M13 - Medical Model and Neurobiology Flashcards
A branch of psychiatry that focuses on understanding mental disorders from a
biological standpoint.
Biological Psychiatry
Focused on the role of current emotional stressors, early childhood
traumas, interpersonal problems, and intrapsychic conflict as causal agents in the development of psychiatric
symptomatology.
Psychologically Oriented Psychiatry
using pharmaceutical drug
Pharmacotherapy
is the study of the use of medications in treating mental disorders.
Psychopharmacology
emphasizes the correlation between drug-induced changes in functioning of
cells in the nervous system and changes in consciousness and behavior.
Neuropsychopharmacology
- to ameliorate the symptoms
- to stabilize the patient using medication; - begins with the initial prescribing of medication, and generally lasts for a period of up to six
months of prescribed use (NIMH).
Acute Treatment
- to prevent relapse after the initial improvement.
- to minimize possibility of patient decompensation after stabilization;
- extends from six months to one year (NIMH).
Continuum Treatment
- to prevent future episodes of a disorder; prescribed drug use for a period of one
to two years; long-term treatment.
Maintenance Treatment
- deals with origin, source, identification, biosynthesis and isolation of the drug.
Pharmacognosy
deals with manufacturing of drugs with dosage, and purity.
Pharmaceutics
- deals with study of chemical nature and synthetic process involved in drug
development.
Pharmaceutical Chemistry
deals with the role of genetic variations in response
Pharmacogenetics
The study of what the body does to a drug.
Pharmacokinetics
the movement of a substance
absorbtion
- involves the scattering of drugs or substances throughout body tissues and fluids
distribution
the transformation or breakdown of substances such that
they are prepared for elimination from the body; occurs in the liver.
Metabolism (biotransformation)
- the process by which substances leave the body; occurs through the kidney
Excretion
- drug metabolism that occurs when a drug goes through the liver soon after
intestinal absorption, before reaching the systemic circulation
Liver First-Pass Extraction
- proportion of administered drug that reaches the systemic circulation
Bioavailability
- total area under the curve that describes the drug plasma as a function of time.
Area Under the Curve (AUC)
apparent volume in which the drug is distributed after absorption.
Volume Distribution (Vd)
drug quantity for unit of plasma
Concentration in Plasma (Cp)
highest plasma concentration.
Peak Plasma Concentration (Cmax)
time that it takes from drug administration to reach Peak
Plasma Concentration.
Time to Peak Plasma Concentration (Tmax)
volume of plasma completely cleared of the drug in a unit of time; the
cumulative result of drug removal that occurs in the liver, kidney, and other parts of the body.
Clearance (Plasma Clearance: CL)
is time required to bring down drug level in body by one half which is dependent on volume of
distribution and clearance.
Half Life
with repeated dosing some drugs accumulate, which is inversely proportional to the
fraction of the dose, lost in each dosing interval.
Drug Accumulation
- it can be immediate, delayed or cumulative
Drug Effect
It studies the mechanism of a drug action and the relationship between drug concentration and effect.
Pharmacodynamics
During absorption, drug-food interactions are more prevalent than drug-drug interactions. Example, absorption of antipsychotic drug, ziprasidone, is slowed down if taken without food. Interactions happen because of misinformation, misuse or often in instances where little or no
guidance is provided at all.
Drug Interactions
- Antidepressants, antipsychotics and some of the older anticonvulsants are linked to significant drug
interactions - Be on alert for the drugs with narrow therapeutic indexes
- Be aware that the risk of drug interactions increases as the number of medications the patient is taking increases.
Psycotropic Medication Drug Interactions Worth Noting
- secreted by the adrenal glands in response to stress or arousal - principal neurotransmitter of sympathetic nerve endings supplying the major organs
and skin. - regulates alertness, anxiety, tension, and the ability to have positive feelings.
- released in response to an imminent danger, resulting in an increase in heart rate, blood pressure and respiration.
- elevated levels can lead to states of increased anxiety, and in some cases, mania.
- low levels are implicated in depression.
Norepinephrine
- a vasoconstrictor present in blood serum that is liked to the regulation of mood, anger, aggression, anxiety, appetite, learning, sleep, sexual functioning, states of consciousness and pain. - low levels are associated with clinical depression, OCD and anxiety disorders.
Serotonin
- influences emotional behavior and cognition, and it regulates motor and endocrine activity, among other factors.
- functions in brain include attention, mood, sociability, motivation, desire, pleasure, and learning.
- associated with reward mechanisms in the brain.
- high level can lead to psychoses and schizophrenia
Dopamine
- an amino acid that is the CNS major inhibitory neurotransmitter. - regulation of this is associated with emotional balance, sleep patterns and anxiety.
- low levels are associated with increased anxiety, irritability and agitation.
- activation of this, results in decreased anxiety which can be facilitated through the
use of anti-anxiety agents, as well as mood stabilizing neuromodulators
GABA
- released through the stimulation of vagus nerve, which alters heart-muscle
contractility. - important to functional memory.
Acetylcholine
- brain’s primary excitatory neurotransmitter; basic building block of proteins and play an
important role in learning and memory.
Glutamate
- Beware of the words “studies show” or “clinical evidence indicates”.
- Realize that the peer review system is not perfect
- Look for who published the data
Research Studies
- Diagnostic journey begins with a thorough assessment of the presenting client’s situation. DSM stays on the
sidelines - Have the ability to frame a series of insightful
- Build rapport
- Observation
- Approach each session with a confident presence
Visits with the Client
- Dressing professionally
- Displaying symbols of comfort in your office
- Discreetly taking notes during sessions
- Leaning slightly forward when addressing the client as a gesture of interest and
- Continually soliciting the client’s beliefs and input when selecting treatment interventions.
Ways and Techniques for Developing Rapport