Definitions Flashcards
Efficacy
The maximum therapeutic effect a drug can achieve, weight with least side effects
Potency
The amount of the drug needed to achieve that maximum effect
Half-life
Time it takes for half of the drug to be removed from the bloodstream. (e.g. Drugs with shorter half life need to be given 3 or 4 times a day)
Typical Anti-Psychotics
traditional first generation major tranquilizers or neuroleptic drugs used in the treatment of psychiatric disorders. Often produced significant neurological side effects
Atypical Anti-Psychotics
new type of anti-psychotics (second generation) with less neurological side effects
Typical anti-psychotics mechanism of action
Dopamine antagonist
Atypical anti-psychotics mechanism of action
Dopamine antagonist and serotonin antagonist
Antagonist (drug type)
Works to block a certain type of receptors
BPSD
Behavioural and psychological symptoms of dementia
Catatonia
Abnormality of movement, may involve repetitive overactivity, or catalepsy (rigid trance or seizure with loss of sensation or consciousness) etc.
Extra pyramidal tracts
Start in the brain stem, carries motor fibres to spinal cord. Controls involuntary/autonomic muscle function.
Akathisia
Muscular discomfort and continuous motor restlessness. Unable to keep still. Can occur whenever but usually in first weeks of treatment. Associated with higher med doses. Anticholinergics effective.
Psuedo-parkinsonism
Tremor, muscle stiffness, shuffling gait, drooling, mask like face, slowed movement. Generally occurs beyond 1 week after starting medication. Due to lowered levels of dopamine.
Tardive dyskinesia (TD)
Spastic facial distortions/movements: mainly tongue, may extend to neck, trunk and extremities. Occurs beyond 6 months of starting treatment usually, may be permanent, occur on discontinuation, or resolve on own.
Neuroleptic malignant syndrome (NMS)
Rigidity, fever, tremor, altered level of consciousness, hypotension, tachycardia, elevated WBC and CK (Creatine Kinase). Mortality 10 – 20%
Anticholinergic side effects
Dry, blurred vision, constipation, urinary retention, mydriasis (dilated pupils)
Atypical anti-psychotics, alternative/special uses
- Mood stabilising properties
- BPSD management
Side effects of atypical anti-psychotics
Less chance of EPS or NMS than typicals. Associated with metabolic syndromes though: greater risk of weight gain/obesity (and therefore T2DM and CVD), lipid abnormalities, increased prolactin, hypertension. Monitoring of metabolic parameters required.
Acute dystonia
Involuntary muscular contractions or spasms that cause repetitive twisting. Can be painful and frightening. Occurs in neck, throat, and eyes, etc.
CIWA assessment
For alcohol addiction
Passivity delusion
Being controlled, thoughts are not one’s own
Clang association
Rhyming/similar sounding words
Thought blocking
Stops speaking in the middle of a sentence/thought
Circumstanciality/ circumstantial speech
Drifting to a different focus of conversation, but comes back to the point. Irrelevant details make it longer to get to the point
Poverty of ideas/thought
No thoughts, feeling of emptiness inside
Poverty of speech / alogia
Restricted speech that does not give any actual information, it is vague and empty, although can be a normal amount of words.
Blunted affect
Slow to react - inbetween restricted and flat
Flat affect
Almost none to no emotional response at all
Restricted affect
One affect the whole time
Euthymic
Normal level of mood
Dysthymic
Depressed mood
Labile mood
Rapid changing of mood
Congruent affect
Matches mood
Incongruent affect
Doesn’t match mood
Anhedonia
Loss of interest/pleasure
Avolition
Lack of motivation
Affective flattening
Symptom of depression, flat affect, showing little to no emotional response externally.
Alogia
Poverty of speech / thoughts
Agnosia
Inability to recognise objects (symptom of dementia)
Thought insertion
Thoughts of another person inserted into the patient’s mind
Thought broadcasting
Belief that others can hear your thoughts
Ideas of reference
Belief that occurrences in the world relate to the patient
Nihilistic delusion
Like dissociation, belief that the patient does not exist, or the patient is dead.
Persecutory delusion
In danger, under attack, threatened
Catatonia
Inability to move normally
Positive symptoms
Adds to patient’s life e.g. hallucinations, delusion
Negative symptoms
Takes away from patient’s life e.g. anhedonia, avolition
Brief psychotic episode
Between 1 and 30 days. More than 30 days can be diagnosed schizophrenia or other psychotic disorder
Phases of schizophrenia
Prodromal, acute, recovery
Dialectical behavioural therapy
focuses on mindfulness and distress tolerance
Motivational interviewing
focuses on feelings of ambivalence, best for addictions
Electro-convulsive therapy
Mostly used for major depression
How many older people experience depression?
15-20%
Stages of dementia
Mild, moderate, severe. Moderate being the longest stage, consisting of profound memory loss and disorientation
How to activate PSNS (parasympathetic nervous system)?
Deep breathing, with a focus on long exhalation
Symptoms of alcohol withdrawals
Nausea, tremors, agitation
Acetylcholine
Neurotransmitter that stimulates muscles and memory function. Relates to dementia
GABA
Neurotransmitter that regulates excitatory neurons and electric activity. Relates to anxiety.
Serotonin
Neurotransmitter that inhibits behaviour and activity, enhances sleep. Relates to depression.
Dopamine
Neurotransmitter that regulates decision making, fine muscle movement, emotions and thoughts. Relates to psychosis/schizophrenia (and parkinsons)
Epinephrine
Neurotransmitter related sympathetic nervous system (paranoia, mania vs. low, dull, depression)
Norepinephrine
Neurotransmitter that relates to sympathetic nervous system, alertness, focus and attention. (anxiety, paranoia vs. low, dull, depression)
Glutamate
Neurotransmitter that relates to memory, metabolic function, learning and thinking. Leads to neural death/degeneration, poor memory and learning, or lack of is related to schizophrenia.
Nigro-striatal
Dopamine pathway relating to involuntary muscle activity
Meso-limbic and meso-cortical
Dopamine pathway in which abnormal functioning causes psychotic symptoms
Tubero-hypophyseal
Dopamine pathway relating to neuroendocrine regulation
