Module 3: Understanding the Biological Components of Mental Illness Flashcards
Prefrontal cortex
front part of brain; very important for executive functioning; take in the environment; prioritize; make decisions
Amygdala, hippocampus, hypothalamus
very important for regulation of emotions and behavior
Function of Brainstem
- Core–regulates internal organs and vital functions
- Hypothalamus–basic drives and link between thought and emotion and function of internal organs
- Brainstem–processing center for sensory information coming from all areas of the body
Function of Cerebellum
- Regulates skeletal muscle
- Coordination and contraction of major muscle groups
Functions of Cerebrum
- At very base of brain–responsible for mental activities.
- Conscious–sense of being
- Emotional status
- Memory
- Control of skeletal muscles–movement
- Language and communication–difficulties with cerebrum will affect patients language.
Dendrites within the brain
- network of neurons
- neurons: smallest component of nerves within brain
- pass signals to various areas of brain
- neurotransmitters: vehicle for passing these signals
Neuronal cleft
- presynaptic membrane at top
- postsynaptic membrane at bottom
- neurotransmitters lie in the neuronal cleft where signals are transferred from neuron to neuron
- at times there is a lack of neurotransmitters within the cleft (one of the major theories of depression)
Neurotransmitters
- vehicles responsible for carrying signals for neuron to neuron
- GABA: responsible for psychotic thoughts
- Serotonin: responsible for depression and depressive disorders (lack of serotonin in neuronal cleft)
- Norepinephrine
- Dopamine
Anti-anxiety Medication
Anxiolytics
- Benzodiazepines (Ativan, Klonopin, Valium)–very short half life; can create tolerance = risk of abuse.
- Buspar (non-benzodiazepine)–takes 2-4 wks to start working; useful for patients with chemical dependency issues who can’t take benzos and for children on autism spectrum.
- Antidepressants–used as anti-anxiety med for patients with long-standing and chronic anxiety; SSRIs (prozac, paxil, zoloft)
Pharmacodynamics
understanding medications impact on the body
Pharmacokinesics
understanding the impact of the individuals body on the medication
Treating the elderly
- complicated livers
- slowed metabolism
- break up of medication in liver slowly
Anti-depressants
- SSRI (selective serotonin reuptake inhibitors)–introduced as first non-tricyclic antidepressant; Prozac, zoloft, paxil, celexa (lexapro)
- Tricyclic–older generation; a lot of side effects; not used as much anymore; Amitryptaline, imipramine, nortryptyline
- Venlafexine–blocks reuptake of serotonin and norepinephrine; newer generation; fewer side effects
Side Effects of Anti-depressants
- TCAs (tricyclic)–sedation, dry mouth, orthostatic hypotension
- SSRIs–weight gain (esp. Paxil), sedation, sexual dysfunction (men: erectile dysfunction; women: inorgasmia)
- Venlafaxine (Effexor)–anxiety, nausea, dry mouth
- Buproprion (Wellbutrin)–contraindicated in individuals w/ seizure hx because it lowers seizure threshold.
Mood Stabilizers
- First introduced in 1970s
- Lithium
- Anticonvulsant drugs (depakoate, tegretol, lamictal)
Lithium
- mood stabilizer
- metabolized and excreted through kidneys
- people with Lithium toxicity will have damage to their kidneys
- important to educate patients about salt intake, dehydration that can lead to lithium toxicity
Anticonvulsant drugs
depakoate, tegretol, lamictal
- often used for bipolar 1 manic depressive d/o w/ mania (depakoate and tegretol)
- mood stabilizer for patients of bipolar 2 (lamictal)
- serious side effects
- stevens johnson syndrome (necrotizing skin condition; patient looks sunburnt, sloughing off of skin)
- educate when beginning medication
- look for rashes that appear on trunk and face (esp. within 1st 8 wks)
Antipsychotics
- Conventional Antipsychotics
- Atypical 2nd generational, 3rd generational
Conventional Antipsychotics
-Phenothiazines
(Thorazine–rarely used now, Haldol, Prolixin)
-Strong blockers of dopamine, ACH, norepinephrine, and histamine–important to consider when talking about side effects
Side Effects for Conventional Antipsychotics
- Dopamine blocade = motor disturbances
(TD–tardive dyskinesia–permanent reaction to med; dyskinesia–sudden onset of spasms of muscles–psychiatric emergency, treat w/ benadryl; parkinsonism–pt has mask like face, shuffling gait; akathesia–feeling that you just can’t sit still) - Anticholinergic blockade = ACH side effects
(blurred vision, dry mouth, constipation) - Norepinephrine blockade = vasodilation, orthostatic hypotension
- H1 receptor blockade = sedation, weight gain
Atypical/Second Generation Antipsychotics
- bind with dopamine in the limbic system vs. basal ganglia
- largest and most problematic side effect–weight gain and metabolic syndrome (weight gain, increased abdominal girth, diabetes type 2, hypercholesterolemia)
Clozapine
atypical/3rd generation antipsychotic
- side effect = agranulocytosis (elimination of WBCs)
- used as a last resort
- tightly regulated
- 2 wk supply dispensed with WBC counts every 2 wks
Zyprexa
side effect of excessive weight gain
