Chp 3 Biological Basis For Psy Disorders Flashcards

(92 cards)

1
Q

Part of brain

Contains most of DA sensitive neurons (reward, attention, short-term memory, planning, motivation)

Executive functions: Self-control, judgemental, modification of emotions to fit social norms

A

Frontal lobe

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2
Q

Parts of brain

Integration of sensory information, proprioception, math, taste, hearing, sight, touch, smell, temperature, pressure ,pain

A

Parietal

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3
Q

Part of brain

Visual memory (long term from hippocampus to amygdala) process audio and visual & assigns meaning, language process,emotional association

A

Temporal Lobe

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4
Q

Group of brain structures that govern emotions & behaviors.

Connected to brains pleasure center

A

Limbic system

Fornix
Corpus collosum
Thalamus
Stria terminalis
Hippocampus
Amygdala (emotions)
Mammilary bodies
Olfactory bulb
Septum (pleasure / reproduction)

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5
Q

Fornix
Corpus collosum
Thalamus
Stria terminalis
Hippocampus
Amygdala (emotions)
Mammilary bodies
Olfactory bulb
Septum (pleasure / reproduction)

Make up this area of the brain

Responsible for…..

A

Limbic system

Epinephrine flow
Emotion
Behavior
Motivation
Long-term memory
Olfactory

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6
Q

Neurons have 3 types of actions

A

Respond to stimuli
Conduct electronic impulses
Release neurotransmitters

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7
Q

Part of the neuron that sends signals

Area in between neurons

Part of neuron that recieves signal

A

Part of the neuron that sends signals
Axon

Area in between neurons
Synapse

Part of neuron that recieves signal
Dendrite

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8
Q

Changing of structure, function, and organization of neurons in response to new experiences

A

Neuroplasticity

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9
Q

Neurotransmitter

Not enough

Low mood / energy
Movement disorders
Inattentive
Lack of motivation / concentration

Too much

Psychomotor agitation
Irritability
Psychosis / Hallucinations
Paranoid, Aggression, Anxiety

A

Dopamine DA

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10
Q

Name Neurotransmitter

Motivation
Focus
Addiction
Mood
Energy
Learning
Psychosis
Motor function
Hallucinations
Retaining memories

A

Dopamine DA

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11
Q

Name Neurotransmitter

Aggression
Sex
Social Behavior
Appetite / Digestion
Sleep
Memory
Body temp
Maintain mood / balance

A

Serotonin (5-HT)

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12
Q

Too low

Low mood
Anxiety
Insomnia
OCD
Panic
Low motivation
Altered social behavior

Too much

N/V
Nervousness
HA
Akathisia
EPS
Anorexia
Sexual Side Effects

A

Serotonin (5 HT)

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13
Q

This Neurotransmitter

In the brain: Inhibitory Neurotransmitter regulating

Mood
Fears
Anxiety
Relaxation
Focus
Learning
Clarity of through

In the Gut:
Satiety
Food carvings
Digestion
Nutrient absorption
Peristalsis

A

Serotonin (5 HT)

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14
Q

Dopamine vs Serotonin

Which is triggered by acts of short-term pleasure/ long-term

A

Dopamine = Short term / addiction

Serotonin = Long term / (grateful for what you have)

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15
Q

Neurotransmitter

Attentiveness
Emotions
Anxiety
Irritability
Focus
Learning
Memory
Mood

Fight or Flight

A

Norepinephrine (NE)

Both neurotransmitter & hormone

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16
Q

Neurotransmitter

Too low

Low mood, focus, energy, motivation
Pain
Insomnia
Memory & learning issues

Too much

Tremors
Tachycardia
Hypertension
Sweating
Insomnia
Erectile dysfunction
Ejaculation Issues

A

Norepinephrine

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17
Q

Isocarboxazid
Phenelzine
Selegiline
Tranylcypromine

When combined with Tyramine rich foods. Cheese, Fermented Foods, Alcohol, Nuts, Pickled

Will raise this neurotransmitter _____

Possibly causing a Hypertensive crisis

A

Norepinephrine

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18
Q

What does GABA (gamma-Aminobutyric Acid) do?

What will happen from a lack of GABA

A

Inhibits neurons from firing uncontrollably.

