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NEUROTRANSMITTERS IN HEALTH AND DISEASE— Overview and Update. Barb Bancroft RN, MSN, PNP CPP Associates Chicago IL www.barbbancroft.com.
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Barb Bancroft RN, MSN, PNP
In the mid-nineteenth century, advocates of physical causes for mental illness recommended bloodletting, purging, cold-water immersion, and various tonics and medications (primarily opium and opium derivatives) as treatment.
Serotonin (5-hydroxytryptamine, or 5-HT)—the most ubiquitous neurotransmitter of all)
5-HT (hydroxytryptamine)—and there are MANY of them…5-HT1 through 5HT7, with many subtypes…5-HT1A, 5-HT1B, 5-HT1D, 5-HT1E, 5-HT1F; 5-HT2A, 5-HT2B, 5-HT2C; 5-HT3; 5-HT4; 5HT-5A; 5-HT6; 5-HT7
(Treximet—Imitrex (85 mg) + naprosyn (500 mg)
Levels of serotonin activity are abnormally high in anorexics—linked to feelings of anxiety and obsessional thinking, classic traits of anorexia; dopamine levels are also high— “addicted to starvation” (autoimmune? Genetics?)
Carbohydrates facilitate the entry of tryptophan (the amino acid required to produce serotonin) into the brain
(US Dept. of Health and Human Services, CDC, National Center for Health Statistics, 2004; Available http://www.cdc.gov/nchs/data/ad/ad347.pdf)
and NE in the descending pain pathways helps treat neuropathic pain
Rx: alosetron (Lotronex)—5-HT3 blocker
Rx: tegaserod (Zelnorm)—a 5-HT4 partial agonist was approved to increase motility of GI tract (March 30 2007—d/c’d due to CV events—can still get from drug company if nothing else works)
Tatro DS, ed. Drug Interaction Facts: Herbal supplements and Food. St. Louis, MO. A. Walters Kluwer Co; 2004; also available at www.factsandcomparisons.com
Benzodiazepines— “zepams” and “zolams”
*Diazepam—Valium (t1/2 20-100 h)
Clonazepam—Clonapin (18-50 h)
Oxazepam—Serax (5 -20)
*t ½ is your age in HOURS…
**chlordiazepoxide (Librium is also a BZ—wrong last name tho’—half life as long as diazepam)
also classified as a mood stabilizer
Dopamine agonists—not as potent; bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex), ropinirole (Requip)
Cocaine metabolites in urine for up to 3 days…some drugs can have a false + as can some diseases