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Nurs 216B > Neurology class 2 > Flashcards

Neurology class 2 Flashcards

1
Q

norepinephrine/epinephrine

A

mainly excitatory; drives motivation

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2
Q

dopamine

A

mainly excitatory; reward and pleasure

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3
Q

serotonin

A

inhibitory; does not require enzyme for transport; balances mood

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4
Q

GABA

A

inhibitory; decreases cell activity

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5
Q

Glutamate

A

excitatory; memory and learning

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6
Q

substance P

A

excitatory; deals with synaptic communication

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7
Q

monoamines

A

dopamine, epinephrine, norepinephrine
- recycled in the synapse by monoamine oxidase

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8
Q

alzheimer’s disease

A

64% of all dementia
- cannot cure but treat with increasing ACh through cholinesterase inhibitors

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9
Q

cholinesterase inhibitors

A

decrease Ach breakdown

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10
Q

Rivastigmine, Galantamine

A

cholinesterase inhibitors

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11
Q

alzheimer’s pathophysiology

A

breakdown and recycling of amyloid proteins–> accumulation of amyloid deposits–> amyloid plaques which interfere with communication–> loss of neurons

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12
Q

Parkinsons

A

2nd most common form of dementia
- no cure but can treat with increasing dopamine

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13
Q

levodopa, Rotigotine

A

dopamine agonists

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14
Q

parkinson’s pathophysiology

A

destruction of dopamine receptors leading to reduced transmission in basal ganglia which filters extra and purposeful movement

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15
Q

hypothalamic SCN

A

generates hormones and is the “computer” of the brain

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16
Q

melatonin

A

secreted from pineal gland located in the epithalamus
tryptophan–> serotonin–> melatonin

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17
Q

sleep cycle

A

circadian rhythm input from hypothalamic SCN–> decreased RAS and cortical stimulation–> decreased excitatory neurotransmitter stimulation

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18
Q

REM sleep stage

A

“wakeful” vital signs but in very deep sleep

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19
Q

Insomnia

A

difficulty falling and staying asleep which can be caused by high cortisol
- often at least one ADL is altered alongside

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20
Q

Flurazepam (Dalmane), Temazepam (Restoril), Triazolam

A

benzodiazepines for insomnia
- will cause pupil dilation due to PNS block

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21
Q

Sonata, Ambien, Lunesta

A

non-benzodiazepines for insomnia
- bind with GABA but from different angle

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22
Q

will cause pupil constriction

A

opioids

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23
Q

will cause pupil dilation

A

stimulants

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24
Q

obstructive sleep apnea

A

has nothing to do with neurotransmitters it deals with collapse of airways; common in obese patients
- common in REM stage
- common due to increased pressure on diaphragm which decreases mobility

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25
Q

obstructive sleep apnea pathophysiology

A

pharynx collapse–> pharyngeal wall collapse–> tongue obstruction of oropharynx

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26
Q

cerebral apnea

A

deficit in the brain stem and respiratory centres

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27
Q

migraine

A

must occur for at least 15 days within a month for 3 months
- higher incidence in adult women due to estrogen levels

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28
Q

migraine pathophysiology

A

trigeminal nerve irritation–> inflammation within meningeal

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29
Q

migraine without aura

A

most common form of migraine

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30
Q

serotonin agonists

A

treat migraines to balance brain activity

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31
Q

triptans (sumatriptan, zolmitriptan)

A

serotonin agonists

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32
Q

botox as treatment for migraines

A

acts as an antiinflammatory to decrease neurotransmitter hyperstimulation

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33
Q

anxiety

A

intense fear due to SNS and HPA axis stimulation leading to S&S of anxiety
- women more affected but present in 12% of the population

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34
Q

excessive and uncontrollable worry with systemic symptoms and unable to modulate with present coping mechanisms

A

generalized anxiety

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35
Q

intense fear with systemic symptoms
- CNS involves major emotional centers (amygdala, hippocampus, prefrontal cortex)
- SNS stimulation

A

panic

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36
Q

benzodiazepines for anxiety

A

increase inhibitory neurotransmitter GABA

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37
Q

Alprazolam (Xanax), diazepam (Valium), Lorazepam (ativan), Midazolam (Versed)

A

benzodiazepines for anxiety

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38
Q

hallucinations

A

abnormalities of sensory perception
- perception without real time input

39
Q

sensory block (hallucinations)

A

stored images replace the intel coming in

40
Q

neuronal dysfunction (hallucinations)

A

hyperactivity or deficit creates dysfunction and images

41
Q

delusions

A

abnormalities of thought
- false beliefs in facts and or personal status

42
Q

psychosis

A

state of perceptive loss of reality
- hallucinations and delusions

43
Q

schizophrenia

A

dysfunction of thoughts and language expression which is chronic
- cause is unknown but will show up on MRI
- dopamine excess

44
Q

incomprehensible speech, disconnected thought process

A

disorganized behaviour of schizophrenia

45
Q

hallucinations, delusions, paranoia, agitation

A

psychotic (positive) behaviour of schizophrenia

46
Q

schizophrenia diagnosis

A

at least 2 S&S plus 2 other functional alterations

47
Q

antipsychotics

A

target limbic system D2 receptors which deals with emotions; decrease hyperexcitation of the brain

48
Q

D2 antagonism in basal ganglia cause issues with tongue movement, muscle rigidity, tremors, restlessness , and muscle spasms