Lack of GABA = Anxiety, seizures, insomnia

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19
Q

This neurotransmitter can be used as an anticonvulsant & muscle relaxor

A

GABA

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20
Q

Neurotransmitter

Alzheimer’s
Consolidation of traumatic memories
Cognitive function & Behavior Tasks

A

Glutamate

Too much glutamate over stimulates the brain cells causing death & calcium to enter which also has problems

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21
Q

Major excitatory neurotransmitter

Can “turn on” almost all CNS neurons

Too much under stress can cause hippocampal damage

A

Glutamate

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22
Q

Difference between GABA & Glutamate

A

GABA = Major inhibitory neurotransmitter

Glutamate = Major excitatory neurotransmitter

Turns on or off other CNS neurons

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23
Q

Histamine is associated with

Alertness or Sedation

A

Histamine associated with Alertness

Antihistamines = Sedation

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24
Q

Acetylcholine (Ach)
Role memory and leaning
Affects sexual & Aggressive behavior

Stimulates parasympathetic NS:SLUDD

What does SLUDD stand for

A

Salivation:
Lacrimation:
Urination:
Digestion:
Defecation:

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25
Decrease in Acetycholine (Ach) is associated with.... Increase...
Decreased = Alzheimer's, Huntington, Parkinson's Increase = Depression
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Neurotransmitters and neuromodulators are both messengers released by neurons that affect cells in the nervous system, but they differ in several ways: Release ___________ are released at specialized junctions _______ can be released in the central nervous system or periphery. Target ________ target fast-acting ionic neuroreceptors _______ target slower G-protein neuroreceptors. Effect ________ affect one or two postsynaptic neurons, muscle cells, or other effector cells. ________ affect groups of neurons or effector cells. Can also alter the cellular or synaptic properties of neurons, which changes how they respond to neurotransmitters. Duration ________ can produce long-lasting effects. Function _________ are directly responsible for information transmission _______ are thought to play a role in cognition, emotion, and behavior, and may control brain states that underlie different behaviors, such as sleep and arousal
Release Neurotransmitters = specialized junctions Neuromodulators = released in the central nervous system or periphery. Target Neurotransmitters target fast-acting ionic neuroreceptors neuromodulators target slower G-protein neuroreceptors. Effect Neurotransmitters affect one or two postsynaptic neurons, muscle cells, or other effector cells Neuromodulators affect groups of neurons or effector cells. Neuromodulators can also alter the cellular or synaptic properties of neurons, which changes how they respond to neurotransmitters. Duration Neuromodulators = long-lasting Function Neurotransmitters = information Neuromodulators play a role in cognition, emotion, and behavior, and brain states ie, sleep and arousal.
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Match Neuromodulators: Peptides Substance P (SP), Somatostatin (SRIF), Neurotensin (NT) Altered levels are associated with cognitive disease Antipsychotic-like properties (Enhances sensitivity to pain. Regulation of mood & anxiety. Promotes & reinforces memory)
Somatostatin (SRIF) Altered levels are associated with cognitive disease Neurotensin (NT) Antipsychotic-like properties Substance P (SP) (Enhances sensitivity to pain. Regulation of mood & anxiety. Promotes & reinforces memory)
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EEG A non-invasive test that measures electrical activity in the brain. Electrodes attached to the scalp to pick up electrical signals EEGs can help diagnose ________, as well as show how other brain disorders affect brain wave patterns. Can't show physical abnormalities in the brain, such as damage.
epilepsy and other seizure disorders
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Nursing considerations for EEG. (
Eat regular meal Avoid caffeine, nicotine, alcohol Avoid hair products Avoid avoid sedatives, anticonvulsants, anxiolytics
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Diagnose disease or injury: Tumors, blood clots, bone fractures, stomach inflammation, and more Plan treatment: Guide biopsies, surgeries, radiation treatment. Monitor treatment: Performed with or without a contrast agent to help visualize
CT Computerized Axial tomography
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CT scan used to look for damaged areas of the body. What are nursing considerations
