chapter 11 psychobiology and psychopharmacology Flashcards
Limbic system
what does it do?
regulate emotional experiences
amygdala is responsible?
fear
anxiety
fight or flight
if it is small !!!!
frontal lobe does what?
helps with speech, execution
temporal lobe does what?
balance
parietal lobe does what?
sensory stimuli
lets you know when its night or day
occipital lobe does what?
vision
Neurotransmitters to know!
Dopamine (DA)
Serotonin (5-HT or 5-hydroxytryptamine)
Gamma-Aminobutyric Acid (GABA)
how we feel pleasure, think and plan
stabilizes our mood, feelings of well-being, and happiness. if the level is off person can be depressed.
anti-seizure and anti-anxiety effects. works by blocking brain signals. usually alcoholism patient.
what are the major neurotransmitters that regulate mood?
dopamine
serotonin
norepinephrine
GABA
computed tomography (CT) can detect?
aneurism area
infarct
lesion
Magnetic resonance imaging (MRI) can detect?
edema
neoplasm
ischemia
positron emission tomography (PET) can detect?
oxygen utilization
glucose metabolism
blood
single photon emission computed tomography (SPECT) can detect
circulation of cerebrospinal fluid
what does an increase in epinephrine cause?
mania
anxiety state
schizophrenia
what does a decrease in epinephrine cause?
depression
what does increase in serotonin cause?
anxiety states
what does decrease in serotonin cause?
depression
what does increase in dopamine cause?
schizophrenia and mania
what does decrease in dopamine cause?
Parkinson’s disease
depression
what does an increase in glutamate cause?
decrease causes ???
prolonged increased state neurotoxic and neurodegeneration inalzheimer’s disease
psychosis
gamma-aminobutyric acid (GABA) an increase cause?
decrease of anxiety
gamma-aminobutyric acid (GABA) a decrease causes?
anxiety disorders
schizophrenia
mania
Huntington diseases (involuntary movement)
Antianxiety-Benzo
used for ______anxiety and agitation
increased risk of ________
side effects:____________
what are the meds??????
SHORT TERM
acute
addiction
drowsiness, fatigue, depression, dizziness, ataxia, slurred speech, weakness and forgetfulness
Diazepam
Clonazepam
Alprazolam
Lorazepam
Antianxiety Drugs-sleep
what are the drugs?
what are the drug that we have to make sure they don’t have any side effects?
Flurazepam
Temazepam -metal taste as side effect
Triazolam
Estazolam
Quazepam
Antianxiety drugs that are short-acting sedative-hypnotic sleep agents (z-hypnotics)
what are the drugs????
what are the drug that has side effect of sleep walking?
zolpidem -sleep walking side effect
zaleplon
eszopiclone
Antianxiety (melatonin receptor agonists)
what are the drugs?
what is the drug that is commonly used 4-6 weeks to be fully effective and not addictive? and also you don’t gain weight on it!
Ramelteon
Doxepin
Buspirone - not addictive, takes 4-6 weeks to work, you don’t gain weight from it.
Tricyclic Antidepressants (TCA’s)
what are the drugs?
Nortriptyline
Amitriptyline
Imipramine
selective serotonin reuptake inhibitors (SSRI’s) antideprassants
_____ line for anxiety and depression
what are the common side effects?
what is the syndrome that can develop?
what is serotonin discontinuation?
anxiety, agitation, GI upset, SEXUAL DYSFUNCTION
serotonin syndrome- (excess serotonin): medical emergency-diarrhea, restlessness, extreme agitation, seizure, hyperthermia, rigidity, coma, and possible death.
agitation, nausea, disequilibrium and flu-like symptoms.
what are the SSRI’s drugs? antidepressants
F
S
P
C
E
F
V
Fluoxetine
Sertraline
Paroxetine
Citalopram
Escitalopram
Fluvoxamine
Vortioxetine
serotonin-norepinephrine reuptake inhibitors (SNRI’s) antidepressants drugs?
