Chp 3 Book Flashcards by Jade Ring

a network of structures in the brain’s temporal lobes that’s responsible for emotional and social processing, learning, and motivation

Limbic system

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Located in limbic system

Responsible for short-term memory and transferring it to long-term storage, as well as spatial memory and emotional processing

Hippocampus

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Located in limbic system

A small structure that processes emotions, especially fear, anxiety, and aggression, and links them to memories, learning, and the senses

Amygdala

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Produces hormones, manages mood, hunger, thirst, sexual arousal, blood pressure, body temperature, and heart rate, and feeds information into the limbic system

Hypothalamus

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Located in limbic system

An arch-shaped convolution that processes emotions, regulates behavior, and controls autonomic motor function

Cingulate gyrus

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Psychotropic medications work by….

changing the amount of neurotransmitters available in the synapse, which is the microscopic gap between neurons.

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Is the range of doses at which a medication is effective without unacceptable adverse events. Drugs with a narrow TI (NTIDs) have a narrow window between their effective doses and those at which they produce adverse toxic effects.

The therapeutic index (TI)

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Explain the hypothalamic-pituitary-adrenal axis

Hypothalamus releases corticotropin-releasing hormones

CRH stimulate pituitary to release adrenocorticotropic hormone

Adrenocorticotropin stimulates adrenal glands and releases cortisol

Cortisol associated with fight or flight

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Name Neurotransmitter

Decrease

Parkinsons & Depression

Increase

Schizophrenia & Mania

Dopamine DA

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Name Neurotransmitter

Decrease:

Depression

Increase:

Mania, Anxiety, Schizophrenia

Norepinephrine NE

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Name Neurotransmitter

Decreased

Depression

Only association

Serotonin 5-HT

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Name Neurotransmitter

Decrease

Sedation & Weight gain

Histamine

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Name the Amino Acid

Decrease:

Anxiety, Schizophrenia, Mania, Huntington’s disease

Increase:

Reduction of Anxiety

GABA

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Name the Cholinergic

Decrease Level

Alzheimer’s, Huntington’s, Parkinson’s

Increase Level

Depression

Acetylcholine ACh

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This peptide is involved in regulation of pain & possibly mood & anxiety

Substance P

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This peptide is possibly involved in disorders involving dopamine, Schizophrenia & Parkinsons

Neurotensin

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Brain Imaging Tech

Can show the state the person is in. Sleep, awake, anesthetized

EEG

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Brain Imaging Tech

Can detect: Lesions, Abrasions, Areas of infraction, Aneurysm

Findings

Schizophrenia
Cognitive disorders

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Brain Imaging Tech

Can detect

Brain edema
Ischemia
Infection
Neoplasm
Trauma

Findings

Schizophrenia
Reduction in temporal & prefrontal lobes

MRI

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Brain Imaging Tech

Can Detect:

Oxygen Ultilization
Glucose Metabolism
Blood flow
Neurotransmitter-receptors interaction

Findings

Schizophrenia
Abnormalities in Limbic system
Mood disorder
Abnormalities in temporal lobe
Adult ADHD
Decreased Ulitilzation of Glucose

PET

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Enzyme responsible for metabolizing most drugs is…

Cytochrome P450

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Flurazepam, temazepam, triazolam

Are approved solely for…

Insomnia

They are benzos

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Chlordiazepoxide, diazepam, lorazepam

Are all commonly prescribed for…

Alcohol withdrawal

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Anterograde amnesia vs retrograde amnesia

Anterograde
This type of amnesia affects a person’s ability to learn new information and form new memories. Can be caused by Benzos, Barbiturates, Alcohol

Retrograde amnesia
This type of amnesia affects a person’s ability to recall past memories, including memories that were recently learned.

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Ataxia

Impaired coordination

Zolpidem

(Ambein) Short Acting Sedative Hypnotic sleep agents (Z-hypnotics)

Zaleplon

(Sonata) Short Acting Sedative Hypnotic sleep agents (Z-hypnotics)

Eszopiclone

(Lunesta) Short Acting Sedative Hypnotic sleep agents (Z-hypnotics)

Ramelteon May lower testosterone & raise Prolactin. Contradicted with Fluvoxamine Name class & use of Ramelteon

Melatonin receptor agonist Sleep

This tricyclic antidepressants is approved for insomnia. It doesn't make you fall asleep faster but keeps you asleep by blocking Histamine which promotes wakefulness. Contradicted in patients with Urinary Retention, Glaucoma, or MAOIs

Doxepin (Silenor)

Suvorexant

Orexin receptor Antagonist Treats insomnia neuropeptid Orexin produced by hypothalamus promotes wakefulness

Lemborexant

Orexin receptor Antagonist Treats insomnia neuropeptid Orexin produced by hypothalamus promotes wakefulness

Suvorexant & Lemborexant Treats insomnia- block Orexin receptors (Promotes Wakefulness) Controlled substances Contradicted in whom

Narcolepsy patients

Buspirone is approved for treatment of ..... Which receptor(s) does it work on? Controlled Substance?

(BuSpar) Anxiety Serotonin Not CS

First line to treat depressive disorder

SSRI

Fluoxetine is the most activating SSRI. Very long half-life. Maybe taken how often

Possibly 1 time per week

Sertraline (SSRI) Causes this SE more than other SSRIs

GI upset

Which SSRI should be taken at bed time due to its Sedation Properties

Fluvoxamine

Paroxetine (SSRI) has this major SE

Anticholinergic

Citalopram (SSRI) has this SE

QT interval prolongation

Bupropion (Wellbutrin) This type of medication Also, FDA approved for...