Take off some or all your clothing and wear a hospital gown. Remove metal objects, such as belts, jewelry, dentures and eyeglasses, that might affect image results. Not eat or drink for a few hours before your scan. Stop Metformin before use with contrast dye
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Technology: CT Scan: Uses X-rays to create cross-sectional images of the body. MRI: Uses strong magnetic fields and radio waves to create detailed images. Image Detail: CT Scan: Better for viewing bone structures and detecting bleeding. MRI: Provides more detailed images of soft tissues, such as the brain, muscles, and ligaments. Radiation Exposure: CT Scan: Involves ionizing radiation. MRI: No ionizing radiation is used. Speed: CT Scan: Generally quicker, often taking just a few minutes. MRI: Can take longer, usually between 15 to 60 minutes. Contrast Agents: CT Scan: Often uses iodine-based contrast agents. MRI: Uses gadolinium-based contrast agents. Suitability for Certain Conditions: CT Scan: Preferred for emergency situations, trauma, and detecting cancers. MRI: Better for diagnosing brain disorders, spinal cord issues, and joint abnormalities. Cost: CT Scan: Generally less expensive. MRI: Usually more expensive. T or F
T
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Technology: Uses radioactive tracers and a special camera to produce images of metabolic processes in the body. Purpose: Primarily used to observe cellular activity and metabolic processes, often for cancer diagnosis, monitoring treatment response, and assessing brain function. Tracer: Involves injecting a small amount of radioactive material (radiotracer) into the body. The tracer accumulates in areas with high metabolic activity. Image Detail: Provides information about how tissues and organs are functioning, rather than just structural details. Radiation Exposure: Involves exposure to a small amount of radiation from the radiotracer. Procedure Time: Typically takes about 30 minutes to 1 hour, including both the tracer injection and the scanning process. Combining with Other Scans: Often combined with CT (PET/CT) or MRI (PET/MRI) to provide detailed anatomical and functional information. Preparation: Patients may need to fast for several hours before the scan and avoid strenuous exercise. Clinical Use: Commonly used for cancer detection, evaluating brain disorders, and examining heart function. Name procedure
PET scan Positron emission tomography
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Difference in Use between EEG, (CT & MRI), & PET Scan
EEG looks at brain waves mostly for seizures CT & MRI Structural Damage Tumors, Strokes, Brain Damage PET: Evaluates brain function, such as which areas are active during specific tasks, cognitive processes, or changes in brain activity in various conditions. PET:
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U.S. federal law enacted in 2008 to protect individuals from discrimination based on their genetic information
GINA
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Technology: Utilizes the same magnetic fields and radio waves as MRI, but focuses on detecting changes in blood oxygen levels (BOLD signal) to infer brain activity.
fMRI MRI provides detailed anatomical images fMRI evaluates brain activity and function in real-time.
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Norepinephrine & Glutamate: Do what to the neuron GABA & Serotonin: Do what to the Neuron Acetylcholine & Dopamine Do what to the Neuron
Norepinephrine & Glutamate: Excite GABA & Serotonin: Inhibit Acetylcholine & Dopamine Excite & Inhibit Cause the Neuron to fire from action potential
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Nervous System 2 main parts... The Peripheral NS is divided into 2 parts..... Motor (Efferent) is divided into 2 parts.... Autonomic (Involuntary) is divided into 2 parts....
CNS & Peripheral NS Peripheral = Sensory (Afferent) & Motor (Efferent) Motor (Efferent) = Somatic (Voluntary) & Autonomic (Involuntary) Autonomic (Involuntary) = Sympathetic (Fight or Flight) Parasympathetic (Rest or Digest)
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Down Regulation Up Regulation
Down Regulation = Less available receptors for a neurotransmitters. Exp. Opioid Receptors & Chronic Opioid Use: With chronic opioid use the brain is exposed to high levels of opioid neurotransmitters. In response, the brain downregulates (decreases) the number of opioid receptors, leading to tolerance. Dopamine Receptors and Drug Addiction: Chronic Stimulant use will artificially increase Dopamine level. Downregulation of dopamine receptors avoid overstimulation, resulting in a reduced sensitivity to dopamine. Creating tolerance and dependence. Need more drugs to get high Up Regulation: More available receptors for neurotransmitters. Exp. Dopamine Receptors in Parkinson's Parkinson's = decrease in dopamine ( loss of dopamine-producing neurons) To compensate brain upregulates dopamine receptors, increasing their sensitivity to dopamine to maintain normal functioning. Antidepressants and Serotonin Receptors: (SSRIs), increase serotonin levels. Over time, as serotonin levels rise, the brain may upregulate (increase) the number of certain serotonin receptors to enhance the effects of serotonin.
