CH2 Neurobiologic Theories And Psychopharmacology Flashcards
What are the 4 lobes of the Cerebrum and what does each control?
1) Frontal Lobe - Controls the organization of thought, body movement, memories, emotions, and moral behavior.
2) Parietal Lobes - Taste, touch and spatial orientation.
3) Temporal Lobes - Smelling, hearing, memory, and emotional expression.
4) Occipital Lobes - Language and visual interpretation (i.e., depth perception).
What is the difference, with respect to function, between the right and left brain?
1) Left Brain - Controls the right side of the body and is the center for reasoning and analytical functioning such as reading, writing and math.
2) Right Brain - Controls the left side of the body and is the center for active thinking, intuition and artistic abilities.
Which 3 Psych disorders are associated with abnormalities in the Frontal Lobes?
1) Schizophrenia
2) ADHD
3) Dementia
What is the function of the cerebellum and how is associated with Parkinson’s Disease and Dementia?
The Cerebellum coordinates movement and postural adjustments. Research has shown that ⬇ Dopamine to this area is associated with lack of smooth coordinated movement as seen in Parkinson’s Disease and Dementia.
Describe the anatomical location of the midbrain. What is it’s function?
The midbrain connects the Pons and the Cerebellum. It controls the Reticular Activating System and the Extrapyramidal System.
What is the function of the Reticular Activating System and the Extrapyramidal System.
1) Reticular Activating System - Motor activity, sleep/consciousness, and awareness.
2) Extrapyramidal System - Relays information about movement and coordination from the brain to the spinal nerves.
What is the Locus Ceruleus?
Locus Ceruleus - A small group of Norepinephrine-producing neurons in the brain stem associated with stress, anxiety, and impulsive behavior.
Where is the Limbic System and which anatomical structure are included?
The Limbic System is an area of the brain located above the brain stem and includes the following:
1) Thalamus - Regulates activity, sensation, and emotion.
2) Hypothalamus - Regulates temperature, appetite control, endocrine function, sex drive and impulsive behavior associated with anger, or excitement.
3) Hippocampus - Emotional arousal
4) Amygdala - Memory
Define Psychoimmunology
Psychoimmunology - A new field of study that examines the effect of psychosocial stressors on the body’s immune system.
Define Depot Injection
Depot Injection - A slow release, injectable form of antipsychotic medication for maintenance therapy.
What are the 4 Excitatory Neurotransmitters and what do each control?
1) Dopamine - Complex movements, motivation, cognition, regulation of emotional response.
2) Norepinephrine - Attention, learning, memory, sleep/wakefulness, moods.
3) Epinephrine - Fight or flight response.
4) Glutamate - Major neurotoxic effects at high levels.
What are the 2 Neurotransmitters that are Inhibitory and what does each regulate?
1) Serotonin - Food intake, sleep/wakefulness, temp, pain, sexual behaviors and emotions.
2) GABA - Regulates other Neurotransmitters.
Which Neurotransmitter is both excitatory and inhibitory and what does it regulate?
Acetylcholine - Regulates sleep/wakefulness, and signals muscles to become alert.
Which Neurotransmitter is classified as a neuromodulator?
Histamine
Define the following terms as they relate to Psychopharmacology:
1) Efficacy
2) Potency
3) Half-Life
1) Efficacy - Maximum therapeutic effect
2) Potency - Amount of drug needed for maximum effect.
3) Half-Life - Amount of time it takes for half the drug to be eliminated form the body.
What are the 3 types of Neuroleptics (Antypsychotic drugs)?
1) Conventional - Chlorpromazine, fluphenazine, thioridazine, haloperidol, loxapine.
2) Atypical - Clozapine, risperidone, olanzapine.
3) New Generation (Dopamine system stabilizers) - Aripiprazole
What is the MOA of Neuroleptics aka Antipsychotic drugs?
Neuroleptics block dopamine receptors
What are the 4 main side effects and 4 less common side effects of Antipsychotics.
MAIN SIDE EFFECTS 1) Extrapyramidal Syndrome 2) Neuroleptic Malignant Sysndrome 3) Tardive Dyskenesia 4) Anticholinergic Effects LESS COMMON SIDE EFFECTS 1) ⬆ Prolactin 2) Weight gain (Atypical agents except zipasidone) 3) Prolonged QT intervals 4) Agranulocytosis (clozapine)
What are the symptoms of the following side effects associated with Antipsychotic drugs:
1) Extrapyramidal Syndrome
2) Neuroleptic Malignant Sysndrome
3) Tardive Dyskenesia
4) Anticholinergic Effects
1) Extrapyramidal Syndrome - Includes Acute Dystonia, Pseudoparkinsonism, and Akathisia.
2) Neuroleptic Malignant Syndrome - Ridgidity, high fever, unstable BP, diaphoresis, pallor, delirium, ⬆ phosphor insane.
3) Tardive Dyskenesia - Involuntary movements of the tongue, face, neck, extremities and truncal musculature.
4) Anticholinergic Effects - Dry mouth constipation, urinary retention, blurred vision, photophobia, nasal congestion and memory loss.
What signs should the nurse look for in patient with the following Extrapyramidal Symptoms associated with the use of Antipsychotic drugs:
1) Dystonia
2) Pseudoparkinsonism
3) Akathisia
1) Dystonia - Acute muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing, and laryngospasms.
2) Pseudoparkinsonism - Stiff/stooped posture, mask-like facies, ⬇ arm swing, shuffling gait, drooling, tremor and bradycardia.
3) Akathisia - An intense need to move about. Client appears restless, anxious, and agitated.
What are the 4 types of Antipdepressants?