A

Extrapyramidal side effects of antipsychotics

49
Q

neuroleptic malignant syndrome

A

VS crisis characterized by hyperthermia, unstable BP, incontinence, and diaphoresis

50
Q

schizoaffective disorder

A

schizophrenia accompanied with another disorder

51
Q

‘typical’ antipsychotic drugs

A

high efficacy for ‘positive’ (psychotic) symptoms

52
Q

phenothiazines and non-phenothiazines

A

‘typical’ antipsychotic drugs

53
Q

chlorpromazine

A

type of phenothiazine (antipsychotic)

54
Q

haloperidol

A

type of non-phenothiazine (antipsychotic)

55
Q

olanzapine (zyprexa), quetiapine (seroquel), clozapine (clozaril), risperidone (risperdal)

A

‘atypical’ antipsychotic drugs

56
Q

‘atypical’ antipsychotic drugs

A

high efficacy for ‘positive’ and negative symptoms and cause less sedation

57
Q

depression

A

lack of serotonin and norepinephrine, may be accompanied by hallucination and delusions
** make sure to rule out hypothyroidism due to similar symptoms

58
Q

SSRI’s

A

“ine” ; 1st line drugs that take 1-2 weeks to take effect

59
Q

Fluoxetine (prozac), sertraline (zoloft), paroxetine (Paxil)

A

SSRI’s

60
Q

SNRI (atypical antidepressants)

A

increase serotonin and norepinephrine

61
Q

Mirtazapine (Remeron), Bupropion (Wellbutrin)

A

SNRI

62
Q

tricyclic antidepressants

A

serotonin, norepinephrine, and dopamine reuptake inhibitors

63
Q

Imipramine (Impril)

A

tricyclic antidepressants

64
Q

MAO inhibitors

A

inhibit monoamine oxidase enzyme which increases neurotransmitter presence

65
Q

ketamine

A

dissociative anesthetic; its receptors are glutamate, serotonin and opioid
- when used for anesthetic the dose is 10x lower

66
Q

Esketamine

A

type of ketamine

67
Q

Lithium

A

sodium channel blocker that increases serotonin and decreases sodium to decrease impulsivity and mood swings
- narrow TI, toxicity, slow onset, drug interactions

68
Q

loss of sensation in a focused area of the body
- used for minor procedures such as sutures

A

local anesthesia

69
Q

loss of sensation in a body region
- used in dental procedures

A

regional anesthesia

70
Q

systemic; loss of consciousness and combines many drugs for an optimal effect
- used for major procedures such as abdominal surgery

A

general anesthesia

71
Q

systemic; low level sedation to maintain VS without intubation

A

monitored anesthesia care (MAC)

72
Q

sleepy, able to awaken, able to respond when prompted, maintain VS without assistance

A

conscious sedation

73
Q

sedation of a patient for the purposes of a medical procedure/intervention

A

anesthesia

74
Q

“sodium channel blockers”
- impede action potential so cell cannot depolarize leading to decreased sensory impulses to other cells
- work on efferent and afferent pathways
- lipophilic, cleared through circulation, hepatic metabolism, no BBB significance

A

local anesthetics

75
Q

“caine”
- Prilocaine, Lidocaine, Bupivacaine, Ropivacaine, Cocaine

A

local anesthetics or “sodium channel blockers”

76
Q

shortest acting local anesthetic

A

Lidocaine

77
Q

longest acting local anesthetic

A

Bupivacaine

78
Q

known to be systemic, very lipophilic, vasoconstriction at local level

A

cocaine

79
Q

topical, infiltration, nerve block, epidural, spinal

A

local anesthetic routes

80
Q

solarcaine

A

topical anesthetic

81
Q

used as an adjunct in anesthesia
- localizes vasoconstriction which helps with bleeding control and increases the duration of the anesthetic

A

Epinephrine

82
Q

used as an adjunct in anesthesia
- helps neutralize the pH of a tissue in case of a bacterial infection

A

sodium bicarbonate

83
Q

location ensured by no CSF return in needle
- there will be a loss of sensation to the spinal nerves as the anesthetic bathes the nerves
- onset will be in 20-30 min and there will be a continuous infusion through an indwelling catheter
- dosage is higher than spinal route

A

epidural

84
Q

location ensured by CSF return in needle drawback
- always injected below L2
- quick onset

A

spinal anesthetic route

85
Q

very little side effects, can use small amounts due to its potency, analgesic

A

fentanyl

86
Q

cause good analgesia without euphoric effects, has depressive symptomologies, good for patients with previous addictions

A

Dilaudid

87
Q

“thane”; decrease action potentials, increase GABA

A

inhaled general anesthetics

88
Q

nitrous oxide, halothane, isoflurane

A

inhaled general anesthetics

89
Q

propofol (diprivan)

A

IV anesthetic

90
Q

increase GABA and has a rapid onset of action as well as a short half life
- requires continuous infusion for effect and requires intubation as well as VS support

A

Propofol (Diprivan)

91
Q

dissociative anesthetic that is also a CNS depressant

A

ketamine

92
Q

block Ach binding at nicotinic receptors; “nium”
- no BBB penetration just PNS
- muscle paralysis including the diaphragm
- ideal for complex procedures

A

neuromuscular blocking agents

93
Q

vecuronium, rocuronium, pancuronium

A

neuromuscular blocking agents

Nurs 216B (19 decks)

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