CNS affective disorders (2) Flashcards
bipolar mood disorder
- alteration between _____ and _____
- subtypes:
- -bipolar 1 (full _____ episodes)
- -bipolar 2 (_____ episodes)
- -_____ (“moodiness” - up and down)
depression mania manic hypomanic cyclothymia
mania (“the high”)
- inflated self-esteem
- severe _____
- excessive _____
- racing thoughts
- distractibility
- activities done in excess (e.g. spending money)
- _____ behaviors/activities
insomnia
talkativeness
risky
depression (“the low”)
- loss of interest in activities
- changes in _____ resulting in weight gain or loss
- changes in _____ patterns
- loss of energy
- trouble concentrating or thinking
- repeated thoughts of _____ or death
appetite
sleep
suicide
bipolar disorder
- _____
- _____ acid: an anti-epileptic
- _____:
- -anticonvulsant
- -reasonable alternative to _____
- -mechanism unclear
- _____
- _____
lithium valproic carbamazepine clonazepam gabapentin
pharmacology of lithium
- Li was accidentally found to have a _____ effect in patients with _____
- -mood stabilizer, reduces both manic and depressive symptoms
- -_____ the _____ in patients with bipolar disorder
- -has greater activity against _____ symptoms than _____
calming mania normalizes mood manic depression
pharmacology of lithium
MOA: (multiple)
1. effects on _____ and _____ transport
2. effects on _____ (NTs) and _____ - receptor binding
3. effects on _____ pathways following NT - receptor binding
–suppresses the formation of _____ (inositiol triphosphate) and _____ (diaclyglycerol)
–IP3 and DAG are important in _____ neurotransmission
electrolyte ion neurotransmitters NT signaling IP3 DAG amine
pharmacology of lithium pharmacokinetics (oral): -well absorbed, 95-100% -widely distributed --high levels in \_\_\_\_\_ bone and some areas of the brain -not \_\_\_\_\_ -half life - 24 hours
- maintenance therapy
- -decreases _____ behavior and reduces both the frequency and magnitude of _____
- _____ may be required adjectively during maintenance
thyroid metabolized manic mood swings antidepressants
pharmacology of lithium
pharmacokinetics:
-excreted in the _____, extensively reabsorbed
-clearance is increased in _____
-_____ competes for renal tubular reabsorption
-_____ therapeutic window
-elevated levels cause neurotoxicity and cardiotoxicity
-nausea, vomiting, diarrhea, tremor, confusion, arrhythmias, convulsions
urine
pregnancy
sodium
narrow
pharmacology of lithium
therapeutic effect:
-maximal response requires several _____ or _____ of treatment
–during early phase, patient requires other _____
–drug _____ when initiating treatment and at periodic intervals therafter
–initially, patients may require neuroleptics or _____
days weeks medications monitoring benzodiazepines
pharmacology of lithium
adverse effects:
-drowsiness, weight gain, fine hand tremor (can be controlled by B-adrenergic antagonist)
-_____- because it interferes with antidiuretic hormone, inhibiting the kidneys ability to concentrate urine (resistant to ADH)
-_____ enlargement (dysfunction rare): hypothyroidism by blocking thyroid hormone synthesis and release
-salivary gland _____
polyuria
thyroid
hyposecretion
pharmacology of lithium drug interactions: -\_\_\_\_\_ -\_\_\_\_\_ diuretics --lithium clearance is reduced by 25% -\_\_\_\_\_ drugs (with the exception of clozapine), produced more severe \_\_\_\_\_ syndromes when combined with lithium -sodium chloride
NSAIDs
thiazide
antipsychotic
extrapyramidal
alzheimers disease
- most common form of _____
- worsens as it progresses, and eventually leads to death
- it was first described by german psychiatrist and neuropathologist Alois Alzheimer in 1906
- although the less-prevalent early-onset Alzheimers can occur much earlier
- in 2006, there were 26.6 million sufferers worldwide. Alzheimers is predicted to affect 1 in 85 people globally by 2050
dementia
pre dementia
-executive functions of attentiveness, planning, flexibility, and abstract thinking
-impairments in semantic memory (memory of meanings, and concept relationships) can also be symptomatic of the early stages of AD
-_____
-executive function loss
-perception (_____)
executive movement loss (apraxia)
apathy
agnosia
moderate alzheimers
- recall vocabulary, which leads to frequent incorrect word substitutions (_____)
- illusionary misidentifications and other delusional symptoms (_____)
- urinary _____
- _____ term memory loss
- failure to function _____ and _____
paraphasias persecution incontinence long socially professionally
advanced disease
- complete loss of _____
- can often understand and return emotional signals
- aggression, apathy and exhaustion are common
- people with AD will ultimately not be able to perform even the simplest task without assistance
- _____ and _____ deteriorate to the point where they are bedridden, and they lose the ability to feed themselves
- AD is a terminal illness, with the cause of death typically being an _____ factor, such as infection of pressure ulcers or pneumonia
speech
muscle mass
mobility
external
