8: Poison, Medicine, and Pharmacology #
- Pharmakon: medicine and poison at the same time
Everything is a poison. The difference between a poison and a remedy depends on the dose.
– Paracelsus - Botulinum Toxin
- Strongest toxin known
- Disrupts acetylcholine transmitters of neuromuscular junctions
- Human LD$_{50}$ = lethal dose for 50%: 2 ng / kg
- E.x. lethal dose for 50kg is 100ng
- Therapeutic (Botox) dosage: ~5ng
- Therapeutic Index (TI): lethal dose / therapeutic dose
- E.x. 100/5 = 20 (unitlest)
- Therapeutic Index (TI): lethal dose / therapeutic dose
- Brain
- The brain needs lots of energy; makes up ~25% of the body’s energy intake at rest
- The brain receives robust blood flow via the circulatory system
- Blood-brain barrier (BBB): Everywhere, except the brain and spinal cord, have pores in the blood vessel walls (allowing medium-large molecules system)
- Walls are composed of phospholipid bilayer biological membrane – thus most of the thickness is hydrophobic
- Ways to pass
- Transport proteins: glucose sugar, some amino acids (too big for channels)
- Diffusion: Sufficiently lipophilic / hydrophobic molecules – how non-endogenous molecules pass
Natural poisons #
Tetrodotoxin (TTX) #
- Blocks voltage-gated sodium channels
- Peripheral nerves unable to generate normal action potential
- Leads to numbness, muscle weakness, paralysis
- Can lead to death through respiratory paralysis
- Does not get into the brain
- No CNS effects!
- In skin and organs of puffer/blow fish, octopus, newts, fugu
- All unrelated animals; there are symbiotic bacteria that cause this resistance
- TTX resistance: how do these animals (and their predators) not die?
- Genetic variance can lead to an amino acid change in the sodium channel
- Only 1/1800 amino acids are sufficient to be resistant
Saxitoxin #
- Also called Paralytic Shellfish Poisoning (PSP)
- Found in dinoflagellates and other protists
- Causes numbness, muscular weakness, paralysis
- Resistance results from mutations in the Sodium channel
- Mutation changing a single amino acid from glutamic acid to aspartic acid (one carbon difference!) causes 1000x decrease in STX sensitivity
Batrachotoxins #
- Discovered in skins of tiny amazonian frogs
- Used for blow darts to hunt birds
- Also found in birds which eat a certain beadle
- Thought that inside the beadle live symbiotic organisms that produce the molecule
- Paralytic effect
- Rather than blocking VG sodium channels, these trigger the receptors (open) which causes a similar effect
- Similar to local anesthetics (i.e cocaine, benzocaine, lidocaine, procaine)
2 Acetylcholine Receptors #
- Ionotropic (nicotinic ACh receptor)
- Occurs in brain, neuromuscular junctions
- Agonists: nicotine
- Antagonist: tubocurarine
- GPCR (muscarinic ACh receptor)
- Occurs in brain, parasympathetic NS
- Agonists: Muscarine
- Antagonist: Atropine (parasympatholytic)
9: Psychoactive Drugs #
Psychoactive drugs: top 5 #
- Caffeine: tea leaves, coffee, chocolate
- Molecule blocks adenosine receptors (antagonist)
- Ethyl alcohol: beer, wine
- From fermentation of sugar by yeast
- Enhances GABA action at receptors
- Antagonist at some glutamate receptors
- Blocks presynaptic uptake of adenosine
- Most popular sedative-hypnotic drugs; those that are calming at lower doses and can lead to death
- TI is low; ~10 for ethanol
- Also: Barbiturates (TI <10; used in lethal injection), benzodiazepines (Xanax, Valium), general anesthetics (gases; global loss of sensation for surgeries)
- All enhance inhibitory action of Cl- GABA receptor in CNS
- Nicotine: tobacco plant
- Agonist at nicotinic AChRs
- Found in basal forebrain nuclei
- CNS effects: stimulation and relaxation
- PNS effects: partial sympathominetic via facilitation of norepinephrine release
- Arecoline: betel (areca) nut
- Similar to nuts/dates
- Popular in Asia
- Commonly mixed with betel lea, slaked lime (Calcium hydroxide), spices, and, in India, tobacco
- Slaked lime enhances psychoactive effects
- Major psychoactive is Arecoline; muscarinic AChR (GPCR) agonist
- PNS: Activates parasympathetic NS (parasympathomimetic)
- CNS: stimulant/relaxant effects, like nicotine
- Cannabinoids: cannabis
- Effects
- Analgesic
- Anti-inflammatory
- Muscle relaxant
- Appetite stimulant
- Antiemetic
- Reduces intraocular pressure
- Anti-seizure
- Sedative
- Hypnotic
- Unique botanical chemistry involving cannabinoids (THC, CBD)
