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Flashcards in Test #1 Deck (58)
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1
Q

Steps in an Action Potential

A

When one nerve cell is activated it sends information like a neurotransmitter down through the axon via a vesicle which protects it and keeps it all there which then brings it to the edge of the presynaptic neuron which goes pew and sends it into the synaptic gap and then the receptors are what takes in the neurotransmitter, reuptake when the presynaptic nerve RECYCLES the neurotransmitter that is existing in that presynaptic gap

2
Q

a neuron from the axon terminal of which an electrical impulse is transmitted across a synaptic cleft to the cell body or one or more dendrites of a postsynaptic neuron by the release of a chemical neurotransmitter.

A

Presynaptic Neuron

3
Q

a chemical substance that is released at the end of a nerve fiber by the arrival of a nerve impulse and, by diffusing across the synapse or junction, causes the transfer of the impulse to another nerve fiber, a muscle fiber, or some other structure.

A

Neuotransmitters

4
Q

store various neurotransmitters that are released at the synapse.

A

Vesicles

5
Q

cell’s gatekeeper. It’s the outer layer that surrounds a cell, letting substances in - or keeping them out.

A

Cell Membrane

6
Q

a junction between two nerve cells, consisting of a minute gap across which impulses pass by diffusion of a neurotransmitter.

A

Synapse

7
Q

Nerve cell on the receiving end of an electrical impulse from a neighboring cell

A

Post Synaptic Neuron

8
Q

proteins that are on the surface of each cell. They act as little receivers (or ears) that listen to the messages of the chemical messenger molecules as they float in the intercellular fluid surrounding every cell.

A

Receptor Site

9
Q

the process by which the presynaptic terminal of a neuron reabsorbs and recycles the molecules of neurotransmitter it has previously secreted in conveying an impulse to another neuron.

A

Reuptake

10
Q

the space between neurons at a nerve synapse across which a nerve impulse is transmitted by a neurotransmitter

The gap between the presynaptic gap and the post synaptic nerve, its where the neurotransmitters go and then the receptors receive it

A

Synaptic Gap

11
Q

o Responsible for communication and integration in the nervous system

A

Neuron

12
Q

Input to the neuron

A

Dendrites

13
Q

Output of the neuron

Designed to carry information

Branch to connect to go to different neurons

A

Axon

14
Q

End; make the connection with the other neuron.

A

Axon Terminal

15
Q

BODY -> DRUG

How the body moves or processes the drug

How your body effects the drug

A

Pharmacokinetics

16
Q

ADME of Pharmacokinetics

A

Absorption
Distribution
Metabolism
Excretion

17
Q

Max concentration when drug in blood stream

A

Peak Concentration

18
Q

When med in blood stream is at its lowest, wait to take next dose of meds

A

Trough Levels

19
Q

Amount of time required to reach a stable concentration level in blood stream, the amount entering your body is equal to the amount leaving your body

A

Half-Life

20
Q

Amount of time required for drug to be stable in blood stream amount entering is equal to amount exiting

A

Steady State

21
Q

Concentration in liquid portion of the blood

Therapeutic index: window having meds concentrated rather than toxic

A

Plasma Levels

22
Q

Minimum concentration much be reached for effectiveness and not exceeded

A

Therapeutic Window

23
Q

DRUG -> BODY

How the drug affects the body

“Start low and go slow”
Work your way up to see what’s the best dosage
too much could be toxic

A

Pharmacodynamics

24
Q

Something that “mimics” an already occurring neurotransmitter in the body, chemical process already occurring in the body

A

Agonist

25
Q

It blocks

A

Antagonist

26
Q

An averse side effect

-discomfort

A

EgoDystonic

27
Q

Signals to others? Symptom/side effect that other people see as aversive but person experiencing doesn’t care.

El se siente SYN symptoms pero tu los ves

A

EgoSyntonic

28
Q

The root of the pathology, physiological root to pathological symptoms

A

Pathophysiology

29
Q

What you want to address with meds

“target” of the medication

A

Target Symptoms

30
Q

Toxic effect of med on the body, having aversive effects to the point of lethality

A

Toxicity

31
Q

drugs used to treat bipolar II

A
First-line agents:
Mood stabilizers (Lithium, Carbamazepine, Divalproex, Lamotrigine, Quetiapine)

2nd-generation antipsychotics

  • Good for Acute Depressive
  • Acute mania - mood stabilizer + antipsychotic (remove antipsychotic when mania resolves)
32
Q

periodic treatment for Bipolar

A

Anti-Depressants/ Anti Psychotics

33
Q

Long term treatment for Bipolar

A

Medication

Mood Stablizers -> Neuroprotective effects

34
Q

Dry mouth, blurred vision, constipation, urinary retention, intestine paralysis, etc.

Parasympathetic Nervous System

A

Anticholinergic

35
Q

Sweating, sexual dysfunction, orthostatic hypotension (drop in bp upon rising), etc.

Norepinephrine

A

Adrenergic

36
Q

Sedation, weight gain, etc.