Norepinephrine & Dopamine reuptake inhibitor NDRI - Antidepressants Also, Smoking Cessation

Mirtazapine (Remeron) Vs Bupropion (Wellbutrin) Energy levels... Appetite.... Sex....

Mirtazapine (NaSSA) Sedation & Weight Gain & Less Sex Dysfunction Bupropion (NDRI) Insomnia, Anorexia, Weight loss , Less Sexual Dysfunction

SSRI or SNRI Can help with neuropathic pain

SNRI

Duloxetine (SNRI) Antidepressants Helps these areas of pain management

Diabetic peripheral neuropathy Fibromyalgia Chronic musculoskeletal pain

Tricyclic antidepressants are not often prescribed due to...

SE Lethal upon OD

Last line Antidepressants

MAOI

Valproate is an Anti convulsant & mood stabilizer. Balmces GABA & Glutamate Common SE: Sedation, weight gain, tremor Serious SE: Contradicted:

Thrombocytopenia Pancreatitis Hepatic failure Hyperammonemia Contradicted: Preggers or Liver Failure

Carbamazepine 2nd line mood stabilizer or Bipolar & Anticonvulsants Monitor CBC, ECG, LFT & Sodium Pregnancy test needed This serious adverse affect may happen.... (Esp in this population) These types of medications maybe affected...

Stevens-Johnson syndrome Asians Antivirals, anticontraceptives, immunosuppressant

Lamotrigine Anticonvulsant & Mood stabilizer For (Acute or Maintenance) of bipolar Serious adverse SE

Maintenance Stevens-Johnson syndrome

Taking an Antipsychotic & depletion of dopamine can lead to this potentially fatal condition S/S

Neuroleptic malignant syndrome Muscle rigidity Alter mental status Hyperthermia BP, HR, RR

Which are typical or atypical antipsychotics

Typical = 1st generation Atypical = 2nd generation

First line of treatment in schizophrenia

2nd generation atypical antipsychotics Less SE Treat both positive & Negative Symptoms of schizophrenia

1st generation antipsychotic block dopamine Whereas, 2nd generation are Antagonist for...

Dopamine & Serotonin

Hyperprolactinemia & Gynoclamastia are seen in these meds

1st generation antipsychotic

Pimavanserin 2nd generation atypical antipsychotics Is only FDA approved for...

Parkinson's psychosis Unique that it only Antagonises serotonin receptors

Aripiprazole, brexipipazole, quetiapine 2nd generation atypical antipsychotics Also approved for...

Major depressive disorder as adjucates to antidepressants

Cariprazine, lurasidone, quetiapine 2nd generation atypical antipsychotics Also approved for...

Bipolar disorder

2nd generation atypical antipsychotics All have this SE

Weight gain, hyperglycemia, Hyperlipidemia

Absolute neutrophil count is measured weekly for 6 months. Then once every 2 weeks fo 6 months. Then every 4 weeks afterwards in this medication

Clozapine Best antipsychotic med - only prescribed after 2 other meds failed due to strong SE

Clozapine 2nd generation atypical antipsychotics Most effective- only prescribed after 2 other meds failed. Serious SE: Contradicted:

Weight gain / Diabetes Sever Sedation, Orthostatic Hypotension, anticholinergic Seizures Bone marrow & Neutropenia Contradicted: Seizures conditions

Clozapine 2nd generation atypical antipsychotics Levels with smoking

Smoking lowers levels in blood

Risperidone Potent D² Antagonist. High rates of EPS Hyperprolactinemia Orthostatic hypotension Class of medication

2nd generation atypical antipsychotics

Quetiapine 2nd generation atypical antipsychotics Potency?

Low High risk for Sedation / low for EPS

Olanzapine 2nd generation atypical antipsychotics Posses Sedation & anticholinergic effects. Weight gain & hyperglycemia Long-acting Injectable formulario is available. Precautions with Injectable

Server Delirium/ Sedation Most be monitored fir 3 hours after

An inherited condition in which nerve cells in the brain break down over time. It typically starts in a person's 30s or 40s. Results in progressive movement, thinking (cognitive), and psychiatric symptoms. Drug interventions:

Huntington's disease Antipsychotics

Atomoxetine, Guanfacine, Clonidine All approved for treating...

ADHD

In Alzheimer’s all approved medication targets these neurotransmitters...

Glutamate & Acetylcholine

Donepezil, galantamine, rivastigmine Class Use

Cholinesterase inhibitors ( Stop destruction of Acetylcholine) Helping memory issues in Alzheimer's

Fill in with appropriate neurotransmitters Excess ____ is involved in thought Disturbances of schizophrenia Deficiencies of _____ and/or _____ underline depression & Anxiety. Insufficient ____ may also play a role in Anxiety Excess ____ & Insufficient _____ are involved in Alzheimer's

Dopamine Norepinephrine/ Serotonin GABA Glutamate / Acetylcholine

Do ADHD meds increase or decrease dopamine/ norepinephrine

Increase

Antipsychotics (decrease / increase) Dopamine Antidepressants (decrease / increase) Serotonin/ Norepinephrine Alzheimer's meds do what to Acetylcholine & Glutamate

Decrease dopamine Increase Serotonin Norepinephrine Decrease Glutamate/ Increase Acetylcholine

Which medication increases blood levels of lamotrigine, increasing Stevens-Johnson Syndrome risk? A. Carbamazepine B. Lithium C. Quetiapine D. Valproate

D. Valproate

Chp 3 Book Flashcards

(72 cards)