Psych/Mental Health: Psychobiology & Psychopharmacology

cerebellum

1. concerned w/ balance & coordination 2. regulates skeletal muscle

extrapyramidal effects

1. dystonia (painful involuntary muscle movements of head & neck) 2. akathisia (restlessness, pacing, shaking, etc.) 3. parkinsonism (rigid limb muscles, tremor, increased salivation) 4. neuroleptic malignant syndrome (rare but serious! hyperthermia, seizures, CNS disturbances) 5. tardive dyskinesia (painless involuntary muscle movements of head & tongue)

+ psychotic symptoms

1. hallucinations 2. speech peculiarities 3. circumstantial speech 4. tangential speech 5. word salad

hypothalamus

1. homeostatic mechanisms that control hunger, thirst, and sexual desire 2. endocrine & hormonal control 3. automatic nervous system control (body temperature) 4. limbic system (emotion)

dopamine (DA)

1. involved in fine motor movement 2. involved in integration of emotions & thoughts 3. involved in decision making 4. stimulates hypothalamus to release hormones

norepinephrine (NE)

1. level in the brain affects mood 2. concerned w/ attention & arousal 3. stimulate SNS "fight or flight" in response to stress

neuron

1. respond to stimuli 2. conduct electrical impulses 3. release chemicals (neurotransmitters)

serotonin syndrome

common symptoms: delirium, agitation, tachycardia, sweating, shivering, coarse tremors, extensor plantar responses, and myoclonus (muscle spasm) severe symptoms: hypernatremia, seizures, rhabdomyolysis, renal failure, cardiac dysthymias, disseminated IV coagulation

their job is to carry chemical signals ("messages") from one neuron (nerve cell) to another until it reaches target cell

describe how a neurotransmitter functions as a chemical messenger

structure: MRI & CT function/activity: PET & SPECT

describe how the use of imaging techniques can be helpful for understanding mental illness

1. serotonin 2. norepinephrine 3. dopamine

list the monoamines

1. norepinephrine; anxiety & depression 2. serotonin; depression 3. dopamine; schizophrenia & parkinson's disease 4. glutamate; dementia/alzheimer's disease 5. GABA (y-aminobutyric acid); anxiety 6. acetylcholine; dementia/alzheimer's disease

list the neurotransmitters & the mental conditions associated to their abnormal levels

1.5: confusion, jitteriness, diarrhea 2.0: comatose, stupor, lethargic 2.5: death

list the symptoms associated with lithium toxicity

MAOIs (monoamine oxidase inhibitors)

mechanism of action: destroy the enzyme that destroys monoamines (serotonin, NE, dopamine) which then increases synaptic levels of these neurotransmitters uses: depression (rarely used in practice today) common side effects: dry mouth, diarrhea, constipation, insomnia, drowsiness nursing considerations: teach patient to avoid foods that contain tyramine which can cause a hypertensive crisis

glutamate

1. excitatory 2. AMPA plays a role in learning & memory

cerebrum

1. executive functioning & thinking 2. memory 3. awareness/conscious sense of being 4. control of skeletal muscles (movement) 5. language & communication

- psychotic symptoms

1. flat affect 2. alogia 3. poor grooming/hygiene 4. anhedonia 5. asociality

GABA (y-aminobutyric acid)

1. plays a role in inhibition; reduces aggression, excitation, and anxiety 2. may play a role in pain perception 3. has anticonvulsant & muscle relaxant properties 4. may impair cognition & psychomotor functioning

acetylcholine (ACh)

1. plays a role in learning & memory 2. stimulates PNS "rest & digest" actions 3. affects sexual & aggressive behavior

serotonin (5-HT)

1. plays a role in sleep regulation, hunger, mood states, and pain perception 2. hormonal activity 3. plays a role in aggression & sexual behavior

