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Pharm Unit 5 > Intro to CNS, Depression, and Bipolar Mood Disorder > Flashcards

Intro to CNS, Depression, and Bipolar Mood Disorder Flashcards

1
Q

excitatory neurotransmitters

A

generate action potentials that release additional NTs at nerve endings

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2
Q

excitatory NT examples

A

ACH, NE, serotonin, DA

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3
Q

inhibitory neurotransmitters

A

inhibit generation of action potentials, reduce neuronal excitability and brain activity, promotes sleep

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4
Q

inhibitory NT examples

A

DA, GABA

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5
Q

what is cerebrum responsible for

A

higher intellect abilities

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6
Q

parts of cerebrum

A

cortex and medulla

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7
Q

cerebral cortex

A

outer gray matter, cell bodies

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8
Q

what is cerebral cortex responsible for

A

conscious activities, sensory perception, muscle movement, speech, abstract thought, problem solving, hearing, learning, memory, language, vision

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9
Q

cerebral medulla

A

inner, white matter nerve cell axons

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10
Q

what is cerebral medulla responsible for

A

regulation and coordination of motor activity, extrapyramidal system (EPS)

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11
Q

what is brain stem responsible for

A

unconscious control

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12
Q

parts of brain stem

A

pons, medulla oblongata

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13
Q

what is pons responsible for

A

regulation of respiration and sleep, relay station, reticular formation

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14
Q

what is medulla oblongata responsible for

A

vital centers, vasomotor/BP, cardiac, respiratory, swallowing/coughing/gagging

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15
Q

what is cerebellum responsible for

A

body movement, posture, equilibrium

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16
Q

what is thalamus responsible for

A

pain, temp, touch, some motor control, sends info to cerebral cortex

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17
Q

what is the hypothalamus responsible for

A

temp, appetite, sleep, sexual desire, water balance, ANS control, emotion/behavior response

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18
Q

spinal cord

A

collection of nerve axons travel to and from brain

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19
Q

afferent nerve

A

travel to brain, sensory info

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20
Q

efferent nerves

A

travel away from brain, motor impulses

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21
Q

excitatory fibers of CNS

A

stimulated by noise/light/danger, increases alertness

22
Q

inhibitory fibers of CNS

A

more active when there is no external stimuli, decreased alertness (sleep/rest)

23
Q

limbic system (CNS)

A

emotional and behavioral responses

reward, punishment, sexual behavior, anger, fear

24
Q

depression

A

decrease in NE and serotonin (5HT)

25
Q

two types of depression

A

exogenous/reactive and major depression disorder

26
Q

exogenous/reactive depression

A

shock or depression occurs by external factors, then resolution and readjustment occurs with support

27
Q

major depressive disorder

A

more serious, psychological disturbances, maladjustments, biochemical altercations occur, need for treatment

28
Q

mania

A

increase in NE and serotonin (5HT)

29
Q

what is the cause of mental illness

A

chemical imbalance

30
Q

drug therapy categories for depression

A

TCAs, MAOIs, SSRIs, SNRIs, miscellaneous

31
Q

tricyclic antidepressants (TCAs) MOA

A

block reuptake of NE and 5HT, increases level of neuronal activity to alleviate symptoms

32
Q

pt teaching/ SE of tricyclic antidepressants (TCAs)

A

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

33
Q

MAO inhibitors (MAOIs) MOA

A

block MAO, increase NE and 5HT

34
Q

pt teaching/SE for MAO inhibitors (MAOIs)

A

2-4 weeks for max effect, avoid foods with tyramine (can cause hypertensive crisis), report yellowing of skin

35
Q

selective serotonin reuptake inhibitors (SSRIs) MOA

A

block reuptake of 5HT, increase 5HT activity in brain

36
Q

pt teaching/SE of SSRIs

A

educate pt on signs of serotonin syndrome: agitation, sweating tremors, hyperreflexia, fever, tachycardia

37
Q

selective serotonin and norepinephrine reuptake inhibitors (SNRIs) MOA

A

block reuptake of 5HT and NE in brain, increases 5HT and NE

38
Q

pt teaching/SE of SNRIs

A

educate of signs of serotonin syndrome

39
Q

miscellaneous antidepressants MOA

A

can affect 5HT, NE, DA

40
Q

MOA of bupropion (Wellbutrin®) (miscellaneous AD)

A

NE and DA reuptake inhibitor

also used for pts to quit smoking

41
Q

MOA of mirtazapine (Remeron®) (miscellaneous AD)

A

tetracyclic, similar to SSRI but added receptor blocker to enhance neurotransmission

42
Q

MOA of trazodone (Desyrel®) (miscellaneous AD)

A

tetracyclic, similar to SSRI but added receptor blocker to enhance neurotransmission

43
Q

stepped care approach

A

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

44
Q

safety measures of AD

A

do not abruptly stop taking, must be discontinued under physicians care, need support system and counseling

45
Q

mania

A

mental state of excitement, hyperactivity, excessive elevation in mood, excess NE and 5HT

46
Q

symptoms of mania

A

hyperactivity, elated mood, unrealistic ideas, talkative, spontaneous

47
Q

bipolar mood disorder

A

alternating cycles of depression and mania, mood episodes, usually requires poly pharmacy

48
Q

drug for bipolar and mania tx

A

lithium carbonate (Lithium®)

49
Q

MOA of lithium carbonate (Lithium®) (bipolar and mania tx)

A

acts similar to sodium/Na, decreases excitability of nerve tissues, decreases release and reuptake of NE

50
Q

pt teaching/SE of lithium carbonate (Lithium®)

A

1-2 weeks to see effects, adequate sodium intake, may cause thirst, tremors, nausea, drug levels routinely checked, can interfere with thyroid function

51
Q

overdoe and toxic level symptoms of lithium carbonate (Lithium®)

A

OD: vomitting, diarrhea, ringing in ears, low BP, loss of equilibrium
toxic: nephritis, arrhythmias

52
Q

types of tx for bipolar mood disorder

A 
(Lithium®)
atypical antipsychotics
antidepressants
anticonvulsants
antianxierty

Pharm Unit 5 (6 decks)

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