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psychobiological influences Flashcards

1
Q

psychobiology

A

the study of the effect of biological influences on behavior, emotions, and cognitive processes

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2
Q

origins of psychiatric illness

A

genetics, neurodevelopment, drugs, infections, psychosocial experiences

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3
Q

target of psychotropic drugs

A

alterations in brain function

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4
Q

when did tx of mental illnesses with psychotropic drugs begin?

A

1950s

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5
Q

brain stem

A

connects spinal cord to the brain, controls autonomic body funtions, cranial nerves arise here

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6
Q

cerebrum

A

largest portion if the brain, 2 hemispheres and 4 lobes

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7
Q

cerebellum

A

control center for coordination of voluntary movements, maintains equilibrium, muscle tone, and postural control

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8
Q

frontal lobe

A

insight, decision making, motivation, judgement, voluntary motor ability

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9
Q

temporal lobe

A

connects to limbic system (emotional brain), allows expression of all emotions such as love, hate, aggression, fear

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10
Q

occipital lobe

A

interprets visual images & language formation

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11
Q

parietal lobe

A

concept formation and abstraction, reading, math, right and left orientation

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12
Q

neurotransmitters

A

give rise to human activity, body functions, emotions, dreams, memory, creativity, intelligence

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13
Q

neurotransmitters are manufactured in the

A

neurons, then released from axons into the synaptic cleft, then to be received by dendrites

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14
Q

what causes the process of neurotransmission to occur?

A

stimuli snd memories

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15
Q

neuroendocrinology

A

study of the interaction between the nervous system and the endocrine system

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16
Q

a decreased level of thyroid hormone results in

A

a lowered basal metabolic rate and is indicated in depressive disorders

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17
Q

an increased level of thyroid hormone is indicated in

A

manic episodes or psychosis

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18
Q

increased cortisol may be related to

A

depression

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19
Q

depression is associated with dysfunction of the

A

adrenal cortex & is commonly observed in both addisons and cushings syndrome

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20
Q

cortisol -

A

slows down the immune system, freeing the energy dedicated for immune functions to flow into fight or flight rxns

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21
Q

ultradian rhythm

A

blinking, heart rate, appetite

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22
Q

rhythm pattern disturbances are well documented in

A

bipolar disorders and depression

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23
Q

kindling

A

psychological process similar to the seizure phenomenon, the limbic system is the recipient of repeated, daily subthreshold electrical stimulation, leading to an increase responsiveness to stable low doses of the stimulus

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24
Q

result of kindling

A

covert seizure like activity, a lowered seizure threshold, eventually the client becomes ultra sensitive that seizures occur from a milder stimulus or even absence of any stimulus

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25
Q

the ideal psychiatric drug

A

relieves mental systems w/out inducing unwanted mental effects

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26
Q

benzodiazepines

A

promote the activity of GABA

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27
Q

antianxiety/ benzo

A

alprazolam (xanax)

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28
Q

benzodiazepine uses

A

ptsd, anxiety, skeletal muscle disorders, ETOH w/drawal, panic disorders, insomnia

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29
Q

benzodiazepine AE

A

addictive, w/drawl, sedation, ataxia, dizziness, feelings of detachment, increased irritability, hostility, rebound insomnia/anxiety

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30
Q

benzo antagonist

A

flumazenil/ romazicon

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31
Q

benzodiazepine interaction

A

interacts w/ alcohol, barbs, opioids = resp depression

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32
Q

short acting sedative hypnotic drugs

A

zolpidem/ambien, zaleplon/sonata, eszopiclone/lunesta

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33
Q

tricyclic antidepressants

A

amitriptyline/elavil

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34
Q

TCA AE

A

sedation, weight gain, orthostatic hypotension, anticholinergic, photosensitivity

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35
Q

anticholinergic effects

A

dry mouth, urinary retention, constipation, blurred vision, weight gain, sedation

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36
Q

TCA implications

A

black box warning, high overdose potential, taper dose, sedation

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37
Q

SSRI

A

fluoxetine

38
Q

SSRI AE

A

akathisia, agitation, insomnia, GI disturbances, sexual dysfuntion

39
Q

serotonin syndrome

A

2-72 hrs after starting tx, confusion, agitation, poor concentration, disorientation, seizures, tachycardia, fever, nausea, vomiting, coma

40
Q

SNRI

A

venlafaxine

41
Q

venlafaxine AE

A

increase BP and pulse

42
Q

MAOi’s

A

isocarboxazid

43
Q

Foods to avoid with MAOi’s

A

cheese, aged protein, pickles/smokes foods, wines/draft beer, yeast, overripe fruit, MSG, beef/chicken liver

44
Q

MAOi AE

A

hypertensive crisis when pt eats tyramine containing food

45
Q

mood stabilizer

A

lithium

46
Q

lithium uses

A

acute mania, recurrent bipolar, aggressive conduct disorder

47
Q

lithium toxicity

A

usually dose related, nausea/vomit, diarrhea, hand tremor, twitching, lethargy, deep tendon reflexes can lead to death

