inhibitoryneurotransmittersincludedopamine,somet ypesofserotonin,andGABA(gamma-aminobutyricacid). DIF: CognitiveLevel:Knowing REF: p.159 2. HowdoesthedrugtolcaponerelievethesymptomsofParkinsondisease? a . Actsasadopamineagonist,replacingtheactivityofdopamine b . Forcesthesubstantianigratoincreasetheproductionandreleaseofnaturaldopamine c . Suppressestheactivityofanenzymethatnormallybreaksdownnaturallyoccurringdopamine d . Increasesthenumberofdopaminereceptorssitesthroughoutthecentralnervoussystem,thusinc reasingtheeffectivenessofdopamineanddopamineagonists ANS: C Catechol-Omethyltransferase(COMT)isanenzymethatbreaksdown(metabolizes)naturallyoccurringcatech olaminebasedneurotransmitters,includingdopamine.Italsobreaksdowndopamineagonistdrugs.Catech ol-Omethyltransferase(COMT)inhibitorsaredrugsthatsuppresstheactivityoftheCOMTenzymesobo thnaturallyoccurringdopamineanddopamineagonistdrugsremainactiveinthebodylonger,helpin gtorestoretheacetylcholine– dopaminebalanceinthebrain.Entacapone(Comtan)andtolcapone(Tasmar)aretwoCOMTinhibit orsthatareusedcurrentlyforPD. DIF: CognitiveLevel:Understanding REF: p.162 3. Whyarecarbidopaandlevodopausuallygiventogether? a. Carbidopaisadopamineagonistandlevodopaisadopamineantagonist. b. Levodopaisadopamineagonistandcarbidopaisadopamineantagonist. c. Carbidopaenhancestheactionoflevodopa,andlessdrugisneeded. d. Levodopareversesorpreventsth