1) Tricyclic and related cyclic Antidepressants (TCAs)
2) Selective Serotonin Reuptake Inhibitors
3) Monoamine Oxidase Inhibitors (MAOIs)
4) Others - i.e., venlafaxine, buprioprion, duloxitine, trazodone, nefazodone. L
What are the 7 Side Effects of SSRIs used to treat depression?
1) Anxiety
2) Agitation
3) Akathisia
4) Insomnia
5) Nausea
6) Sexual Dysfunction
7) Weight gain
What are the 6 Side Effects of TCAs used to treat depression?
1) Anticholinergic effects
2) Orthostatic hypotension
3) Sedation
4) Weight gain
5) Tachycardia
6) Sexual dysfunction
What rare the 7 Side Effects of the MAOIs used to treat depression?
1) Daytime sedation
2) Insomnia
3) Weight gain
4) Dry mouth
5) Orthostatic hypotension
6) Sexual dysfunction
7) Hypertensive crisis (with foods containing Tyramine)
What is Serotonin Syndrome and what are the SxS?
Serotonin Syndrome is. Drug interaction that happens when a patient takes and SSRI in conjunction with an MAOI. SxS include agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia, coma and death.
Whatare the appropriate teaching for a patient taking SSRIs, TCAs, and MAOIs?
1) SSRIs - Take 1st thing in the morning, skip dose if missed dose is over 8 hours.
2) TCAs - Take at night and skip dose if missed dose is over 3 hours.
3) MAOIs - Avoid foods with Tyramine i.e., cheeses, aged meats, and beers.
Which drug is the first line of choice in the treatment of Bipolar disorder?
Lithium
Which 5 Anticonvulsants are used as mood stabilizers in treating bipolar disorder?
1) Carbamazepine
2) Valproic acid
3) Topiramate
4) Gabapentin
5) Oxcarbazepine
Define Kindling Process
Kindling Process - the snowball like effect seen when minor seizure activity seems to build up into more frequent and severe seizures.
What are the 9 common side effects of Lithium?
1) Nausea
2) Diarrhea
3) Anorexia
4) Fine hand tremor
5) Polydipsia and polyuria
6) Metallic taste
7) Fatigue
8) Weight gain
9) Acne
What are the 5 SxS of Lithium Toxicity?
1) Vomiting
2) Diarrhea
3) Muscle weakness
4) Drowsiness
5) Lack of coordination
What are the side effect of the following Anticonvulsants used to as mood stabilizer to treat bipolar disorder:
1) Carbamazepine
2) Valproic Acid
3) Topiramate
1) Carbamazepine - Drowsiness, sedation, dry mouth, blurred vision, rash and orthostatic hypotension.
2) Valproic Acid - Drowsiness, sedation, dry mouth, blurred vision, weight gain, alopecia, and hand tremor.
3) Topiramate - Drowsiness, sedation, dry mouth, blurred vision, dizziness, sedation, and weight loss.
What are the appropriate patient teaching for a patient taking Lithium and Anticonvulsants for Tx of Bipolar disorder?
1) Check blood levels of lithium 12 hours after dose
2) Take these drugs with meals
What are the 4 Side affects of Benzodiazepines used to treat anxiety?
1) Physical and psychological dependence
2) Tolerance build up
3) CNS depression
4) Hangover effect
What are the 2 Side affects of Buspirone, used to treat anxiety?
1) Dizziness
2) Sedation
3) Nausea
4) Headache
What should you teach your patient who is taking Benzodiazapines or Buspirone to treat their anxiety?
1) Avoid alcohol (Benzodiazepines potentiate alcohol’s side effects)
2) Do not discontinue use abruptly
What are some of the drugs included in the Stimulant drug class and what are their indications?
Stimulants include Amphetamines such as methylphenidate (Ritalin), adderall, and dextroamphetamine.
Stimulants are indicated for ADHD, ADD, and narcolepsy.
What are the 4 Side Effects of Stimulants?
1) Anorexia
2) Weight Loss
3) Irritability growth
4) Weight Suppression
What 4 patient teachings are appropriate for a client taking stimulants?
1) Dose after meals
2) Avoid caffeine, sugar and chocolate
3) Take drug holidays to normalize growing process
4) Store out of reach of children
What is the indication for the Disulfiram (Antabuse)?
Used as a deterrent from drinking alcohol.
What are the 5 Side Effects experienced by clients taking Disulfiram?
1) Fatigue
2) Drowsiness
3) Halitosis
4) Tremor
5) Impotence
What are some common products that contain alcohol that should be avoided by clients taking disulfiram?
1) Shaving cream
2) Deodorant
3) OTC cough meds
In which 3 ways are Extrapyramidal Symptoms (dystonia, akathisia, and pseudopasrkinsonism) managed?
1) Lowering the dosage of the antipsychotic
2) Changing to a different antipsychotic
3) Administering anticholinergics (i.e., Cogentin or Benadryl)
Which 3 major disorder of spasms and stiffness can happen to patients with Acute Dystonia?
1) Torticollis - Twisted head and neck
2) Opisthotonus - Tightness in the entire body with the head back and an arched neck.
3) Oculogyric - Eyes rolled back in a locked position
Along with Anticholinergics, which other drug can be administered to a patient experiencing Pseudoparkinsonism?
Amantadine - A dopamine agonist that increases transmission of dopamine blocked by the antipsychotic drugs.
Along with Anticholinergics, which other drug can be administered to a patient experiencing Akathisia?
Beta-Blockers or Benzodiazapines
What is Tardive Dyskenesia?
Tardive Dyskinesia is a syndrome of PERMANENT involuntary movement caused by the longterm use of conventional antipsychotics.
Clozapine is Atypical antipsychotic drug that has a high risk of causing Agranulocytosis. What are the symptoms of Agranulocytosis and how is it treated?
SxS of Agranulocytosis are fever, malaise, ulcerative sore throat and leukopenia.