40
What goes up must come down Rule 1 of 3 in neurotransmitters. What is this rule stating
That Withdrawal effects will be the oppsite of intoxication from drugs. Ie. Cocaine with drawl go down Heroine Withdrawal go up
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Rule 2 of 3 Neurotransmitters Neurotransmitters are not easily fooled. Describes Upregulation & Downregulation Give examples. Upregulation & Antidepressants Downregulation & Opioid receptors
Upregulation Antidepressants and Serotonin Receptors: Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), increase serotonin levels in the brain. Over time, as serotonin levels rise, the brain may upregulate (increase) the number of certain serotonin receptors to enhance the effects of serotonin. Downregulation Opioid Receptors and Chronic Opioid Use: When someone uses opioid drugs (e.g., morphine or heroin) chronically, the brain is exposed to high levels of opioid neurotransmitters. In response, the brain downregulates (decreases) the number of opioid receptors, leading to tolerance, where more of the drug is needed to achieve the same effect.
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Rule 3 of 3 Neurotransmitters With great power comes great responsibility Stating that the strongest Neurotransmitters also have the greatest SE
125,000$ Psych NP job
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Describe Full agonist Partial agonist Neutral Antagonist Inverse agonist
Full agonist: Mimics affects of Neurotransmitter Partial agonist: Mimics to partial lower point Neutral Antagonist: Blocks affects of Neurotransmitters Inverse agonist: Produces oppsite effect to Neurotransmitters
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Give examples of Full agonist, Partial agonist, Neutral Antagonist, Inverse Agonist. Using opioids as an example
Full Agonist: Example: Morphine acting on opioid receptors. Explanation: A full agonist binds to a receptor and activates it, producing the maximum possible response. Partial Agonist: Example: Buprenorphine acting on opioid receptors. Explanation: A partial agonist binds to a receptor and activates it but only produces a partial response, even if all receptors are occupied. Neutral Antagonist: Example: Naloxone acting on opioid receptors. Explanation: A neutral antagonist binds to a receptor but does not activate it. Instead, it blocks the receptor, preventing other substances (like a full agonist) from binding and activating it. Naloxone binds to opioid receptors without activating them, but it blocks opioids like morphine or heroin from binding, thus reversing their effects. inverse agonist Opioid receptors is naloxone methiodide when it acts on the μ-opioid receptor. Unlike naloxone (which is typically a neutral antagonist), naloxone methiodide can exhibit inverse agonist properties by reducing the basal activity of the μ-opioid receptor, thereby producing effects opposite to those of opioid agonists. This means that instead of just blocking the receptor, naloxone methiodide can decrease any inherent activity the receptor might have in the absence of an agonist, potentially leading to effects like withdrawal symptoms in someone dependent on opioids.
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Drive psychOsis Parkinsonism Attention Motor Inhibition of Prolactin Narcotics Extrapyrmidal Describes this neurotransmitter
Dopamine
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Neurotransmitter Governs Motivation & Reward Exp. Sex, Gambling, Drugs, Fun Social Interactions, Food, Exercise
Dopamine
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Drugs that block ( this neurotransmitter) medigate (lessen) features of psychosis. (Hallucinations & Delusions) Give examples of drugs that block dopamine
Dopamine Exp. Antipsychotics (Neuroleptics): Example: Haloperidol, Risperidone, Olanzapine Anti-Nausea Medications: Example: Metoclopramide & Prochlorperazine (Blocking dopamine lessens N/V esp. In chemo patients) Mood Stabilizers with Dopamine Antagonist Properties: Example: Lithium Use: While lithium is primarily known as a mood stabilizer, it also has some dopamine antagonist effects, which may contribute to its effectiveness in treating bipolar disorder by reducing mania and stabilizing mood swings.
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Decreased ability to secrete dopamine is the core of this disease pathology
Parkinsons Motor / Extrapiramidal issues
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Dopamine increases or decreases Attention
Increases
50
This neurotransmitter is most associated with the Reward Pathway
