Psych Ch.2 Neurobiologic theories
black box warning for Bupropion
can cause seizures at a rate 4X that of other antidepressants.
serotonin syndrome
can result from taking an MAOI or SSRI at the same time. symptoms; agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia, and in extreme reactions even coma and death.
Norepinephrine (excitatory)
causes changes in attention, learning and memory, sleep and wakefulness, mood.
what is the cerebellum?
center for coordination of movements, postural adjustments. integration of information from all body areas to coordinate movement
what does the temporal lobe do?
centers for sense of smell and hearing and for memory and emotional expression
histamine (neuromodulator)
controls alertness, gastric secretions, cardiac stimulation, peripheral allergic responses
what is the purpose of the dopamine neurotransmitter?
controls complex movements, motivation, cognition; regulates emotional response.
epinephrine (excitatory)
controls fight or flight response
serotonin (inhibitory)
controls food intake, sleep and wakefulness, temperature regulations, pain control, sexual behaviors, regulation of emotions
potency
describes the amount of the drug needed to achieve the maximum effect; low-potency drugs require higher dosages to achieve efficacy, whereas high potency drugs achieve efficacy at lower dosages.
what does the amygdala do?
emotional arousal, memory
Neuropeptides (neuromodulators)
enhance, prolong, inhibit, or limit the effects of principle neurotransmitters
symptoms of TD
involuntary movements of the tongue, facial and neck muscles, upper and lower extremities, and truncal musculature. tongue thrusting and protruding lip smacking, blinking, grimacing, and other excessive uneccesary facial movements.
efficacy
maximum therapeutic effect that a drug can achieve.
black box warning for Nefazodone
may cause rare but potentially life threatening liver damage, which could lead to liver failure
Gamma-aminobutyric (GABA) - inhibitory
modulates other neurotransmitters
what are the nerves that control voluntary acts?
neurotransmitters
what is the biggest concern when taking MAOIs (antidepressant)
not to ingest foods containing tyramine! this can cause hypertensive crisis
neuroleptic malignant syndrome
potentially fatal idiosyncratic reaction to an anti psychotic (or neuroleptic) drug.
what does the thalamus do?
regulates activity, sensation, and emotion
what would an abnormality in the frontal lobe of the brain cause?
schizophrenia, ADHD, and dementia
Extrapyramidal symptoms
serious neurological symptoms, that are the major side effects of anti-psychotic
what does the hypothalamus do?
temperature regulation, appetite control, endocrine function, sexual drive, impulsive behavior.
what cranial nerves are located in the brainstem?
III-XII
what is the locus ceruleus?
NE producing neurons in the brain stem. (stress, anxiety, impulse behavior)
what is the pons?
Primary motor pathway.
what does the midbrain control?
RAS (motor activity, sleep, consiousness, awareness)
what is the first choice in treating depression?
SSRIs
T/F elderly patients with dementia-related psychosis treated with atypical anti psychotic drugs are at an increased risk for death
True. causes of deaths were varied, but most of the deaths appeared to be either cardiovascular or infectious in nature.
psychoimmunology
a relatively new field of study, examines the effect of psychosocial stressors on the body's immune system.
tarditive dyskinesia (TD)
a syndrome of permanent involuntary movements commonly causes by the long term use of conventional antipsychotic drugs. TD is irreversible.
what is the limbic system?
an area of the brain located above the brainstem that includes the thalamus, hypothalamus, hippocampus, and amygdala.
what does the occipital lobe do?
assists in coordinating language generation and visual interpretation, such as depth perception.
acetylcholine (excitatory or inhibitory)
controls sleep and wakefulness cycle; signals muscles to become alert
what does the hippocampus do?
emotional arousal, memory
major symptoms of neuroleptic maligant syndrome:
high fever, automatic instability, such as unstable blood pressure, diaphoresis and pallor, delirium, and elevated levels of enzymes. these patients are usually confused and often mute.
what are common anticholinergic side effects?
hypotension, dry mouth, constipation urinary hesitance or retention, blurred vision, dry eyees, photophobia, nasal congestion, decreased memory. S&S usually decrease within 3-4 weeks
what is the treatment for NMS?
immediate discontinuance of all anti psychotic medications and the institution of supportive medical care to treat dehydration and hyperthermia until the patients condition stabilizes.
acute dystonia
includes acute muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing and in severe cases laryngospasm and respiratory difficulties
what does the parietal lobe of the brain do?
interprets sensation of taste and touch and assists in spatial orientation.
pseudoparkinsonism
is often referred to by the generic of EPS. symptoms resemble those of parkinson's disease. (stooped, stiff posture, masklike face, decreased arm swing, shuffling)
half-life
is the time it takes for half of the drug to be removed from the bloodstream
black box warning for clozapine
may cause agranulocytosis, a potentially life threatening event. clients who are treated with clozapine must have a baseline WBC count and differential before intiation of treatment and a WBC count every week throughout treatment for 4 weeks after discontinuation of the drug.
Black box warning for Droperidol, Thioridazine, and Mesoridazine
may lengthen the QT interval, leading to potentially life-threatening cardiac dysrhythmias or cardiac arrest.
what does the frontal lobe of the brain control?
organization of thought, body movement, memories, emotions, and moral behavior.
akathisia
reported by the client as an intense need to move about. the client appears restless or anxious and agitated, often with a rigid posture or gait and a lack of spontaneous gestures.
glutamate (excitatory)
results in neurotoxicity if levels are too high
what does the left side of the brain control?
the left side of the brain controls the right side of the body. it is the center for logical reasoning and analytic functions such as reading, writing, and mathematics
what does the right side of the brain control?
the right side controls the left side of the body. it is the center for creative thinking, intuition, and abstract abilities.
what does the medulla oblongata control?
the vital center for cardiac and respiratory function
how is akathisia treated?
treated by a change in the antipsychotic medication or by an addition of an oral medication such as a beta blocker, anticholinergic, or benzodiazepine
how is pseudoparkinsonism treated?
treated by changing to an anti-psychotic medication that has a lower incidence of EPS or by adding an oral anticholinergic agent or amatidine.
mood stabilizing drugs
used to treat bipolar disorder by stabilizing the clients mood.