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NURS 416 > Week 11c: Mood disorders, Anxiety, Psychosis > Flashcards

Week 11c: Mood disorders, Anxiety, Psychosis Flashcards

1
Q

major depressive disorder

A

clinical depression as defined by the DSM-5

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2
Q

Dysthymia

A

mild, chronic depression for two or more years

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3
Q

bipolar disorder

A

alternating between manic and major depressive disorder

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4
Q

cyclothymia

A

alternating between hypomanic and mild depressive phases

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5
Q

characteristics of depression

A
  • depressed mood
  • anhedonia
  • feelings of worthlessness of excessive guilt
  • decreased concentration
  • psychomotor agitation or retardation
  • insomnia or hypersomnia
  • decreased libido
  • change in weight or appetite
  • thoughts of death or suicidal ideation
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6
Q

PET and MRI findings in bipolar disorder and MDD

A

show a reduction in the volume of grey matter in the prefrontal cortex with an associated decrease in activity in the region

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7
Q

PET and MRI findings in bipolar disorder and MDD: brain regions with decreased regional glucose metabolism

A

inferior frontal gyrus, bilateral superior and middle temporal gyrus and bilateral anterior cingulate cortex

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8
Q

PET and MRI findings in bipolar disorder and MDD: brain regions with increased regional glucose metabolism

A

bilateral hippocampus and left thalamus

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9
Q

4 classes of meds for depression

A
  1. TCAs
  2. SSRIs
  3. Atypical antidepressants
  4. MAOIs
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10
Q

prototype drug of TCAs

A

Imipramine (tofranil)

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11
Q

adverse effects of TCAs

A
  • anticholinergic effects
  • confusion, drowsiness
  • orthostatic hypotension
  • sedation
  • sexual dysfunction and weight gain
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12
Q

what is a major contraindication of TCAs

A

dysrhythmias and recent MI

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13
Q

It may take _____ weeks for TCAs to have a therapeutic effect

A

2-6 weeks

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14
Q

mechanism of action of SSRIs

A

prevent the reuptake of serotonin by the presynaptic nerve terminals in the limbic system

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15
Q

when are the therapeutic effects of SSRIs seen

A

4-6 weeks

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16
Q

SSRIs + TCAs and MAOIs can cause

A

serotonin excitation syndrome

17
Q

serotonin excitation syndrome symptoms

A

hyperpyrexia, hypertension, confusion, sweating, tremors, ataxia

18
Q

SSRI discontinuation syndrome

A

occurs when SSRIs are abruptly stopped

19
Q

Signs and Symptoms of SSRI discontinuation syndrome

A
  • dizziness, confusion
  • lethargy
  • paresthesia
  • vivid dreams
  • nausea
20
Q

Prototype drug for MAOIs

A

Phenelzine (Nardil)

21
Q

MAOIs have equal efficacy as SSRIs and TCAs but…

A

they have a smaller margin of safety

22
Q

adverse effects of MAOIs

A
  • hepatotoxicity
  • orthostatic hypotension
  • headache
  • insomnia
  • diarrhea
23
Q

adverse effects of lithium

A
  • kidney impairment
  • dysrhythmias and circulatory collapse
  • leukocytosis
  • hypothyroidism and goiter (lithium decreases the production of thyroid hormones)
24
Q

what are the 3 brain areas associated with anxiety

A
  1. limbic system
  2. reticular formation
  3. prefrontal cortex
25
Q

which brain area is associated with emotion, learning and memory

A

limbic system

26
Q

stimulation of the reticular formation increases?

A

arousal and alertness

27
Q

inhibition of the reticular activating system promotes?

A

drowsiness and sleep

28
Q

side effects of short term use of benzodiazepines

A
  • aggression
  • dizziness
  • drowsiness
  • sexual dysfunction
  • depression
  • blurred vision
29
Q

side effects of long term use of benzodiazepines?

A
  • cognitive problems
  • sleep disturbances
  • mental disorders
  • immune system suppression
  • cancer risk
  • addiction
30
Q

neurotransmitter imbalance in psychosis

A

overactive dopaminergic pathways in the basal nuclei leads to overstimulation of dopamine type 2 receptors

31
Q

blocking of the dopamine receptors can produce?

A

EPS, similar to what happens in PKD

32
Q

muscle spasms of the back, neck and tongue at onset of treatment

A

acute dystonia

33
Q

akathisia

A

restlessness

34
Q

unusual tongue and face movements associated with long-term use

A

Tardive dyskinesia

35
Q

neuroleptic malignant syndrome signs and symptoms

A
  • high fever, diaphoresis
  • muscle rigidity
  • tachycardia, blood pressure fluctuations
36
Q

treatment for NMS

A

muscle relaxants and antipyretics

NURS 416 (17 decks)

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