A

Antihistaminic

37
Q
  • Mild, moderate (adjustment disorder w/depressed mood), or severe (MDD)
  • Response to psychosocial stressors
  • Acute/intense; insidious; distant past
  • Lack physiological symptoms
  • No impact on sleep
A

Reactive Depression

38
Q

Medical illness
- Ex. Chronic pain, thyroid issues

  • Female sex-hormone fluctuation
  • Post-partum, menopause

Medications and recreational drugs
- Alcohol, birth control

Endogenous biological depressions (genetic)

A

Biological Depression

39
Q

Start as reactive which lead to physiological symptoms that influence the brain

Large % of depressions seen clinically

Start as reactive -> various physiological symptoms -> adversely influence brain functioning

Psychological and biological symptoms

A

Reactive-Biological Depression

40
Q

Subtype characterized by symptoms:

  • Reactive dysphoria
  • Profound fatigue, low energy
  • Hypersomnia
  • Increased appetite and weight gain
  • Marked sensitivity to interpersonal rejection/separation
A

Atypical Depression

41
Q

Which type of medication is NOT most suitable to treat bipolar

A

Antidepressants

42
Q

Consequences of taking antidepressants to treat bipolar

A

may induce mania

43
Q

When to refer depressed clients for Medication Treatment

A

Greif becomes Clinical Depression
- SXS: Early morning awakening; serious weight loss; anhedonia; agitation

MD has vegetative sxs
- SXS: Sleep disturbance; appetite disturbance; fatigue; decreased sex drive; agitation or psychomotor retardation; anhedonia

MD has atypical sxs
- SXS: Pronounced fatigue; hypersomnia; increased appetite and weight gain; rejection sensitivity; reactive dysphoria

Dysthymia presents with sustained sxs
- SXS: Low energy; anhedonia

Daily functioning markedly impaired

Presence of sever Suicidal impulses of psychotic sxs

MD or Dysthymia fails to respond to psychotherapy

44
Q

How to counteract effects of SSRI’s on sexual dysfunction

A

Antidote - adding to prescribed med (Wellbutrin, gingko biloba, cyproheptadine, Viagra, etc.)

Substitution (buproprion, mirtazapine, nefazodone);

Atypical Anti-depressants

45
Q

Common Neurotransmitters that play a role in Anti-Depressants

A

SSRIs (Prozac/Fluoxetine, Zoloft/Sertraline, Paxil/Paroxetine, Celexa/Citalopram, Lexapro/Escitalopram)

SNRIs (Effexor/Venlafaxine, Cymbalta/Duloxetine)

Serotonin norepinephrine reuptake inhibitor

TCAs (Tofranil/Imipramine, Elavil/Amitriptyline)

MAOIs (Nardil/Phenelzine, Parnate/Tranylcypromine)

Atypicals (Wellbutrin/Bupropion [dopamine-norepinephrine reuptake inhibitor], Serzone, BuSpar/Buspirone)

NRIs (Strattera, Vestra [not available in US])

Stimulants (Ritalin, Dexedrine)

46
Q

Adjunctive agents

FDA approved for mania and mixed mania
- Aripiprazole, Asenapine, Cariprazine, Olanzapine, Quetiapine, Risperdone, Ziprasidone

FDA approved for bipolar depression
- Lurasidone, Quetiapine, Olanzapine + Fluoxetine (Symbyax)

Less risk for extrapyramidal side effects

Serious side effects:
- seizures, cardiac arrhythmias, hypertension, metabolic syndrome (increased weight, type II diabetes, hyperlipidemia)

A

2nd generation Anti-psychotics

47
Q

Treatment of Bipolar

A

Pharmacotherapy** + psychotherapy + psychoeducation

Treatment team (psychiatrist + therapist + patient’s family)

Inpatient/outpatient

Complicated course of illness; symptom severity/presentation

Medication regimens:

  • Multiple mood stabilizers
  • Concurrent antidepressants
  • Other adjunctive agents:
    - Benzodiazepines
    - Antipsychotics

Resistance/poor response to treatment is common

48
Q

Problematic side effects of depression

A

Activation - acute onset side effect within first few hours of starting drug or increasing dose - every time I take this I’m going to feel this each time

Low dose tranquilizer (lorazepam)

Common patient-initiated discontinuation

Switching - provoked into a manic state (after several weeks of taking antidepressant)
Sexual dysfunction - is it because of the drug or due to bipolar?
-Wellbutrin; Viagra

Weight gain
-Remeron
Anorexia
Elderly

49
Q

o Used to treat Depression
o SNRI
o Blocks reuptake of serotonin norepinephrine, and dopamine into presynaptic neurons

A

Effexor

50
Q

o Atypical Anti-depressant
o Primary use for depression
o Used to augment current SSRI - use to combat sexual dysfunction
“ Fewer sexual side effects

A

Wellbutrin

51
Q

type of drug

Primary for MDD but has other uses

Median grade sedative, antianxiety properties, mood improver
- Premature ejaculation, women undergoing cancer Tx to combat hot flashes

Fewer drug interactions compared to other SSRI’s

A

Zolaft

52
Q

type of drug
Anticonvulsant / mood stabilizer
GABA
manic episodes

A

Depakote

53
Q

Type of drug

Treats Manic/Depressive bipolar

interferes with the production and uptake of chemical messengers by which nerves communicate with each other (neurotransmitters).

affects the concentrations of tryptophan and serotonin in the brain.

increases the production of white blood cells in the bone marrow

A

Lithium

54
Q

augment antidepressants

should only be taken in the morning

A

stimulants

55
Q

off label treatment of depression

effective in improving energy and cognition with little to no sexual dysfunction

A

NRI

56
Q

use when other antidepressants have failed in treating MD and Panic D/O

A

MAO

57
Q

Dual action

may be more effective than SSRI’s for SEVERE depression but have additional side effects

A

SNRI

58
Q

cleaner
fewer side effects
reacts only with serotonin

A

SSRIS