65 topics with concise breakdowns: definitions, key facts, and class questions.
This section focuses on the pharmacotherapy of key central nervous system disorders. Here we study drugs that directly interfere with neurotransmitter balance and alter the quality of life of patients with neurological and psychiatric pathologies.
The material covers a wide range of groups: from antiepileptic drugs (phenytoin, carbamazepine, valproates) and antiparkinsonian agents (levodopa, COMT inhibitors, selegiline) to the heavy artillery of psychiatry — typical and atypical antipsychotics, antidepressants (TCAs, SSRIs, MAO inhibitors), and mood stabilizers. CNS depressants (benzodiazepines, barbiturates, modern Z-drugs) are examined in detail, as well as psychostimulants (caffeine, mesocarb) and the pathophysiology of pain.
In seminars and exams, students are most often tripped up by the mechanisms of action of benzodiazepines, the differences between typical and atypical antipsychotics (for example, phenothiazine derivatives versus clozapine or olanzapine), and the principles of drug selection for various types of epileptic seizures. Learn the receptor profile — this is the absolute key to understanding both therapeutic and adverse effects.
Why do antidepressants start helping only after 2–3 weeks?
This time is necessary for the nervous system to adapt. Due to the constant excess of neurotransmitters in the synapse, down-regulation occurs — a decrease in the density and sensitivity of central adrenergic receptors, which produces the therapeutic effect.
Why are benzodiazepines called non-narcotic hypnotics?
Because they have no intrinsic activity to open chloride channels. They only modulate the receptor, increasing its sensitivity to endogenous GABA, which excludes a direct narcotic effect.
Why do doctors prefer benzodiazepines over barbiturates today?
Benzodiazepines have a significantly larger therapeutic window (safety in overdose), distort normal sleep structure less, and cause fewer side effects, including slower development of dependence.
Why might a patient feel weak and drowsy the day after taking nitrazepam?
This is due to pronounced hangover effects. The half-life of the drug reaches 24–36 hours, meaning it does not have time to be completely eliminated from the body by morning, continuing to depress the CNS, slow down reactions, and reduce attention.
What drugs are contraindicated in combination with flunitrazepam?
Flunitrazepam is not recommended to be combined with MAO inhibitors.
What is the main advantage of Z-drugs over classical benzodiazepines?
The main advantage of this group is minimal interference with the physiological structure of sleep; they preserve the natural alternation and duration of phases.
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