3rd Flashcards
Which neurotransmitter is implicated in the development of Tourette Disorder
Excess dopamine in the cortico-striatal-thalma-cortal circuit (CSTC)
Schizophreniform
shares features with schizophrenia but has shorter duration - usually less than 6 months.
What type of therapy can be good for someone with schizophrenia
Group therapy for addressing social withdrawal and enhancing social skills.
Which medication has been extensively studied to reduce risk of suicide in schizophrenia
clozapine (clozaril)
Which antipsychotic medication has been shown to have the least amount of weight gain
aripiprazole (Abilify)
Which mood stabilizer has the least amount of weight gain
lamotrigine (Lamictal)
Which antipsychotic medication is the least sedating
aripiprazole (Abilify)
Which antidepressant is least sedating
Lexapro (escitalopram)
Which mood stablizer is considered the safest during pregnancy
lamotrigine (lamictal)
Which SGA is known to have greatest potential for prolonging QT
ziprasidone (Geodon)
which SGA has the shortest half-life
ziprasidone (Geodon)
Concern of Kava for anxiety
has been associated with potential liver toxicity
Generic name for Latuda
larasidone - “give lara latitude”
ziprasidone Trade name
Geodon (Geod Don’s zipper)
Which medication is used as an ajunct medication to normalize prolactin levels with risperidone.
Apiprazole - Abilify
Which antipsychotic requires at least 350 calories of food for absorption
Latuda - Lurasidone
Geodon (500 calories)
which SGA is the most metabollicaly favorable
lurasidone (Latuda)
Mood neurotransmitters
- Serotonin body’s “feel good” transmitter
- low serotonin levels are associated with depression, anxiety and other mood disorders
- Dopamine - feelings of reward and motivation, decreased in depression and increased in mania
neurotransmitters involved in OCD
- Glutamate primary neurotransmitter in the cotico-striatal-thalmic circuit involved in OCD
- People with OCD have higher levels of glutamate in the brain, especially in the frontal regions particularly in the ACC (anterior cingulate cortex)
- Gaba - lower levels in frontal region particularly in the ACC
- Dopamine - dopaminergic overactivity is involved the frontostriatal pathways
- Serotonin - diminished in the frontolimbic systems
neurotransmitters involved in Parkinson’s
Increase acetylcholine
Decrease dopamine
Neurotransmitters involved in psychosis
Increased glutamate
Increase dopamine
Medications that can cause stomach pain
ranitidine, famotidine, omeprazole
Relationship between antipsychotics and antacids
Antacids decrease absorption of psychotropic medication
Primary Prevention
Prevent/promotion, safety initiatives, education, classes, modifying enviroment
Secondary
screen-early detection, crisis hotline, disaster
Tertiary
treat to prevent further deterioration, rehab, restoration, day treatment, social skills
IADLs
Instrumental activities of daily
* managing finances
* managing medication
* preparing meals
* cleaning (laundry, dishes, etc.)
* getting around (traveling, car, taxi, bus)
* commumicating - using phones, computers and other devices to communicate wit others
* Managing health - communicating with healthcare providers and scheduling appointmenst
ADLs - feeding, dressing, bathing, and walking
Cortical dementia examples
Alzheimers, creutzfield jacon disease
* Severe memory impairment with aphasia
subcortical dementia example and characterisitics
Huntington’s disease, parkinson’s disease and aids dementia
* Changes in personality and attention span, depression, clumsiness, irritability or apathy.
On a genetic profile screening what is considered normal
Extensive metabolizer
Lamictal side effects
(treats mood disorders and bipolar affective disorder)
Severe - Steven Johnson
Common - drowsiness, dizzy, ataxia, diplopia, nausea, headache, hepatotoxity
What medication when given with lamictal can double lamictal levels
Depakote
What medication when given with lamictal can decrease lamictal levels
carbamazepine
name the inhibitors and specific binding sites
- Buproprion (2D6)
- Clomipramine
- Cimetidine (1A2)
- Clarithromycin (3A4)
- Fluoroquinolones (1A2)
- Omeprazole (1A2)
- Grapefruit Juice
- Ketoconazole
- Nefazodone
- Alcohol (acute)
- Valporate
- SSRI (2D6)
Be Careful Cause COVID Feels Overwhelmingly Gross, Keep Nana always very Safe
Neuropeptides
- Substance P/endorphins
- serve to trigger and control the body’s response to injury and stress and is involved in pain perception
- Low levels are seen in substance abuse
what does excess of glutamate do?
- Ecitatory neurotransmitter so increased levels will increase anxiety
*
What does decreased levels of glutamate look like
- Memory and learning difficulty
- negative symptoms of schizophrenia
Examples of the neuropeptides involved in addiction
- Orexin AKA hypocretins regulate energy metabolism, sleep, feeding, and stress response. Drug abuse can alter orexin system which may contribute to uncontrolled drug intake and relapse
- Substance p related to pain perception, stress, immune response, and inflammation
- Endorphins
- Galanin - feeding and drug seeking behaviors
Tuberoinfundibular neural pathway
*originates from hypothalmus (specifically arcuate nucleus) to pituitary gland (anterior pituitary)
* Regulates release of dopamine
* .Primarily inhibits prolactin secretion
* When dopamine decreases, there is an increase in prolactin causing galactorrhea
* Rationale for antipsychotics prolactin side effect
Function of acetylcholine
cholinergic -
* Learning, short term memory, arousal, reward (delerium), motivation, ACH are higher during wake and REM sleep and lower during NREM sleep
Low levels of acetylcholine are associated with
Alzheimers disease / impaired memory
Increased levels of acetylcholine are associated with
parkinsonian symptoms (acetylcholine stimulates muscles to conract. Overstimulation causes tremors and jerking movements)
increased levels contribute to motor symptoms. Imbalance of reduced dopamine levels causing muscles to become over excited leading to tremors and other involuntary movements. Dopamine normally acts to inhibit acetlcholine release. when dopamine is low acetylcholine is high.
Decreasing GABA levels would have what effect?
Increase anxiety
Decreased levels of GABA are noted in this mood disorder
Depression
GABA is the site of action for what
- benzodiazepines, ETOH, barbituates, and other CNS depressants
- Benzodiazepines are used to bind with GABA receptors to potentiate calming effects of GABA
which conditions are associated with low levels of serotonin (5-HT)
depression, OCD, anxiety disorders, violence, schizoaffective and personality disorders
Norepinephrine function
- fight or flight
- arousal, reward, attention (depression, ADHD)
- major transmitter implicated in mood, anxiety, and concentration disorders
Low levels of norepinephrine are found in which disorders
- mood and concentration disorders
- Depression, schizophrenia, and parkinsons, ADHD
Increased levels of norepinephrine are noted in which disorders
anxiety
family systems theory
based on the idea that on cant understand a member/part without understanding how all family members operate together (system)
Overt rules
- part of family systems therapy
- openly stated and clearly communicated
**Example **- a set curfew, chore responsibilites, expectations regading respectful communication
covert rules
Family systems therapy concept that families are governed by unspoken rules, may not be explicity stated, but still guide their actions (family members may not be conciously aware of them).
Example: “dont show weakness”, “dont talk about problems”, “the father is the decision maker.”
Boundaries
Family systems therapy
* barriers that protect and enhance functional integrity of families, individuals and subsystems.