Mental health pharmacology Flashcards
Serotonin:
function and problems caused by imbalances
- function: affects mood, hunger, sleep, and arousal
- undersupply linked to depression
Dopamine
function and problems caused by imbalances
- function: influences movement, learning, attention, and emotion
- oversupply linked to schizophrenia
- undersupply linked to tremors and decreased mobility in parkinsons disease and ADHD
Acetylcholine
function and problems caused by imbalances
- function: enables muscule action, learning, memory
- ACh producing neurons deteriorate as alzhemiers disease progresses
Norepinephrine
function and problems caused by imbalances
- Helps control alertness and arousal
- undersupply can depress mood and cause ADHD-like attention problems
GABA
function and problems caused by imbalances
- function: major inhibitory neurotransmitter
- undersupply linked to seizures, tremors, and insomnia
Glutamate
function and problems caused by imbalances
- a major excitiroy neurotransmitter, involved in memory
- oversupply can overstimulate the brain, producing migraines, or seizures; this is why some people avoid monosodium glutamate in foods
Neuroleptic malignant syndrome
- medical emergency
- signs: catonia (no response), stupor (slow response), rigitidy, tremors
- can lead to death
- related to high dose of antipsychotics
- also related to abrupt withdrawl of dopamine
EPS
extrapyramidal symptoms
- akathisa: inability to remain still
- dyskinesia/dystonia
- pseudoparkinsomism
- tardive dyskinesia
Tardive dyskinesia
- repetitive, involuntary movements
- caused by supersensitivity of dopamine receptors rather than blockade
- irreversible, related to total lifetime dose
- tongue movements, lip smacking, grimacing
Nonmotor effects of medication
- metabolic effects (wt gain, DM)
- sedation
- anticholinergic effects -increased HR, blurred vision, dry mouth, constipation, urinary retention
Lithium
1. indications
2. adverse reactions
3. common examples
- indications: bipolar disorder
- adverse reactions: Li Toxicity with dehydration
- GI upset,
- tremor
- weight gain
- hypothroidism
- common examples: lithium
Antipsychotics
1. indications
2. adverse reactions
3. common examples
- indications: schizophrenia
- adverse reactions: agent dependent, sedation, orthostasis, weight gain, QT prolongation, EPS
- common examples: haldol, seroquel, clozapine, abilify
SSRIs
1. indications
2. adverse reactions
3. common examples
- indications: anxiety, depression
- adverse reactions: anxiety, irritability, sedation, sexual dysfunction, serotonin syndrome
- common examples: prozac, paxil, zoloft
SNRIs
1. indications
2. adverse reactions
3. common examples
- indications: depression, fibromyalgia, diabetic peripheral neuropathy pain
- adverse reactions: anticholinergic side effects
- common examples: Cymbalta
Tricyclic antidepressants
1. indications
2. adverse reactions
3. common examples
- indications: insomnia, neurapathic pain, fibromyalgia, depression limited
- adverse reactions: sedation, anticholinergic, weight gain, sexual dysfunction, lethal in OD caused by cardiovascular effects- hypotension, seizures, arrhythmias
- common examples: Elavil
Benzodiazepines
1. indications
2. adverse reactions
3. common examples
- indications: anxiety/insomnia
- adverse reactions: hangover effect, drowsiness, sedation, confusion, decreased concetration and recall, tolerance and dependence risk of toxicity in OD
- common examples: ativan, Xanax, Klonopin
Adverse effects of mental health medications
increased serotinin levels
- monitor dehydration because ADH is affected
- headache
- confusion
- loss of appetite
- muscle cramps
Adverse effects of mental health medications
Extrapyramidal effects
- dystonias
- sustained abnormal movemens
- restlessness, anxiety, akathisia (pacing), parkinson-like symptoms
- long term use can cause permanent choreoathetiod movements of face, jaw, tongue and extremities
Adverse effects of mental health medications
Anticholinergic effects
- increase heart rate
- dry mouth, constipation
- blurred vision
- urinary retention
Adverse effects of mental health medications
Neuroleptic malignant syndrome
signs and symptoms
- medical emergence
- catatonia
- stupor
- rigidity
- tremor
- fever
Lithium
- indications:
- side effects:
- indications: bipolar disorder
- side effects: GI upset, tremor, weight gain, hypothyroidism
lithium toxicity
- CNS signs
- GI:
- ECG changes
- renal
- CNS signs: tremor, fatigue, weakness, ataxia, confusion, seizures, coma
- GI: nausea, loss of appetite, abdominal pain vomiting, diarrhea
- ECG changes: sycope, bradycardia, arrhythmias
- renal: polydipsia, polyuria/renal insufficiency
Typical anti-psychotis
- action:
- indications
- implications for PT:
- action: dopamine recepotr blockade, no effect on 5 HT, serotonin, treat postive symptoms
- indications: schizophrenia
- implications for PT: aware of SE, EPS
Typical anti-psychotics
side effects
- metabolic
- anticholinergic SE
- EPS: more common with higher potency agents
- QT prolongation, hyperprolactinemia
- wt gain, sedation sexual dysfunction
