Intro to CNS, Depression, and Bipolar Mood Disorder Flashcards
excitatory neurotransmitters
generate action potentials that release additional NTs at nerve endings
excitatory NT examples
ACH, NE, serotonin, DA
inhibitory neurotransmitters
inhibit generation of action potentials, reduce neuronal excitability and brain activity, promotes sleep
inhibitory NT examples
DA, GABA
what is cerebrum responsible for
higher intellect abilities
parts of cerebrum
cortex and medulla
cerebral cortex
outer gray matter, cell bodies
what is cerebral cortex responsible for
conscious activities, sensory perception, muscle movement, speech, abstract thought, problem solving, hearing, learning, memory, language, vision
cerebral medulla
inner, white matter nerve cell axons
what is cerebral medulla responsible for
regulation and coordination of motor activity, extrapyramidal system (EPS)
what is brain stem responsible for
unconscious control
parts of brain stem
pons, medulla oblongata
what is pons responsible for
regulation of respiration and sleep, relay station, reticular formation
what is medulla oblongata responsible for
vital centers, vasomotor/BP, cardiac, respiratory, swallowing/coughing/gagging
what is cerebellum responsible for
body movement, posture, equilibrium
what is thalamus responsible for
pain, temp, touch, some motor control, sends info to cerebral cortex
what is the hypothalamus responsible for
temp, appetite, sleep, sexual desire, water balance, ANS control, emotion/behavior response
spinal cord
collection of nerve axons travel to and from brain
afferent nerve
travel to brain, sensory info
efferent nerves
travel away from brain, motor impulses
excitatory fibers of CNS
stimulated by noise/light/danger, increases alertness
inhibitory fibers of CNS
more active when there is no external stimuli, decreased alertness (sleep/rest)
limbic system (CNS)
emotional and behavioral responses
reward, punishment, sexual behavior, anger, fear
depression
decrease in NE and serotonin (5HT)
two types of depression
exogenous/reactive and major depression disorder
exogenous/reactive depression
shock or depression occurs by external factors, then resolution and readjustment occurs with support
major depressive disorder
more serious, psychological disturbances, maladjustments, biochemical altercations occur, need for treatment
mania
increase in NE and serotonin (5HT)
what is the cause of mental illness
chemical imbalance
drug therapy categories for depression
TCAs, MAOIs, SSRIs, SNRIs, miscellaneous
tricyclic antidepressants (TCAs) MOA
block reuptake of NE and 5HT, increases level of neuronal activity to alleviate symptoms
pt teaching/ SE of tricyclic antidepressants (TCAs)
therapeutic effect in 2-4 weeks and remains 2 week after D/C drug
may cause sedation/drowsiness, dry mouth, constipation, urinary retention, rapid HR, hypotension, blurred vision, tremors, restlessness, arrhythmias, jaundice
MAO inhibitors (MAOIs) MOA
block MAO, increase NE and 5HT
pt teaching/SE for MAO inhibitors (MAOIs)
2-4 weeks for max effect, avoid foods with tyramine (can cause hypertensive crisis), report yellowing of skin
selective serotonin reuptake inhibitors (SSRIs) MOA
block reuptake of 5HT, increase 5HT activity in brain
pt teaching/SE of SSRIs
educate pt on signs of serotonin syndrome: agitation, sweating tremors, hyperreflexia, fever, tachycardia
selective serotonin and norepinephrine reuptake inhibitors (SNRIs) MOA
block reuptake of 5HT and NE in brain, increases 5HT and NE
pt teaching/SE of SNRIs
educate of signs of serotonin syndrome
miscellaneous antidepressants MOA
can affect 5HT, NE, DA
MOA of bupropion (Wellbutrin®) (miscellaneous AD)
NE and DA reuptake inhibitor
also used for pts to quit smoking
MOA of mirtazapine (Remeron®) (miscellaneous AD)
tetracyclic, similar to SSRI but added receptor blocker to enhance neurotransmission
MOA of trazodone (Desyrel®) (miscellaneous AD)
tetracyclic, similar to SSRI but added receptor blocker to enhance neurotransmission
stepped care approach
week 1: increase sleep and appetite
weeks 1-3: thinking normalizes, sexual desire increases, self care improves
weeks 4-6: mood improves, less hopelessness, decreased suicidal thoughts
safety measures of AD
do not abruptly stop taking, must be discontinued under physicians care, need support system and counseling
mania
mental state of excitement, hyperactivity, excessive elevation in mood, excess NE and 5HT
symptoms of mania
hyperactivity, elated mood, unrealistic ideas, talkative, spontaneous
bipolar mood disorder
alternating cycles of depression and mania, mood episodes, usually requires poly pharmacy
drug for bipolar and mania tx
lithium carbonate (Lithium®)
MOA of lithium carbonate (Lithium®) (bipolar and mania tx)
acts similar to sodium/Na, decreases excitability of nerve tissues, decreases release and reuptake of NE
pt teaching/SE of lithium carbonate (Lithium®)
1-2 weeks to see effects, adequate sodium intake, may cause thirst, tremors, nausea, drug levels routinely checked, can interfere with thyroid function
overdoe and toxic level symptoms of lithium carbonate (Lithium®)
OD: vomitting, diarrhea, ringing in ears, low BP, loss of equilibrium
toxic: nephritis, arrhythmias
types of tx for bipolar mood disorder
(Lithium®) atypical antipsychotics antidepressants anticonvulsants antianxierty