48
Q

tx for lithium toxicity

A

hold med, vital signs (LOC & rectal temp), protect airway, check Li blood levels, hydration

49
Q

common cause of Li toxicity

A

decreased Na intake, diuretic therapy, decreased renal func, medical illness, OD, fluid/electrolyte loss, NSAID tx

50
Q

Li therapy teaching

A

2-3 fluid/day, know signs of toxicity, periodic blood levels, physical checkup,

51
Q

mood stabilizers- antidepressants

A

valproate

52
Q

valproate

A

use- bipolar
AE- thrombocytopenia, hepatic dysfunction

53
Q

antipsychotic uses

A

schizophrenia, organic brain syndrome w psychosis, psychotic depression, acute mania, vocal tics, aggressiveness

54
Q

antipsychotics action (typical)

A

dopamine antagonists

55
Q

antipsychotics action (atypical)

A

dopamine antagonists and blocks serotonin reuptake

56
Q

what do antipsychotics decrease the availibility of to basal ganglia?

A

dopamine

57
Q

positive symptoms of schizophrenia

A

hallucinations, delusions, bizarre behaviors, disorganization

58
Q

negative symptoms of schizophrenia

A

poverty of speech, flat affect, decreased social interaction, low motivation, low energy

59
Q

antipsychotic drug

A

chlorpromazine

60
Q

chlorpromazine action

A

strong antagonists, block attachment of dopamine, reduce dopaminergic transmission

61
Q

chlorpromazine AE

A

weight gain, sedation

62
Q

what do nurses need to monitor with chlorpromazine?

A

extrapyramidal symptoms - acute dystonia (1-5 days after 1st dose), pseudoparkinsonism (5-30 days after 1st dose), akathisia (5-60 days after), tardive dyskinesia (months to yrs)

63
Q

neuroleptic malignant syndrome manifestations

A

sudden high fever, muscle rigidity, BP fluctuation, diaphoresis, tachycardia, LOC decreased, coma

64
Q

NMS nursing action

A

med emergency- happens w/in 1st wk of tx– stop med, admin dantrolene (musc relax), transfer to ICU, wait 2 weeks for therapy resume

65
Q

2nd gen/atypical antipsychotics info

A

fewer EPS, target neg/pos symptoms, 1st line tx, DA & 5HT antagonists

66
Q

2nd gen/atypical antipsychtoic- less likely for EPS/NMS

A

clozapine

67
Q

clozapine AE

A

potential for fatal agranulocytosis

68
Q

second gen/atypical drug

A

aripiprazole

69
Q

psycho-stimulants MOA

A

block the reuptake of NE and DA

70
Q

psycho- stimulants drug

A

methylphenidate - 1st line for adhd in kids

71
Q

psycho-stimulants use

A

adhd, narcolepsy, tx resistant depression, geriatric depression

72
Q

psycho-stimulants nursing implications

A

growth (drug holidays during low stress times), anorexia, insomnia, stomach ache

73
Q

alzheimers meds (some efficacy in slowing memory loss)

A

donepezil

74
Q

herbal medicine concerns

A

potential long term effects (nerve, kidney, liver damage), adverse chemical rxn (st johns wort- serotonin syndrome w/ SSRI’s)

75
Q

a physical assessment can uncover the source of symptoms that can be treated before considering a

A

psychiatric diagnosis

76
Q

a health history may uncover these stressors

A

car accident, sexual assault, surgery, substance abuse, domestic violence

77
Q

physical exam essentials

A

BP, temp, pulse, baseline labs, general appearance/behavior, heart and lung auscultation, last meds/drugs/alcohol

78
Q

routine labs

A

CBC, liver function test, creatinine phosphokinase, thyroid func, drug screen, urinalysis

79
Q

physical condition that may produce psychiatric symptoms

A

UTI

80
Q

EEG

A

measures and records electrical impulses or activity from the cortex of the brain

81
Q

CT AND MRI

A

images brain structure

82
Q

BEAM, PET, SPECT

A

images brain activity and functioning

83
Q

schizophrenia is associated with 4 neurotransmitters

A

dopamine, serotonin, norepinephrine, GABA

84
Q

schizophrenic brain scans have shown

A

decreased cerebral/cranial size, lowered number of cortical neurons, decreased volume of other brain areas

85
Q

pathology of alzheimers

A

loss of neurons, incr in neurofibrillary tangles, appearance of abnormal protein deposits, general atrophy and degeneration of the brain, decreased acetylcholine (memory and learning)

86
Q

neurotransmitter hypothesis

A

epinephrine, serotonin, acetycholine, dopamine, GABA

87
Q

neuroendocrine hypothesis

A

correlation btwn hormonal activity and mood disorders

88
Q

biological rhythms

A

circadian, cyclic recurrence, seasonality

89
Q

kindling

A

early episodes of mood disturbance require a precipitating event, later episodes occur spontaneously

90
Q

major neurotransmitters in anxiety

A

norepinephrine, serotonin, GABA

91
Q
A

mental (2 decks)

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