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PMHNP > Bipolar Disorder Pathophysiology > Flashcards

Bipolar Disorder Pathophysiology Flashcards

1
Q

Etiology

A

Genetics

Epigenetics

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2
Q

Proposed pathophysiology

A

calcium dysregulation

dopamine hypothesis

Hypothalamic pituitary axis dysregulation

Autonomic dysregulation

Less popular:
Altered brain connectivity
oxidative stress
mitochondrial dysfunction
inflammatory markers
altered circadian rhythm

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3
Q

monoamine hypothesis of depression

A

Dec NE, 5HT, DA

leads to depression

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4
Q

monoamine receptor hypothesis of depression

A

Dec NE, 5HT, DA

leads to inc receptors (upregulate)

leads to depression

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5
Q

Glutamate

A

major excitatory NT in the CNS

Can turn on almost all CNS neurons

VSSC may modulate release

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6
Q

GABA

A

Gamma Aminobutyric Acid

Major inhibitory NT in the CNS

Opposes glutamate effects

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7
Q

How does norepinephrine form

A

Tyrosine (+enzyme)
leads to
DOPA (+enzyme)
leads to
Dopamine (+enzyme)
leads to
NOREPINEPHRINE

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8
Q

Presynaptic NE receptors

A

NET (transporter) clears excess NE out of synapse

VMAT2 takes NE up into vesicles and stores for future

A2 regulates release of NE from presynaptic neuron

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9
Q

Postsynaptic NE receptors

A

A1
A2a
A2b
A2c
B1
B2
B3

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10
Q

Dopamine formation

A

Tyrosine (+enzyme)
leads to
DOPA (+enzyme)
leads to
Dopamine

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11
Q

Presynaptic Dopamine receptors

A

DAT (transporter) clears excess DA out of synapse
VMAT2: stores in vesicles for future
D2 regulates release of DA from presynaptic neuron

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12
Q

Postsynaptic NE receptors

A

D1
D2
D3
D4
D5

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13
Q

Serotonin formation

A

Tryptophan (+enzyme)
leads to
5HTP (+enzyme)
leads to
Serotonin (5HT)

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14
Q

Serotonin receptor stimulation 5HT2A

A

5HT2A

Enhance glutamate release
leads to
release inhibitory GABA
leads to
Block downstream dopamine release

So agonism of receptor decreases dopamine

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15
Q

Serotonin receptor antagonism 5HT2A

A

5HT2A

Decrease glutamate
leads to
Decrease release of GABA
leads to
Stimulate dopamine release

So antagonism of receptor increases dopamine

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16
Q

Serotonin receptor stimulation 5HT1A

A

same as blocking 5HT2A in that it increases dopamine

17
Q

Autoreceptors job and name for NE, DA and 5HT

A

Regulate the release of the monoamine that acts on it

In the presence of the monamine will turn off further release of that monomamine

Autoreceptors
(1) NE
(a) A2

(2) DA
(a) D2

(3) Serotonin
(a) 5HT1A and 5HT1B/D

18
Q

Termination of monoamine action (inactivation)

A

Enzymes:
MAO A or B
COMT (only NE and DA)

turns NE, DA and 5HT into inactive metabolites

19
Q

Termination of monoamine action (removal from the synapse)

A

basically transporters

NET or NE reuptake

DAT

SERT

PMHNP (26 decks)

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