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Final Exam Summary Notes

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CHEM 183
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World of Chem DrugsFinal Exam Summary Notes MENTAL ILLNESS Neurotransmittersreleased by neurons modulate brain function role in mental illnessEx serotonin dopamine norepinephrine GABANeurotransmitters are synthesized within a nerve cell and stored at tip of axon of transmitting cell in vesiclesNeuron fires electrical impulse carried along one cell and is transmitted to nextcarrying electrical impulse constitutes the nerve signalWhen impulse reaches end of axon neurotransmitters released into synapse and react with neurotransmitter receptors causes propagation of electrical impulse on dendrite of next neuronDendritesinvolved in receiving a signalshort wavy arms from cell central bodyAxon Tailinvolved in transmitting signallongtail Synapsespace bw axon of one cell and dendrite of anotherWays to Chemically Interfere with Neurotransmitter Signaling Pathway 1Lock and Key Methoddrug designed to block neurotransmitterreceiving receptors on signalreceiving cell no electrical impulse transmitter bw cells 2Drugs designed to interfere with synthesis of neurotransmitters3Prevention or Stimulation of Neurotransmitter ReleaseNeurotransmitters are recycledtaken up by transmitting original cell following signal firing where it is recycled to produce more neurotransmitterdrugs can interfere with enzymes that modulate biochemical recycling of neurotransmitterDrugs designed to block reuptake by blocking enzyme involved in reuptake Reserpinestops nerve impulses by causes norepinephrine to leak out of vesicles if neurotransmitter leaks out then impulse cannot be transferred across synapse Amphetamines are stimulantssqueeze Norepinephrine and Dopamine out of vesicles causes them to release into synapseTricyclics mood elevatorsprevent reuptake of neurotransmitters by increasing concentration of neurotransmitters in synapse MAO Inhibitorsinterferes with enzyme responsible for breakdown of neurotransmitters preventing breakdown of neurotransmitters which increases concentration in synapseNeuroleptics used to treat Schizophreniablock receptors on receiving cells specific for dopamine neurotransmitterSchizophreniaClassic mental illness mad people not a splitpersonality disorderHistorically up to 20th c treated horrifically Mental condition characterized by a loss of contact with realityvisualauditory hallucinations delusions of persecution common belief that people are out to get themHenri Laborit 1952physician contributed to development of modern treatment of schizophrenia Noticed patients had heart attacks right before a planned surgery believed it was due to anxiety Antihistamines were available at the time to cure anxiety Laborit thought anxiety could be treated with antihistamines bc histamine was a bad thing to have released in your blood Used Promethazine Phenergan an antihistamine to try and stop anxietydid not alleviate anxiety but made patients more prone to sleepingsuggested use of it to psychiatric deptScientists analyzed Promethazine tried to find similar molecules to see if they had parallel effects on patientsChlorpromazine Thorainesimilar to Promethazineinduces calming effects with patients by reducing dopamine levels through blocking dopamine receptorspsychiatric patients and schizophrenics treated with thisproblem was it provoked shaking and paralysis Parkinsonlike symptoms Nathan Kline 1952psychiatrist experimenting with drugs for schizophrenia Reserpinesnakeroot plantused for lowering blood pressure antihypertensivehad tranquilizing and calming effectsused on Schizophrenics had Parkinsonlike symptoms Chlorpromazine and Reserpine have different structures but appeared to have the same effectpossible because there is a difference in the mechanism of actionboth drugs deprive a postsynaptic neuron of dopamineChlorpromazineblocks dopamine receptorsoverproduction of dopamine causes schizophrenia by blocking receptors activity on receiving nerve cells dopamine cannot carry out its functionReserpinecauses dopamine to leak out of vesiclesless dopamine released upon nerve excitation which reduces level of dopamine in synapse Parkinsons Diseasecaused by lack of dopaminetoo much dopamine blocked may causes Parkinsonslike symptoms 1World of Chem DrugsFinal Exam Summary Notes Perphenazineimproved version of Chlorpromazinemolecular structure similar to Chlorpromazinereduces side effects which is why its a popular drug for treatment of SchizophreniaHaldol HaloperidolSchizophrenia drug still has Parkinsonslike side effectsalso used on agitated patients esp in retirement homes and hospitals Other Common Drugs Clozapine Clozaril Risperidone Risperdal Olanzapine Zyprexa25 of Schizophrenics achieve remission with approp medicationsBest Drug just bc a drug is new does not make it better new drugs more expensive and efficacy is relatively the same as old drugs Depression Characterized by a feeling of hopelessness pessimism and uselessnessdepressed feel this way for no apparent reasonAntidepressants used to treat depression most popular prescription drugsScientologyagainst the use of drugs to treat mental illnessTricyclicsfirst group of antidepressants discoveredCalled Tricyclics bc they have 3 rings of carbon atoms in their molecular structure Discovery was the result of a search for a better version of ChlorpromazineImipramine Tofranil was a Chlorpromazine derivativeineffective in treating Schizophrenia but improved moodblocks reuptake of serotonin and norepinephrine neurotransmitters involved in mood causes an increased concentration of neurotransmitter in synapse leading to constant firing of neuron causing improved moodAmitriptyline Deprexdiscovered by modifying Imipraminevery successful antidepressantAnafranil Side Effects of Tricyclics Anticholinergicdry mouth blurred visionAntiAcetylcholine actions caused by blocking Acetylcholine neurotransmitter receptor Antiadrenergicirregular heart beatAntiEpinephrine actions caused by blocking epinephrine adrenaline receptorAlso block reuptake of other neurotransmitters which leads to side effects Ideally antidepressant will minimize crossreaction with receptors of other neurotransmitters thereby reducing the severity of side effects caused by drug Selective Serotonin Reuptake Inhibitor SSRIprevent reuptake of serotonin no crossreactivity with acetylcholine or epinephrineblocks serotonin reuptake increases concentration of serotonin in synapse results in increased feelings of happinessProzacincreases levels of serotonin and norepinephrine in synapse without causing side effects of tricyclicsit is the most frequently prescribed antidepressant by psychiatrists Other SSRIs Sertraline Zoloft Fluovoxamine Luvox Maprotiline Ludiomil Paroxetine Paxil Trazodone Desyrel Citalopram CelexaSide Effects of SSRIs Nausea Anxiety Sleep disturbances Sexual dysfunctionA possible side effect is a higher suicide ratedebate over if the drug is causing the higher suicide rate or if it is the depression itselfno scientific proof it is the SSRIsJoseph Wesbecker Louisville KY 1989went on shooting spree was taking Prozac for depressionProzac never shown as cause of rampageMAO Monoamine Oxidase Inhibitors Discovered accidentally in 1950s prime drug used to treat TB was Iproniazid also caused patients to be happyNathan Kline tried Iproniazid on depressed patients and found that it worked Some patients developed high blood pressure or suffered strokespatients that suffered from these side effects had eaten aged cheese or meatTyramine found in cheese red wine aged meat is a vasopressor leads to high blood pressuretyramine is broken down by MAO blocking MAO with MAO inhibitors stops breakdown of Tyramine which raises blood pressurePatients on MAO Inhibitors should stay away from foods with tyramine beer wine chocolate chicken liver herring aged cheese demerol decongestantsMAO regulates norepinephrine dopamine serotonin MAO is the enzyme that breaks down these neurotransmittersto increase amount of neurotransmitters decrease the action of MAOMAO inhibitors ex Iproniazid increase the concentration of neurotransmitters and happy moods 2
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