Neuro Theories & Psychopharmacology Flashcards
Neurotransmitters
chemical substances to facilitate neurotransmission
Excitatory Neurotransmitters
Dopamine
Norepinephrine
Epinephrine
Glutamate
Dopamine
complex movement
motivation
cognition
regulation of emotional response
Norepinephrine
attention, learning, memory
sleep, wakefulness
mood regulation
Epinephrine
fight or flight response
Inhibitory Neurotransmitters
Serotonin
GABA
Serotonin
food intake, sleep, wakefulness, temperature, pain control, sexual behaviors, mood
GABA
modulation of other neurotransmitters
Excitatory or Inhibitory
Acetylcholine
Acetylcholine
sleep and wakefulness cycle-signals muscles to become alert
Histamine
neuromodulator
Neurobiologic Causes
Genetics and Heredity
Psychoimmunology
Infections
Genetics and Heredity
Play a role, but is NOT solely genetic
Psychoimmunology
compromised immunity system possible contributes, especially in “at risk” populations
Infections
particularly viruses during fetal development
Psychotropic Drugs
Antipsychotic Antidepressants Mood stabilizers Anxiolytics Stimulants
Efficacy
the maximal therapeutic effect a drug can achieve
Potency
the amount of the drug needed to achieve the maximum effect
Off-Label Use
a drug will prove effective for a disease that differs from the one involved in original testing and FDA approval
Black Box Warning
label the FDA will issue if a drug is found to have serious or life threatening side effects, even of the side effects are rare
How is a medication selected?
Based on the effect on the client’s target symptoms
Should older adults start out with a higher dosage or a lower dosage?
lower
Should psychotropic drugs be stopped abruptly or slowly tapered off?
Tapering rather than abruptly to avoid rebound or withdrawal
Rebound
temporary return of symptoms
Withdrawal
new symptoms resulting from discontinuation of the drug
What is essential for ensuring compliance with the medication regime?
Follow-up care
What may increase compliance with the medication regime?
Simple regime
Antipsychotic Drugs
used to treat psychotic symptoms by blocking dopamine receptors
Antipsychotic Agents-Neuroleptics
Typical, First Generation or Conventional
Atypical Second Generation
Third Generation
First Generation Antipsychotics
Thorazine Fluphenazine Thioridazine Haloperidol Loxapine
Second Generation Antipsychotics
Clozapine
Risperidone
Olanzapine
Third Generation Antipsychotic
Dopamine System Stabilizers
Aripiprazole = Abilify
Extrapyramidal Side Effects (EPS)
serious neurologic symptoms are the major side effects of antipsychotic drugs
-acute dystonia, pseudoparkinsonism, akathsia
Acute Dystonia
acute muscular rigidity and cramping, stiff neck or thick tongue with difficulty swallowing, and in severe cases laryngospasms abd respiratory difficulties
Torticollis
twisted head and neck from spasms or stiffness in muscle groups
Opisthotonus
tightness in the entire body with head back and an arched neck
Oculogyric crisis
eyes rolled back in locked position
Pseudoparkinsonism
stooped posture, mask like faces, shuffling gate
Akathisia
restlessness, anxiety, agitation
What is the treatment for EPS?
Anticholinergic drugs or diphenhydramine
Neuroleptic Malignant Syndrome (NMS)
rigidity, high fever, unstable elevated BP, diaphoresis, delirium
Treatment for NMS
immediate D/C of antipsychotic
Supportive medical care to treat dehydration and hyperthermia
Tardive Dyskinesia
irreversible involuntary movement
Anticholinergic Effects
Dry mouth, constipation, urinary hesitancy, or retention
Treatment for Anticholinergic Side Effects
sugar free hard candies and gum, adequate fluids, increase fiber/stool softeners
Metabolic Syndrome
cluster of conditions that increase the risk for heart disease, diabetes, and stroke
How is Metabolic Syndrome diagnosed?
When 3 or more of the following are present:
Obesity, increased BP, high cholesterol, high blood sugar
Antidepressants
used in the treatment of major depressive illness, anxiety disorders, depressed phase bipolar disorder, psychotic depression
What are the four groups of Antidepressants?
Tricyclic and related cycle antidepressants (TCAs)
MAO Inhibitors
Selective Serotonin Reuptake Inhibitors (SSRIs)
MAO Inhibitors
Nardil (phenelzine)
Parnate (tranylcypromine)
Marplan (isocarboxazid)
What is the preferred drug for clients at high risk for suicide?
SSRI’s
Side Effects of SSRI’s
SEXUAL DYSFUNCTION, WEIGHT GAIN
anxiety, agitation, akathisia, nausea, insomnia
TCA’s Side Effects
Anticholinergic effects, orthostatic hypotension, sedation, weight gain, tachycardia, sexual dysfunction
MAOI’s Side Effects
DAYTIME SEDATION, insomnia, weight gain, dry mouth, orthostatic hypotension, sexual dysfunction
HYPERTENSIVE CRISIS
Hypertensive Crisis
happens with foods containing tyramine
severe hypertension, hyperpyrexia, tachycardia, daiphoresis, tremors, cardiac dysrhythmias
Serotonin Syndrome
Mix of taking MAOI + SSRI
agitation, sweating, fever, tachycardia, hypotension, coma, death
What time of the day should you take an SSRI?
first thing in the morning
When should you take a TCA?
at night
What is the gold standard for mood stabilizing drugs?
Lithium
Mood Stabilizing Drugs
treatment of bipolar disorder
Lithium Side Effects
nausea, diarrhea, anorexia, METALLIC TASTE, fatigue, WEIGHT GAIN
Toxic Dose = severe diarrhea, N/V, weakness, lack of coordination
Antianxiety Drugs
treatment of anxiety and anxiety disorders
insomnia, OCD, depression, PTSD, alcohol withdrawal
Most common Antianxiety Drug
Benzodiazepines
Benzodiazepine Side Effects
physical, psychological dependance
CNS depression
Hangover Effect
Tolerance