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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
the ideal psychiatric drug
relieves mental systems w/out inducing unwanted mental effects
26
benzodiazepines
promote the activity of GABA
27
antianxiety/ benzo
alprazolam (xanax)
28
benzodiazepine uses
ptsd, anxiety, skeletal muscle disorders, ETOH w/drawal, panic disorders, insomnia
29
benzodiazepine AE
addictive, w/drawl, sedation, ataxia, dizziness, feelings of detachment, increased irritability, hostility, rebound insomnia/anxiety
30
benzo antagonist
flumazenil/ romazicon
31
benzodiazepine interaction
interacts w/ alcohol, barbs, opioids = resp depression
32
short acting sedative hypnotic drugs
zolpidem/ambien, zaleplon/sonata, eszopiclone/lunesta
33
tricyclic antidepressants
amitriptyline/elavil
34
TCA AE
sedation, weight gain, orthostatic hypotension, anticholinergic, photosensitivity
35
anticholinergic effects
dry mouth, urinary retention, constipation, blurred vision, weight gain, sedation
36
TCA implications
black box warning, high overdose potential, taper dose, sedation
37
SSRI
fluoxetine
38
SSRI AE
akathisia, agitation, insomnia, GI disturbances, sexual dysfuntion
39
serotonin syndrome
2-72 hrs after starting tx, confusion, agitation, poor concentration, disorientation, seizures, tachycardia, fever, nausea, vomiting, coma
40
SNRI
venlafaxine
41
venlafaxine AE
increase BP and pulse
42
MAOi's
isocarboxazid
43
Foods to avoid with MAOi's
cheese, aged protein, pickles/smokes foods, wines/draft beer, yeast, overripe fruit, MSG, beef/chicken liver
44
MAOi AE
hypertensive crisis when pt eats tyramine containing food
45
mood stabilizer
lithium
46
lithium uses
acute mania, recurrent bipolar, aggressive conduct disorder
47
lithium toxicity
usually dose related, nausea/vomit, diarrhea, hand tremor, twitching, lethargy, deep tendon reflexes can lead to death
48
tx for lithium toxicity
hold med, vital signs (LOC & rectal temp), protect airway, check Li blood levels, hydration
49
common cause of Li toxicity
decreased Na intake, diuretic therapy, decreased renal func, medical illness, OD, fluid/electrolyte loss, NSAID tx
50
Li therapy teaching
2-3 fluid/day, know signs of toxicity, periodic blood levels, physical checkup,
51
mood stabilizers- antidepressants
valproate
52
valproate
use- bipolar AE- thrombocytopenia, hepatic dysfunction
53
antipsychotic uses
schizophrenia, organic brain syndrome w psychosis, psychotic depression, acute mania, vocal tics, aggressiveness
54
antipsychotics action (typical)
dopamine antagonists
55
antipsychotics action (atypical)
dopamine antagonists and blocks serotonin reuptake
56
what do antipsychotics decrease the availibility of to basal ganglia?
dopamine
57
positive symptoms of schizophrenia
hallucinations, delusions, bizarre behaviors, disorganization
58
negative symptoms of schizophrenia
poverty of speech, flat affect, decreased social interaction, low motivation, low energy
59
antipsychotic drug
chlorpromazine
60
chlorpromazine action
strong antagonists, block attachment of dopamine, reduce dopaminergic transmission
61
chlorpromazine AE
weight gain, sedation
62
what do nurses need to monitor with chlorpromazine?
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
neuroleptic malignant syndrome manifestations
sudden high fever, muscle rigidity, BP fluctuation, diaphoresis, tachycardia, LOC decreased, coma
64
NMS nursing action
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
2nd gen/atypical antipsychotics info
fewer EPS, target neg/pos symptoms, 1st line tx, DA & 5HT antagonists
66
2nd gen/atypical antipsychtoic- less likely for EPS/NMS
clozapine
67
clozapine AE
potential for fatal agranulocytosis
68
second gen/atypical drug
aripiprazole
69
psycho-stimulants MOA
block the reuptake of NE and DA
70
psycho- stimulants drug
methylphenidate - 1st line for adhd in kids
71
psycho-stimulants use
adhd, narcolepsy, tx resistant depression, geriatric depression
72
psycho-stimulants nursing implications
growth (drug holidays during low stress times), anorexia, insomnia, stomach ache
73
alzheimers meds (some efficacy in slowing memory loss)
donepezil
74
herbal medicine concerns
potential long term effects (nerve, kidney, liver damage), adverse chemical rxn (st johns wort- serotonin syndrome w/ SSRI's)
75
a physical assessment can uncover the source of symptoms that can be treated before considering a
psychiatric diagnosis
76
a health history may uncover these stressors
car accident, sexual assault, surgery, substance abuse, domestic violence
77
physical exam essentials
BP, temp, pulse, baseline labs, general appearance/behavior, heart and lung auscultation, last meds/drugs/alcohol
78
routine labs
CBC, liver function test, creatinine phosphokinase, thyroid func, drug screen, urinalysis
79
physical condition that may produce psychiatric symptoms
UTI
80
EEG
measures and records electrical impulses or activity from the cortex of the brain
81
CT AND MRI
images brain structure
82
BEAM, PET, SPECT
images brain activity and functioning
83
schizophrenia is associated with 4 neurotransmitters
dopamine, serotonin, norepinephrine, GABA
84
schizophrenic brain scans have shown
decreased cerebral/cranial size, lowered number of cortical neurons, decreased volume of other brain areas
85
pathology of alzheimers
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
neurotransmitter hypothesis
epinephrine, serotonin, acetycholine, dopamine, GABA
87
neuroendocrine hypothesis
correlation btwn hormonal activity and mood disorders
88
biological rhythms
circadian, cyclic recurrence, seasonality
89
kindling
early episodes of mood disturbance require a precipitating event, later episodes occur spontaneously
90
major neurotransmitters in anxiety
norepinephrine, serotonin, GABA
91

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