Test 1 Flashcards
(55 cards)
1
Q
The effects of bipolar disorder
A
-Lifetime treatment no cure
-unstable, unpredictable
- high incidence of:
•broken marriages/remarriages
•unemployment/ Fire from job
• loss of relationships
• severe disability
• one of the most lethal psychiatric disorders
2
Q
Bipolar in children
A
-1% prevalence
- misdiagnosed, other disorders with mood instability
• ADHD
•reactive attachment
•anxiety
• PTSD
•brain damage
• abuse
•situational anxiety
• neurodevelopmental disorders
3
Q
Bipolar onset
A
- prepubertal children: 15%
- teenagers up to 18: 35%
- adults: 50%
4
Q
Bipolar symptoms in children
A
- grandiosity
- elevated/expansive mood
- decreased need for sleep
- flight of ideas
- distracibility
- pressured speech
- increased activity
- risk taking behavior
5
Q
Bipolar facts
A
- affects .5-1.5% of the US population
- strong heritable component
- bipolar 1 equally in both gender
- type II more common in females
- rarely occurs after 50
- can often occur in childhood; ADHD, ODD, unipolar depression.
6
Q
Manic episode
A
At least one week
7
Q
Hypomania episode
A
At least 4 days and does not impair social functioning
8
Q
Bipolar treatment
A
- pharmacology is the first line of defense
- inpatient/ outpatient
- medication
9
Q
Medication yet:
Agonist
A
Mimics
10
Q
Medication term:
Antagonist
A
Block
11
Q
Medication term:
Egodystonic
A
Aversive
12
Q
Medication term:
Egosyntonic
A
Not aversive
13
Q
Medication term:
Pathophysiology
A
The root of symptoms
14
Q
Medication terms:
Target symptoms
A
The target of medication
15
Q
Medication terms
Toxicity
A
Toxic effects of medication on the body
16
Q
Medication History
A
- late 1800s: medical model
- early/mid 1900: biological psychiatry halted, favored psychological explanations
- 1960: renewed interest in biological psychiatry
- 1970s: developed of new tranquilizers
- 1980: movement from unidimensional models to integrated views
17
Q
Integrated Model
A
- you can have a biological reasoning for a psychological functioning. i.e UTI in elders
18
Q
Psychodynamic of pharmacological treatment
A
- stimulas- response specificity
- psychological factors that influence medication treatment, (genetic and personal meaning)
- culture (metabolism, beliefs/tradition, perspectives, SES)
19
Q
Neuron/nerve cell
A
- nucleus
- dendrites
- stimulus
- cellbody
- axon hillock
20
Q
What happens to the nerve cell when it gets activated
A
-a nerve cell is activated the dendrites get the signal and then activates the nerve cell then sends the neuro transmitters down the axon to the terminal buttons
21
Q
Action Potential
A
- presynaptic neuron
- neurotransmitters
- vesicles
- cell membrane
- synapse
- postsynaptic neuron
- receptor site
- reuptake
22
Q
Common Neurotransmitters
A
- acetylcholine
- dopamine
- GABA
- Neoepinephrine
- serotonin
23
Q
The nervous systems
A
-approx. 100 billion nerve cells/neurons in the brain
24
Q
Central nervous system
A
- spinal cord
- subcortical brain
- cerebral cortex
25
Peripheral nervous system
- sensory nerves/ neurons
| - motor nerves/ neurons (somatic, autonomic: sympathetic & parasympathetic)
26
autonomic nervous system
- sympathetic: fight or flight action, and adrenergic effects
- parasympathetic: rest and digest, equilibrium, anticholinergic effects
27
Acetycholine
-neurotransmitters of parasympathetic nervous stem
28
Dopamine
controls brains reward system
-if malfunctioned can cause psychotic disorders,
, use antipsychotic and antidepressant meds
29
GABA
- anxiety states and chemical dependency
| - meds used: antianxiety, alcohol and drugs, benzos, barbiturates
30
Nerepinephrine
- wakefulness, activity, mood, sympathetic nervous system,
| - depression,
31
serotonin
mood, sleep, inhibits pain,
- leads to depression, headache, diarrhea, sexual dysfunction,
- use SSRIS for meds
32
pharmacology works by...