Dopamine
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Functions Head: Depression, anxiety, social interaction, sex drive, migraine Red: Platelets binding Fed: Drives GI motility & Neausa
Serotonin
52
What condition Headache, confusion, agitation Hyperthermia, hypertonia, Diaphoresis, Tachycardia Mortality 2 - 12 %
Serotonin Syndrome Too much Serotonin
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What is 5-HT
Serotonin
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Which nervous system is Norepinephrine associated with
Sympathetic
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How is Acetylcholine like the oppsite of Norepinephrine?
Acetylcholine Governs the Parasympathetic NS (Rest y Digest)
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Acetylcholine Describe effects
Autonomic: (Parasympathetic) lowers everything, Rest, Digest, Sexual Contraction: Slows down used to treat diseases like Myasthenia gravis Hippocampus: Learning, Memory, Awakeness, Attention.
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Increase in which neurotransmitters is helpful in improving memory associated with dementia
ACH Acetylcholine
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ACH Autonomic (Parasympathetic) Contraction (Muscles) Hippocampus (Memory) Is this neurotransmitter
Acetylcholine
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( Too Little / Too much) Dopamine: Schizophrenia and mania, addictive and compulsive behaviors, aggression, and anxiety. ( Too little / too much ) Dopamine: Parkinson’s disease, depression, cognitive impairment, and lack of motivation.
Too much: Psychosis, Addiction, Aggression, Mania, Compulsion Too little: Parkinsons, EPS symptoms, Cognitive impairment, lack of motivation
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tremors, rigidity, bradykinesia (slowness of movement), and postural instability. This occurs due to the reduced dopamine activity in the nigrostriatal pathway. Describes which EPS from a High potency 1st generation antipsychotic
Parkinsonism
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feeling of inner restlessness and an urgent need to move, often leading to repetitive movements like pacing or fidgeting. Distressing for many patients. Describes which EPS from a High potency 1st generation antipsychotic
Akathisia
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involuntary muscle contractions, leading to abnormal postures or movements, often of the neck, face, or limbs. Can be severe and painful. Describes which EPS from a High potency 1st generation antipsychotic
Dystonia
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Chronic and often irreversible condition Repetitive, involuntary movements, especially of the face, lips, tongue, and limbs. Associated with long-term use of antipsychotics. Describes which EPS from a High potency 1st generation antipsychotic
Tardive dyskinesia
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(This Neuromodulator) is like a messenger that carries pain signals in the body. When you get hurt, it helps transmit the pain message to your brain, so you feel pain. It’s also involved in inflammation and can affect mood and anxiety.
Substance P
65
(This Neuromodulator) Acts like a traffic cop for hormones, slowing things down. It regulates and reduces the release of certain hormones and neurotransmitters, helping to control things like digestion, growth, and insulin production.
Somatostatin
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(This Neuromodulators) Is like a calming agent in the brain. It helps regulate how the brain processes dopamine, which is involved in mood, reward, and movement. Reduce pain, help with stress, and affect body temperature and digestion.
Neurotensin
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Life-threatening reaction that can occur in response to antipsychotic (neuroleptic) medications. Symptoms include high fever, confusion, rigid muscles, variable blood pressure, sweating, and fast heart rate. Complications may include rhabdomyolysis, high blood potassium, kidney failure, or seizures.
Neuroleptic malignant syndrome (NMS)
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CT or MRI Better at viewing: Acute Bleeding: Acute bleeding in the brain, such as from a stroke or trauma. Skull Fractures: Bone structure, Fractures in the skull. Emergency Situations: Quick to perform, for emergencies
CT Scan
69
CT scan or MRI Soft Tissue Detail: Brain tumors, multiple sclerosis, and other abnormalities. Brain Anatomy: Brain conditions like stroke, dementia, or developmental anomalies. Brainstem and Spinal Cord: Provides clearer images
MRI
