Unit 2 Neurobiology and Pharmacotherapy Chapter 3 Flashcards
What is the function of Serotonin (Hormone) (TRIPPLE S))
Plays role in
*sleep regulation,
* sexual function,
*hunger,
* mood,
*pain
- Plays a role in aggression
- 90% in the gut – GI side effects
What occurs when there is low levels of Serotonin?
A. Libido increase
B. Depression
C. Adequate appetite
D. Increased sensation to pain
B. Depression
Sx sleep disturbance, change in
appetite, mood, motivation alterations in sexual function
Function of Dopamine (Hormone)
Pleasure
*Involved in fine motor movement *Involved in integration of emotions and thoughts
*Involved in decision making
*Stimulates hypothalamus to release hormones
What occurs when there is low dopamine?
A. Parkinsons disease
B. Sexual libido
C. Increased appetite
D. Decreased sensation to pain
A. Parkinsons disease
Decrease:
Parkinson’s disease Depression
Increase: Schizophrenia Mania
Function of Norepinephrine(Hormone)
*Level in brain affects mood
*Attention and arousal
*Stimulates sympathetic branch of
autonomic nervous system for “fight or flight” in response to stress
What occurs when there is low Norepinephrine?
A. Parkinsons disease
B. Sexual libido
C. Depression
D. Decreased sensation to pain
C. Depression
Too much Norepinephrine – Anxiety(overstimulated), Schizophrenia, Mania
- Too little Norepinephrine – Depression
What occurs when there is a lot of Norepinephrine?
A. Anxiety
B. Sexual libido
C. Depression
D. Decreased sensation to pain
A. Anxiety
Too much Norepinephrine – *Anxiety(overstimulated), *Schizophrenia,
* Mania
Function of γ-aminobutyric acid (GABA)(off switch , relaxant)
- Plays a role in inhibition(a feeling that makes one self-conscious and unable to act in a relaxed and natural way.)
- Reduces aggression, excitation and anxiety
- Has anticonvulsant and muscle-relaxing properties
- May impair cognition and psychomotor functioning
What occurs when there is low γ-aminobutyric acid (GABA) ?
A. Anxiety
B. Sexual libido
C. Depression
D. Decreased sensation to pain
A. Anxiety
*Decrease:
*Anxiety
*Schizophrenia Mania
*Huntington’s disease
What occurs when there is an increase of γ-aminobutyric acid (GABA)
A. Reduction of Anxiety
B. Sexual libido
C. Depression
D. Decreased sensation to pain
Increase:
Reduction of anxiety
Function of Glutamate
*Excitatory
*AMPA plays a role in learning and memory
What occurs when there is low GAMA ?
A. Reduction of Anxiety
B. Sexual libido
C. Psychosis
D. Decreased sensation to pain
Decrease (NMDA):
Psychosis
What occurs when there is high GAMA?
A. Neurodegenration in Alzheimers disease
B. Sexual libido
C. Psychosis
D. Decreased sensation to pain
A. Neurodegenration in Alzheimers disease
Increase (NMDA):
Prolonged increased state can be neurotoxic
Neurodegeneration in Alzheimer’s disease
Increase (AMPA):
Improvement of cognitive performance in behavioral tasks
Which on of the Diagnostic exams can visualize blood blow to the brain?
A. Positron emission tomography(PET)
B.Computed tomography (CT)
C. Magnetic resonance imaging (MRI)
D.Electroencephalography (EEG)
A. Positron emission tomography(PET)
FUNCTION - SHOWS ACIVITY OF BRAIN
Can also detect..
*Oxygen utilization
*Glucose metabolism
*Blood flow
*Neurotransmitter-receptor interaction
Which of the following drugs are high contradicted due to a persons’s race and genetic factor?
A. Carbamazepine
B. Acetychloine
C. Valproate Acid
D. Fluoxetine
Pharmacogenetics – different genetics can lead to different
responses to meds..
- Carbamazepine (Tegretol) & Asian decent
- Life threatening Stephen Johnson Syndrome
You are a nurse is working on an interdisciplinary team of an elderly patient diagnosed with anxiety. What is the biggest nursing consideration when administering Benzodiazepines
respiratory depression
What order from the health care provider should the nurse question?
A. acetaminophen 400mg PRN
B. Diazepam 100MG Q2HR
C. Pancreatic enzymes shrinkled on food
D.Folic acid 0.4mg q.d
B. Diazepam 100MG Q2HR
Benzodiazepines should be prescribided due to CNS depression affects
- respiratory depression
-orthostatic hypotension
-low blood pressure
-sedation
Which of the following drugs are best indicated for an older adult patient who has previous substance abuse disorder and anxiety?
