Executive functions of memory, emotions, willful control of skeletal muscles, thoughtful contemplation of goals, actions, insight, judgment. Decision making. Motivation. Comprehension, interpretation, & response to sensory input. People w brain issues can mess up sensory interpretation! When giving a drug all this input and processing will change
The amygdala (and hippocampus), are involved in emotions, learning, memory, and basic drives.
The limbic system
A group of structures that includes parts of the frontal cortex, the basal ganglia, and the brainstem
Controls of voluntary motor movements, procedural learning, routine behaviors or "habits" such as bruxism, eye movements, cognition and emotion
Hypothalamus regulates basic drives (hunger, thirst, sex) & is psychosomatic connection between higher brain functions of thought & emotion with internal organ function.
This area is comprised of a number of structures that make up the limbic system and are responsible for survival through a reward system of pleasure and memory coupled with motivational reinforcement or salience. Is a central core regulates internal organs, blood gases, blood pressure (unconscious processing).
Located behind the brainstem, the is primarily involved in the regulation of skeletal muscle coordination and contraction and the maintenance of equilibrium. It plays a crucial role in coordinating contractions so that movement is accomplished in a smooth and directed manner.
Mesolimbic and mesocortical pathways
Other ascending pathways that seem to play a strong role in modulating the emotional value of sensory material. These pathways project to those areas of the cerebrum collectively known as the limbic system, which plays a crucial role in emotional status and psychological function.
Larger molecules that may bring about long-term changes in the postsynaptic cells by joining neurotransmitters such as norepinephrine or acetylcholine. The result of these changes is an alteration of basic cell functions or genetic expression and may lead to modifications of cell shape and responsiveness to stimuli.
Neuron's three types of physiological actions
(1) respond to stimuli, (2) conduct electrical impulses, and (3) release chemicals called neurotransmitters.
Chemical substance that functions as a neuromessenger. Neurotransmitters are released from the axon terminal at the presynaptic neuron on excitation. This neurotransmitter then diffuses across a space, or synapse, to an adjacent postsynaptic neuron, where it attaches to receptors on the neuron’s surface. After use the neurotransmitter is either taken back into storage in the presynaptic cell or destroyed by waiting enzymes.
Are a family of proteins that are responsible for the growth and survival of developing neurons and the maintenance of mature neurons
Dopamine, Norepinephrine, Serotonin, Histamine.
Mania, anxiety, schizophrenia.
Amino acids, Glutamate.
(Monoamine). Involved in fine muscle movement. Involved in integration of emotions and thoughts putting the together. Involved in decision making Stimulates hypothalamus to release hormones (sex, thyroid, adrenal).
Dopamine changes SE
Increase: schizophrenia, mania (they think too much does this) Decrease: depression, Parkinson’s Disease.
Norepinephrine (NE) or Noradrenaline monoamine.
(Monoamine). Level in brain affects mood, attention & amp; arousal. Stimulates sympathetic branch of autonomic nervous system for “flight or fight” in response to stress.
Norepinephrine changes SE
Increase: mania, anxiety states, schizophrenia Decrease: depression
(Monoamine). Plays role in sleep regulation, hunger, mood states & pain reception. Hormonal activity. Plays a role in aggression & sexual behavior
Serotonin changes SE
Increase: anxiety states Decrease: depression.
(Monoamine). Involved in alertness, inflammatory response. Stimulates gastric secretion (makes us hungry!)
Histamine changes SE
Decrease: depression, sedation, weight gain
Amino acids increase
Reduction in anxiety, improvement in of cognitive performance in behavioral tasks.
GABA γ-aminobutyric acid amino acid
Plays a role in inhibition; reduces aggression, excitation, and anxiety. It should mediate electrical pulses (not too, fast-not too slow) May play a role in pain perception Has anticonvulsant and muscle-relaxing properties. May impair cognition and psychomotor functioning.
GABA γ-aminobutyric acid amino acid
Increase: reduced anxiety Decrease: anxiety disorders, schizophrenia, mania, Huntington’s Disease.
Glutamate amino acid
Is excitatory AMPA plays a role in learning & memory Increase NMDA: prolonged increased state can be neurotoxic, neurodegeneration in Alzheimer’s Increase AMPA: improvement of cognitive performance in behavioral tasks
Glutamate amino acid decrease
Plays a role in learning, memory, regulates mood: mania, sexual aggression. Affects sexual and aggressive behavior. Stimulates parasympathetic nervous system.
Acetylcholine changes SE
Decrease: Parkinson’s disease, Alzheimer’s disease, Huntington’s Disease
Where drugs act
Four sites of action: Biologic action depends on how its structure interacts with a receptor, Receptors (those sites to which a neurotransmitter can specifically adhere to produce a change in the cell membranes), Ion channels, Enzymes, Carrier Proteins
Subspecialty of pharmacology that includes medications affecting the brain and behavior used to treat mental disorders including: Antipsychotics, Mood stabilizers & Antiepileptics (help to smooth the electric impulses in the brain., Antidepressants, Antianxiety medications, Stimulants (for ADHD), Drugs to treat Alzheimer’s (remember Alzheimer = acetylcholine!)
Genetic variations in individuals which alter body’s ability to metabolize a drug. Investigate pt’s backgorund to see how drugs might affects him/her.
How antianxiety & hypnotic drugs work
GABA inhibits or calms frequency of chloride channel openings causing cell membrane polarization. Benzodiazapines bind to GABA receptors to increase frequency of chloride channel openings causing membrane hyperpolarization & decreasing cellular excitation (msgs can travel effectively. Muscles can’t work properly)
Decreased reflexes & attention, causes ataxia
Antianxiety & Hypnotic Drugs function and examples
Sedative-Hypnotic sleep agents bind to different GABA receptor . Puts them to sleep, but it doesn’t keep them asleep.
Examples: zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta)
Faster onset for sleep
No effects for anxiety, seizures, or muscle tension
Side effects: amnestic & ataxic (memory issues!)
Muscarinic receptors blockage SE (Antipsychotics)
Leads to anticholinergic effects such as blurred vision, dry mouth, tachycardia, urinary retention, and constipation.
Alpha 1 Noradrenergic Antagonism (Antipsychotics)
Orthostatic hypotension (very common. Specially if they are in more than one) More than 20 points difference? Report it! HR drops? Give water!!! We want them to do exercise. They have to move around. Ejaculatory failure. Reflux Tachycardia
California involuntary holds numbers
l5150 (72 hour hold)
l5250 (14 day hold) for danger to self
l5270 (30 day hold) for gravely disabled, gives additional 30 days to decide about filing for 1 yr conservatorship
Pharamacodynamics: Where Drugs Act
Receptors (those sites to which a neurotransmitter can specifically adhere to produce a change in the cell membranes)
Melatonin receptor agonist, specifically binding to M1 receptor to cause sleepiness. No abuse potential. It is not addictive like other drugs. Side effects: headache & dizziness
Low dose antidepressant used for sedative effect, to maintain sleep.
Thought to cause histamine 1 blockade. Side effects: increases urinary retention issues (watch for UTIs!!!), sedative effects increased when used with other CNS depressants or antihistamines, MAOIs (anti depressive category ). Helps to maintain asleep. It doesn’t put them to sleep
Dopamine Blockade (Serotonin Blockade is similar)
Parkinsonian, Akinesia, Akathisia, Tardive dyskinesia (not reversible SE) How movement msgs are affected.
Increased prolactin, personality and emotional changes
Prolactin: SE are milk production)
Emotions are affected.
Antidepressant targets which Neurotransmitters
Norepinephrine & Serotonin