- Endogenous ligand; Endocannabinoids: Mediate retrograde signal (backwards!) 1. Anandamide 2. 2-AG
- Can cause psychosis
- Effects
- Erythroxylum coca (cocaine)
- From leaf to prevent insects from munching (similar to nicotine and caffeine)
- Acts at norepinephrine (Locus coeruleus) / dopamine (ventral tegmentum, substantia nigra) receptors to prevent reuptake
- PNS: Norepinephrine; sympathomimetic
- CNS: stimulant; wakefulness, stamina, appetite suppressant, euphoria
- Toxicities: sympathetic + CNS overstimulation, addiction
- Local anesthetic
- Only occurs at high concentration of substance
- Disrupts Na+ reuptake
- Amphetamine (adderall) and other stimulants (ritalin, provigil, etc)
- Act on norepinephrine / dopamine, but make receptors ’leakey'
- Similar effects to cocaine at high doses
- Medical use: treatment of ADHD
- Opium, opium poppy (Papaver somniferum), morphine, opioids
- Acute effects
- Analgesia: reduces pain
- Anxiolytic: disrupts anxiety
- Sedation: calming
- Cough suppression
- Decreased intestinal motility
- Pupil constriction
- Friedrich Wilhelm Sertürner was interested in learning what was inside pharmacy products
- Extracted opium, founding morphine (~1803)
- Later the other primary opiod, codeine, was extracted as well
- Semi-synthetic opioids: synthetic modification of opiates from opium
- Heroin from morphine; 2-3x more potent
- Synthetic opioids: not directly related to morphine in chemical structure
- Fentanyl; 100x more potent
- Wildnil; 10,000x – used to kill large animals
- Toxicity
- Depression of respiratory control centers in brainstem
- Potential OD potential (low TI)
- High addictive potential
- Opioid receptors
- Agonists at opioid receptors (GPCRs: mu, delta, kappa)
- Naloxone (Narcan) is an antagonist which blocks and reverses the effects of opioid agonists; used for ODs
- Endorphins are the neurotransmitter involved
- Acute effects
- Psychedelics (‘mind manifesting’), hallucinogens
- Leads to heightened awareness of internal/external perception
- Acts on 5-HT$_{2A}$ serotonin receptor agonists; found all over brain
- Impacts on brain functionality, synaptic neuroplasticity
- Can be used to treat anxiety, depression, addiction, PTSD
- LSD
- Discovered by Albert Hofmann
- Most popular psychedelic
- Psilocybe mushrooms
- Contains Psilocybin
- Maria Sabina was the first shaman to spread the word to Gordon Wasson
- DMT
- Naturally found; can be converted from tryptophan (amino acid)
- Used in ayahuasca; used in tribal rituals
- Peyote cactus
- Contains Mescaline molecule
- Discovered by Arthur Heffter
10: Neural Development and Neuroplasticity #
- Neuroplasticity:
- Structure and function of synapses always is being modified
- Occurs at all times, prevalent in prenatal development
- Increases by…
- Increase amount of NT released
- Open gates for longer
- Increase number of pre/post synaptic vesicles
- Decrease reuptake transporters
- Increase amount of NT released
- Embryonic Development
- Process
- Starts with an egg full of embryonic stem cells
- Grows into embryonic disc by 2 weeks
- Neural tube (start of NS) starts to develop by week 3
- Controlled by genes
- Process
- Human genome
- 23 chromosomes (from parents haploid cells)
- 3 billion base pairs (ATCGs)
- 21,000 distinct genes coding for proteins
- < 2% of human genome code translated for function protein
- 80% of the remaining 98% is transcribed into RNA
- Cell differentiation is controlled by gene transcription: turning on/off of genes at different times
- Done via transcription factors and regulatory RNA
- E.x brain cells start as stem cells, grow into some nervous system neural progenitor cell, then can change into various types of neurons/gilial cells through axon and dendrite branching + forming connections (synaptogenesis)
- Synaptogenesis involves the axon growing tip (growth cone) extending it’s ‘feelers’ (filopodia) outwards
- Through staining we can see cell’s cytoskeleton (made of microtubules and microfilaments) which are very active in this process
- Roger Sperry speculate there was some feedback so they knew where to go through chemical signals (Chemoaffinity hypothesis)
- Now recognized as neurotrophins: proteins produced by the body important for cell growth and survival
- Guidance Factors
- Initiated by neurotrophin
- ‘Steered’ by contact and soluble factors
- Ephrin receptor interaction can cause either an attraction or repulsive
- Microtubule is driven outwards while microfilaments communicate