A. Buspirone
B. Ativan
C. Naloxone
D. Hydromorphone
A. Buspirone
- Reduces anxiety w/o strong sedative
effect - No risk for addiction or dependence
- Scheduled not PRN
- Not a CNS depressant
Your patient with anxiety doesn’t understand why he cannot drink alcohol while he’s on his anti-anxitey medications. What is the best teaching by the nurse?
A. Alcohol will increase his risk for thrombocytopenia while on this medication.
B. When anti- anxiety medications are combined with other CNS depressants like alcohol it can lead to life threatening respiratory depression.
C. Folic acid can be dangerous with this medication as well
D. Alcohol can cause life treating hypertension
B. When anti- anxiety medications are combined with other CNS depressants like alcohol it can lead to life threatening respiratory depression.
Combined w/other CNS
depressants (alcohol, TCAs,
opiates) can lead to life-
threatening CNS depression
“Antianxitey medications like benzodiazepines combines with other benzodiazepines or alcohol or antidepressants can lead to LIFE THREATENING CNS DEPRESSION
Are Benzo’s easily abused and do patients get easily dependent on them?
A. Yes
B. No
Promote GABA
* Risk for abuse and dependence
* Inhibit Neurons = useful as
anticonvulsant
* Alone – Rarely inhibit the brain
to respiratory depression
* Combined w/other CNS
depressants (alcohol, TCAs,
opiates) can lead to life-
threatening CNS depression
* Interfere with motor ability,
attention, judgement
Which medication is contradicted for combined use with a benzodiazepine?
A. Zolpidem
B. Amitriptyline.
C. Melatonin
D. Doxepin
B. Amitriptyline.(TCA Medication -Antidepressant)
*Benzo’s Combined w/other CNS
depressants (alcohol, TCAs,
opiates) can lead to life-respiratory depression
Your patient who has been diagnosed with insomnia tells you he takes zolpidem right before picking his children from school to reduce driving anxiety. What is the nurses priority action?
A. Educate the patient that a hypnotic like zolpidem should be taken right before bed and not while handling machinary due to sedation factors.
B. The patient can take this medication anytime of the day because the effect is not rapid or onset.
C. The patient may be confused and should be admitted to a psychiatric facility.
D. The patient must be reported to the police due to recklessness in driving.
A. Educate the patient that a hypnotic like zolpidem should be taken right before bed and not while handling machinary due to sedation factors.
Sedative effects without antianxiety,
anticonvulsant or muscle relaxant effects
* Potential for amnestic and ataxic side effects
* Onset of action is fast – take when ready for
sleep
* Tolerance and dependence is less that Benzos
* Reports of sleepwalking, eating and driving w/o
awareness
Zolpidem (Ambien)
* Zaleplon (Sonata)
* Eszopiclone (Lunesta)
Which of the following medications that induce sleep has the lowest chance or abuse or no dependance?
A. Melatonin
B. Zolpidem
C.Zalepon
D. Eszopiclone
A. Melatonin
- malexatonin lacks potential abuse
What is the common side effect of hypnotics that should be reported?
A. Sedation
B. Sleepwalking
C. sinus rhythm
D.Eupnea
B. Sleepwalking
- Reports of sleepwalking, eating and driving w/o
awareness
*Ataxia describes poor muscle control that causes clumsy voluntary movements.
*Amnesia refers to the loss of memories, including facts, information and experiences.
Can Doxepin be used with Phenelizine?
A. Yes
B. No
B. No
use -Insomnia – difficulty maintaining sleep
Doxepin is an old Tricyclic antidepressant and cannot be used with MAOI drugs or pts with urinary incontinence
Avoid other CNS depressants and sedating
meds like antihistamines
Suvorexant (Belsomra
locks orexin – suppresses wakefulness
* Precautions: Daytime sleepiness, abnormal thinking
and behavior changes, worsening depression and S/I,
Sleep paralysis
SSRI antidepressant , less side effects than Tricyltic antidepressants
Blocks the reuptake of Serotonin
making more available
* 1st line tx, less anticholinergic and
sedating SE than tricyclic
antidepressants (previous 1st line)
* Antianxiety effects
* Good efficacy lower SE profile
* SE – low libido, GI upset, nausea,
vomiting (90% of serotonin in gut)
-Paroxetine (Paxil) – most
anticholinergic of the class.
Not
for patients who are
contraindicated for
anticholinergics (ex: narrow
angle glaucoma
You are educating your 24 year old male patient on the Importance of being compliant with taking Paroxetine(SSRI Antidepressant. He is sexually active. What teaching would best educate the patient on the side effects of this medication?
A. There would be little to no adbonimal side effects associated with this medication
B. Inform the patient that one of the side effects of the medication is low libido and GI upset.
C. This medication can be used for Narrow angle glaucoma due to its anticholongeric affects
D. This medication increases sexual libido
B. Inform the patient that one of the side effects of the medication is low libido and GI upset.
Side effects –
*low libido,
*GI upset,
*nausea,
*vomiting (90% of serotonin in gut)