Summary: Neuropharmacology

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• 1 Cell and molecular foundation

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• What kind of neurotransmitters do we have (chemie)?

  Amines
  Peptides
  Small gaseous transmitters

• What are the two cholinoceptors?

  • Nicotinic 

  2 types: muscle type and nerve type 
  

  • Muscarinic 

  
  3 types: neural, cardiac and glandular 
  

• In which diseases does dopamine receptors play a role?

  • Parkinson 
    
  • Schizofrenia 
  • ADD
  • Drug dependence 

  
  
  So this also says a lot about the symptoms and functions dopamine receptors. 

• What kind of receptor is the glutamate receptor?

  Can be an ion channel or a G protein coupled receptor. 
  Ion 
  

  • NMDA
  • AMPA
  • Kainate   

  
  G-protein 
  

  • Metabotropic glu receptor 

• 4 Migraine

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• Is migraine geneticly influenced?

  Strong genetic component: 34%- 51%. But no single genes; so it is a set of genes.  
  (only some rare forms: FMH= familiar hemiph migraine)

• What is the difference between the classic and common migraine? Which type is the most common? And which type is also an option?

  Classic = with aura
  Common = without aura.
  Aura alone; so no headache.
  The same patient can switch between these types.
  
  An aura = focal neurologic symptoms: occur before an attack (less then 60 minutes)
  impairment of a specific region of the body because of impairments of a nerve.

• What are examples of events belonging to focal neurological symptoms?

  Paresthesias = sensation of the skin 
  Photopsia = afraid of light 
  Hallucinations
  Fortification spectra = for a part you see nothing.

• 4.1 Medication for migraine

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• What is the acute migraine treatment (but not that bad that you go to the ER)?

  • When you think you get a migraine attack you take: Aspirin, NSAIDS or paracetamol. 
  • Triptans 
  • Gepants 
  • Ditans 
  • Ergots: classical medication; not common anymore (overall mechanism with triptans) 

• What do people use when the migraine is really bad at the ER?

  
  NOT REALLY imortant 

  • Metoclopramide (DA (dopamine), 5-HT3 (serotonin) anta; 5-HT4 ago)
  • Domperidone (DA anta)
  • Neuroleptics
  • Opioid analgesics

• What should not be used, as medication against migraine?

  A combinations with codeine. Because it is an opoid and it is really addictive.