Neurology Book

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Neurotransmitter

Aka: Neurotransmitter, Neurotransmitter Physiology
  1. See Also
    1. Neuron
    2. Serotonin
  2. Definitions
    1. Neurotransmitter
      1. Endogenous signaling molecules affecting Neuron behavior by acting at nerve Synapse, Muscle Cells and glands
      2. Neurotransmitters are synthesized and released by Neurons
  3. Physiology: Neurotransmitters in General
    1. More than 500 Neurotransmitters have been identified in humans
    2. Chemical Structures
      1. Amino acids (e.g. glutamate, Aspartate, gamma-Aminobutyric acid or GABA, glycine)
      2. Monoamines (e.g. Dopamine, Norepinephrine, Epinephrine, histamine, Serotonin)
      3. Peptides (Oxytocin, somatostatin, substance P)
      4. Purines (Adenosine triphosphate or ATP, Adenosine)
      5. Miscellaneous (acetylcholine or ACh)
    3. Function
      1. Excitatory Neurotransmitters
        1. Acetylcholine
        2. Norepinephrine
        3. Glutamate
      2. Inhibitory Neurotransmitters
        1. Dopamine
          1. Produced in Substantia Nigra and released into Basal Ganglia
        2. Gamma-Aminobutyric acid (GABA)
          1. Broad distribution (see below)
        3. Glycine
          1. Produced in spinal cord
        4. Serotonin
          1. Produced in median raphe and Hypothalamus
      3. Neurotransmitters with Sedative and Analgesic properties (Opioid-like)
        1. Endorphins
        2. Enkephalins
    4. Neuroendocrine Brain Regions (Pigmented Regions)
      1. Locus Ceruleus
        1. Norepinephrine secreting nucleus in pons
        2. Important in wakefulness and attention
      2. Substantia Nigra
        1. Dopamine secreting region in Midbrain
        2. Substantia Nigra degeneration results in Dopamine deficiency and Parkinsonism
  4. Physiology: GABA and NMDA
    1. N-methyl-D-Aspartate (NMDA) receptor
      1. Glutamate binds NMDA receptors and results in excitation
      2. NMDA receptors are up regulated in chronic Alcohol Abuse
      3. NMDA Antagoists include Ketamine
    2. Gamma-aminobutyric acid (GABA) receptor
      1. GABA Agonists bind GABA receptors and result in inhibition
      2. GABA Receptors are down regulated in chronic Alcohol Abuse
  5. Physiology: Neurotransmitter at Synapse
    1. Medications affecting Precursor Uptake
      1. L-Phenylalanine
      2. L-Tyrosine
      3. L-Dopa
      4. Dopamine (DA)
      5. Norepinephrine (NE)
      6. Epinephrine (E)
      7. L-Tryptophan
      8. 5-Hydroxytryptophan,
      9. 5-Hydroxytryptamine (5-HT) = Serotonin
      10. Choline/lecithin + AcetylCoA => Acetylcholine (Ach)
    2. Medications affecting Synthetic Enzymes
      1. Metyrosine (Demser) blocks Tyrosine hydroxylase
        1. Decrease DA, NE, E, 5HT
      2. Methyldopa (Aldomet) blocks decarboxylation
        1. Decrease DA, NE, E, 5HT
    3. Medications affecting Transfer into Vesicle
      1. No clinically available drugs
    4. Medications affecting Vesicle storage
      1. Reserpine (Serpasil) depletes storage
      2. Decreases DA, NE, E, 5HT
    5. Medications affecting Vesicle mobilization
      1. Affects Nerve Impulse Conduction Vesicle release
      2. Electroconvulsive Therapy decreases DA, NE, E, 5HT
    6. Medications affecting Post-synaptic receptors
      1. Reversible receptor blockade by Neuroleptics (Haldol)
    7. Medications affecting Neurotransmitter reuptake
      1. Reuptake inhibition by all Antidepressants (Prozac)
    8. Medications affecting Neurotransmitter breakdown
      1. No drugs available
    9. Medications affecting Neurotransmitter dilution
      1. No drugs available
    10. Medications affecting Neurotransmitter breakdown
      1. Monamine oxidase inhibitor (MOAi) (Parnate, Nardil)
      2. Tacrine Inhibits Acetylcholinesterase
        1. Increases Acetylcholine
  6. Physiology: Neurotransmitter Theory applied to Psychiatric Medication
    1. Neuroleptics
      1. Deplete Neurotransmitter Stores
        1. Rauwolfia alkaloids (e.g. Reserpine)
        2. Phenothiazine: Chlorpromazine (Thorazine)
        3. Thioxanthenes: thiothixene (Navane)
        4. Butyrophenones: Haloperidol (Haldol)
      2. Receptor blockade
        1. Lithium Carbonate
        2. Interferes with Neurotransmitter storage Na-K Pump
    2. Stimulants
      1. Mimic Neurotransmitter at storage or Receptor sites
        1. Amphetamines: Methamphetamine (Methedrine)
        2. Benzyl-piperidines: Methylphenidate (Ritalin)
    3. Antidepressants: MAO inhibitors
      1. Monoamine Oxidase (MAO) is a naturally in-vivo enzyme that metabolizes Serotonin and Norepinephrine
        1. Inactivation or inhibition of MAO results in increased levels of Serotonin and Norepinephrine
      2. Tranylcypromine (Parnate)
        1. Inactivate MAO
      3. Polycyclic: Imipramine HCl (Tofranil)
        1. Inhibit MAO reuptake
    4. Antidepressants: SSRI and SNRI
      1. Decreased Serotonin and norephinephrine are associated with Major Depression
      2. Reuptake inhibitors increase these Neurotransmitters in the Synapse by blocking reuptake
        1. Selective Serotonin Reuptake Inhibitors (SSRI)
        2. Serotonin Norepinephrine Reuptake Inhibitors (SNRI)
  7. Resources
    1. Neurotransmitters (Wikipedia)
      1. https://en.wikipedia.org/wiki/Neurotransmitter
  8. References
    1. Goldberg (2014) Clinical Physiology, MedMaster, p. 88