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This diagnostic imaging can detect Alzheimer’s Disease: Identify brain activity and glucose metabolism that are characteristic of Alzheimer’s disease Reduced activity in the temporal and parietal lobes. Parkinson’s Disease: Revealing decreased dopamine transporter levels in the brain. Epilepsy: Abnormal brain metabolism associated with epileptic seizures. Help in localizing seizure foci for surgical planning. Brain Tumors: Areas of increased metabolic activity, which is often seen in cancerous tissues. Brain Infections and Inflammation: Encephalitis or meningitis. Neurodegenerative Disorders: Huntington’s disease or frontotemporal dementia
PET Scan
71
myoclonus
Muscl3 Jerks
72
periactin, sansert, inderal Use...
Block serotonin receptors in Serotonin Syndrome zyprexa: used to treat mild symptoms
73
venalaxine & desvenalfaxine Class Nursing considerations
SNRI venalaxine & desvenalfaxine: monitor BP (htn)
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NE and D2 reuptake inhibitor (NDRI)
buproprion (Wellbutrin, Zyban, Forfivo XL) no sexual dysfunction can cause weight loss contraindicated: -seizure disorder -ETOH withdrawal -BDZ withdrawal -eating disorders
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SSRI and 5-HT1A receptor partial agonist (SPARI)
vilazodone (Viibryd) causes weight gain, GI problems, joint pain (arthralgia) contraindicated: -abrupt stop Elderly
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vortioxetine (Trintellix) avoid in elderly caution: -abrupt withdrawal -seizure disorder Class...
Serotongic Antidepressants
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mirtazapine (Remeron): tetracyclic Labs.... SE.....
caution: -hepatic and renal impairment -seizure disorders SE: -agranulocytosis -neutropenia -stevens-johnsons Weigh gain
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Lithium Therapeutic dose vs Toxicity dose
0.5 1.5 therapeutic >1.6 toxic
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Lithium test to monitor
lithium levels electrolytes kidney function pregnancy test thyroid function
80
Lithium SE
Bradycardia ataxia/acne tremor/hypothyroid teratogenic edema rash/renal toxicity LeukocYtosis
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carbamazapine Mood stabilizer Therapeutic level SE
4 - 12 SE SE: -anticholinergic effects -OH -pruritis -HTN -ataxia arrhythmias -caution hx ETOH -steven johnsons -decreases birth control
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valproate (depakote, depakene) Therapeutic range SE: .... Indicated: Bipolar depression Labs
useful for rapid cyclers therapeutic range: 50-100 look for valproic acid level SE: -weight gain -mental dulling -tremor -hair loss -loss libido labs: -platelets Liver Pancreas
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lamotrigine (Lamictal)
helpful with depression r/t BPD personality disorder therapeutic range: 3-14 -unsure of toxicity modulates the release of glutamate highest risk for steven johnsons -children/Asians SE: -dizziness -ataxia -blurred vision -HA -anticholinergic -photosensitivity
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Lock jaw can happen from high potency antipsychotics 1st generation Name a serious symptom
Acute dystonia
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artane cogentin benadryl ingrezza Used for...
Controlling EPS
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Describes: high fever: >38C -diaphoresis muscle rigidity increased CPK level: due to muscle breakdown -and liver enzymes LOC changes tachy labile or high BP dysphagia incotinence leukocytosis
neuroleptic malignant syndrom From 1st generation antipsychotic med Or withdrawal from
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poor antipsychotic; better as a mood stabilizer less sedation may cause insomnia no weight gain can be used to treat BPD with other meds
aripiprazole (Abilify, Aristada)
88
The following maybe used for... atomoxetine (Strattera) -GI upset, weight loss, dizziness, mania, aggressive behavior guanfacine (Tenex, Intuniv) -sleepiness, low BP, GI upset clonidine (Kapvay) -irritability, fatigue, drowsiness, low BP, dizziness, URI, nightmares viloxazine (Qelbree) off-label: buproprion (Wellbutrin) venlafaxine (Effexor
ADHD meds non-stimulants
89
3 stages of stress
alarm/acute stress stage resistance/adaptation stage exhaustion stage
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true or false: serotonin synthesis is more active in the alarm phase
true or false: serotonin synthesis is more active in the alarm phase true over time, unremitting synthesis may impair serotonin receptor sites and the brain's ability to use serotonin -may be why chronic stress is correlated with depression
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which reaction to stress is healthy? a. distress b. eustress c. stressor d. none of the above
Eustress is a positive type of stress that can have beneficial effects on health, motivation, performance, and emotional
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Fear is anxiety T or F
false fear is a reaction to a specific danger