- increasing: the amount of neurotransmitter produced by synaptic neurons and released into a synapse
- blocking: the reuptake of a neurotransmitter produced by presynaptic neurons and released into a synapse
- binding: to the receptor site on the postsynaptic neuron, disabling the activity of neurotransmitter present in the synapse
- inhibiting: the enzymes that breakdown neurotransmitters
- changing: the sensitivity of postsynaptic neurons to neurotransmitters
33
Pharmacokinetics
- body affects the drug
- how the body moves or processes the drug
- ADME: Abosroption, metabolism, distrubution, excretion
- pharmacmological parameters: peak concentration, trough levels, half life, steady state, plasma levels, theraputic window
34
Pharmacodynamics
- how the drug affects the body
- how the cell responses to the drug
- start low go slow
- risk-benefit ration
- goal is to find the pharmacological profile that best fits the specific needs.
35
5 primary effects of psychotropic medication
1. Pharmacological effect/ the desired effect
2. Side effects
3. Idiosyncratic effects
i. Very rare adverse effects such as death
4. Allergic reactions
Discontinuance syndrome
36
When to refer for medication treatment
- grief becomes clinical depression
- MD had vegatative symptoms
- MD has atypical symptoms
- daily functioning impaired
- suicidal impulses of psychotic symptoms
- fails to respond to psychotherapy
37
When to use antidepressants
- depression
- anxiety
- PTSD
- OCD
- GAD
- PMS
- panic
- bulimia
- cocain craving
- cmoking cessation
- others
38
Types of antidepressants
```
-SSRIS
SNRIS
-TCA
-MAO
-Atypicals
-NRI
-Stimulants
```
39
1st episode phase of treatment for depression
- at the end of continuation phase, gradually reduce dose and discontinue use
40
sexual dysfunction side effect
-wellbutrin, viagra
41
weight gain, side effect
- remeron
42
2nd episode phase of treatment for depression
- with risk factors: suggest lifelong medication
| - without risk factors gradually discontinue
43
3rd episode phase of treatment for depression
- suggest lifelong medication
44
Depression in children
- possible precursor to future chronic depressive episodes or bipolar disorder
- criteria met with fewer symptoms
- manifest in irritability, anger, defiance, acting out, boredom, vegetative signs
- SSRIs preferred, only prozac approved for kids over 8
- start low and go slow
45
Bipolar Medication regimens
- multiple mood stabilizers
- concurrent antidepressants
- other adjunctive agents: benzodiazepines, antipsychotics
46
Medication combination for manic episodes
lithium, valproate, or 2nd generation antipsychotic
47
anxiety and agitation medication combinations
-mood stabilizers + antianxiety agents
48
what is monotherapy
- antidepressants no mood stabilizers
49
treatment for bipolar 2/depressive
-mood stabilizers, and antidepressants
50
medication for acute mania
-mood stabilizer + antipsychotic, remove antipsychotic when mania resolves
51
lethality of lithium
- death
- coma
- Vomiting or severe nausea
- Coarse trembling of hands or legs
- Frequent muscle twitching -such as pronounced jerking of arms or legs
- Blurred vision
- Marked dizziness
- Difficulty walking
- Slurred speech
- Irregular heartbeat
- Swelling of the feet or lower --legs
52
side affects for SSRIS
```
Drowsiness.
Nausea.
Dry mouth.
Insomnia.
Diarrhea.
Nervousness, agitation or restlessness.
Dizziness.
Sexual problems
```
53
common side affects of anti-depressants
```
nausea.
increased appetite and weight gain.
loss of sexual desire and other sexual problems, such as erectile dysfunction and decreased orgasm.
fatigue and drowsiness.
insomnia.
dry mouth.
blurred vision.
constipation.
```
54
common side affects for antipsychotics
```
Drowsiness.
Dizziness.
Restlessness.
Weight gain (the risk is higher with some atypical antipsychotic medicines)
Dry mouth.
Constipation.
Nausea.
Vomiting.
```
55
common side affects for mood stabilizers
```
Drowsiness.
Dizziness.
Restlessness.
Weight gain (the risk is higher with some atypical antipsychotic medicines)
Dry mouth.
Constipation.
Nausea.
Vomiting.
```