Neurotransmitters (C0027908)

Definition (CHV) a chemical substance produced by nerve cells or hormone that delivers neurologic signals
Definition (CHV) a chemical substance produced by nerve cells or hormone that delivers neurologic signals
Definition (NCI) Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses.
Definition (NCI_NCI-GLOSS) A chemical that is made by nerve cells and used to communicate with other cells, including other nerve cells and muscle cells.
Definition (MSH) Endogenous signaling molecules secreted by neurons that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, neurohormones, and neurohumors, whether or not acting at synapses.
Definition (PSY) Chemical substances, synthesized and released by nerve cells, or glandular hormones that excite or inhibit other nerve, muscle, or gland cells by producing a brief alteration in the postsynaptic membrane of the receiving cell. Use a more specific term if possible.
Definition (CSP) any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron and travel across the synaptic cleft to either excite or inhibit the target cell; included are neuromodulators, neuroregulators, neuromediators, neurohormones, and neurohumors, whether or not acting at synapses.
Concepts Neuroreactive Substance or Biogenic Amine (T124)
MSH D018377
SnomedCT 35069000
English SUBSTANCES NERVE TRANSM, TRANSM SUBSTANCES NERVE, NEUROTRANSM, NERVE TRANSM SUBSTANCES, neurotransmitter, neurotransmitters, Neurotransmitter (substance), Neurotransmitter, NOS, Nerve Transmitter Substances, Neurotransmitters, Substances, Nerve Transmitter, Transmitter Substances, Nerve, Neurotransmitter
Czech neurotransmitery
French Neuromédiateurs endogènes, Médiateurs chimiques, Neurotransmetteurs, Neurotransmetteur
German Neurotransmitter, Transmittersubstanzen, Neuro-
Italian Neurotrasmettitori, Neurotrasmettitore, Sostanze neuro trasmettitrici
Spanish neurotransmisores (sustancia), neurotransmisores
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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