V
D
D
Venlafaxine
Desvenlafaxine
Duloxetine
serotonin-norepinephrine disinhibitors (SNDI’s) antidepressant
what are they also called?
what are the drugs?
when do you give it and what can it cause?
noradrenaline and specific serotonergic agent
Mirtazapine
give at bedtime! highly sedating and can cause weight gain. give to patient that is not eating and needs to gain weight.
antidepressant drugs
Monoamine oxidase inhibitors (MAOI’s)
side effects:
meds?
orthostatic hypotension, weight gain, insomnia, sexual dysfunction and hypertensive crisis if ingested food with tyramine
Isocarboxazid
Phenelzine
Selegiline
Tranylcypromine
food that contains tyramine?
pickles
aged cheese
salami
alcohol
caffeine
chocolate
other antidepressant drugs
serotonin-2 antagonist/reuptake inhibitors (SARI’s)
meds?
Nefazodone -black box warning for hepatotoxicity so not a first line med
Trazodone - priapism in males!!!!!!!(painful erection)
other Antidepressant drugs
norepinephrine dopamine reuptake inhibitor (NDRI)
meds?
what are the risks?
if the client is very irritable, you don’t give it to them!
Bupropion
seizure risk: contraindicated in individuals with seizure history and bulimia
mood stabilizers
1. lithium
2. anticonvulsant drugs
mood stabilizers
what is the normal range for lithium?
what are the side effects?
what are the signs of lithium toxicity?
FLUID INTAKE SHOULD BE CONSISTENT
CHECK BUN AND CREATININE
- 6-1.2 normal range
- 5 or more -stop med and call provider
tremor, weight gain, sedation, stomach upset, polyuria, thirst edema of lower legs, hypothyroid, acne
diarrhea, nausea, vomiting, drowsiness, tremor, muscle weakness, tinnitus this is a medical emergency: stop meds immediately, emesis or lavage, check labs, and EKG dialysis be required.
Anticonvulsant Mood stabilizers
what are the meds that have lower weight gain?
lamotrigine
topamax
Anticonvulsant Mood stabilizers Side Effects
Valproate
what should the blood level be?
carbamazepine
what should blood levels be?
usually give this to eating disorder client!
Lamotrigine
Gabapentin
Topiramate
trileptal
spinal bifida, alopecia, weight gain, diarrhea, thrombocytopinia
50-125
neural tube defect, steven johnsons syndrome, aplastic anemia, agranulocytosis, liver problems, hyponatremia
blood levels 6-12
steven johnson syndrome, insomnia, headache, and dizziness
sedation, ataxia and decreased coordination
short term memory loss, nephrolithiasis, paresthesias, cognitive slowing.
hyponatremia, somnolence (can interfere with birth control prevention)
antipsychotic drugs
first generation drugs cover only ____ symptoms
blocks only_____
greater risk for __________
positive
dopamine
extrapyramidal symptoms
- dystonia (slow muscle spasm in the neck, face)
- tardive dyskinesia (objective abnormal, involuntary muscle movement)
- akathisia (subjective feeling of muscular discomfort and restlessness) cant stay still
- pseudoparkinsonism (shuffling gait)
second-generation (atypical) antipsychotic drugs
target what symptoms?
fewer extrapyramidal side effects
often chosen as first line treatment
what do they block?
positive and negative
dopamine and serotonin blockers
2 nd generation atypical antipsychotic drugs?
C
R
Q
O
Z
P
I
L
A
A
Clozapine
risperidone
quetiapine
olanzapine
ziprasidone (cause cardiac problem)
paliperidone
lloperidone
Lurasidone- very effective for bipolar depression
Asenapine
Apripiprazole (dopamine stabilizer
ADHD meds
check BP, can cause insomnia
METHYLPHENIDATE
ADDERALL -bing eating and watch for addictive behavior. check family for sudden death
ATOMOXETINE -good for pt with depression
INTUNIV-good for patient with HTN and tics
CLONIDINE-good for pt with HTN and tics
what does ADHD drugs suppress?
growth
appetite
alzheimers disease drugs
side effects:
drug? for severe dementia
drug? for mild to moderate
nausea, diarrhea, vomiting, appetite loss, increased gastric and secretion
Memantine -for severe dementia
Tacrine - not first line, hepatotoxic
donepezil-first line, can increase LFT’s
Galantamaine -
Revastigmine - available in a patch
herbal medicine
what are potential long-term effects?
adverse chemical reactions
nerve damage
kidney damage
liver damage
with other substances
with conventional medications
drink tea after. never give it together !!!!!!