1. maintenance of homeostasis 2. regulation of the ANS & hormones 3. control of biological drives & behavior 4. cycle of sleep & wakefulness; circadian rhythms 5. conscious mental activity & memory

list functions & activities of the brain

1. isocarboxazid (Marplan) 2. phenelzine (Nardil) 3. selegiline (EMSAM) 4. tranylcypromine (Parnate)

list some common MAOs

1. fluoxetine (Prozac) 2. sertraline (Zoloft) 3. paroxetine (Paxil) 4. citalopram (Celexa) 5. escitalopram (Lexapro) 6. fluvoxamine (Luvox)

list some common SSRIs

1. nortriptyline (Pamelor) 2. amitriptyline (Elavil) 3. imipramine (Tofranil)

list some common TCAs

1. aripiprazole 2. chlorpromazine 3. clozapine 4. risperidone 5. olanzapine

list some common antipsychotic drugs

1. diazepam (Valium) 2. clonazepam (Klonopin) 3. alprazolam (Xanax) 4. lorazepam (Ativan)

list some common benzodiazepines

1. dextroamphetamine 2. methylphenidate 3. atomoxetine 4. guanfacine 5. clonidine

list some common psychostimulant drugs

1. zolpidem (Ambien) 2. zaleplon (Sonata) 3. eszopiclone (Lunesta)

list some common z-hypnotics

1. smoked or processed meats 2. citrus fruits 3. aged cheeses 4. alcohol (wine & beer)

list some foods that contain tyramine

1. frontal; motor area, personality, behavior, emotional expression, intellectual function, memory storage, conscious sensation & initiation of movement 2. temporal; primary auditory cortex, wernicke's area, long-term memory 3. parietal; somatosensory area, spatial sense, proprioception (navigation), sensory perception, sense of touch 4. occipital; concerned w/ central vision, vision related reflex & functions (reading, judging distance, seeing in three dimensions)

list the lobes of the brain & their functions

SSRIs (selective serotonin reuptake inhibitors)

mechanism of action: inhibit the reuptake of serotonin which increases levels in the brain to help elevate mood uses: depression, other mental disorders common side effects: nausea, restlessness/jitteriness, sleep disturbances, sexual dysfunction nursing considerations: these drugs must be slowly tapered to decrease effects of serotonin syndrome or withdrawals

TCAs (tricyclic antidepressants)

mechanism of action: primarily block reuptake of serotonin & NE uses: migraine headaches, neuropathic pain, depression (sometimes) common side effects: weight gain, dizziness, orthostatic hypotension, blurred vision, dry mouth, tachycardia nursing considerations: should not be given to a patient w/ suicidal history or ideation, these drugs can stop the heart by blocking sodium channels in the heart & causing cardiac dysthymias

psychotropic drugs

medications used to treat mental illnesses/conditions; ALL, except lithium, work on the synaptic cleft (space b/t two neurons in which a nerve impulse is transmitted by a neurotransmitter)

cholinesterase inhibitors

prototype: donepezil use: alzheimer's/dementia mechanism of action: destroys enzyme that breaks down acetylcholine which makes more acetylcholine available, slowing down the progression of the disease adverse effects: dry mouth, insomnia, drowsiness

NMDA receptor agonists

prototype: memantine use: alzheimer's/dementia mechanism of action: fills NMDA receptor sides, reducing glutamate binding which decreases the effects of alzheminers adverse effects: confusion, Gi upset, musculoskeletal pain, fatigue

brainstem

responsible for automatic survival functions (breathing, BP, HR, coughing, swallowing, vomiting, etc.)

psychostimulants

uses: ADHD; block reuptake of NE & dopamine, amphetamines also increase neurotransmitter release common side effects: insomnia, hyper-agitation, anorexia, slow growth, hypertension, increased heart rate nursing considerations: give drug after meals to prevent anorexia and decreased appetite side effect, avoid abrupt discontinuation

z-hypnotics

uses: chemically structured like benzodiazepines, but their hypnotic abilities are used to promote sleep (insomnia; sometimes used for restless patients in hospitals) & reduce anxiety common effects: sedation, ataxia, parasomnias, CNS depression when in combo with other substances (alcohol) nursing considerations: not for long term use, use w/ extreme caution in

lithum

uses: mood stabilizer; bipolar disorder, schizophrenia common side effects: acne, alopecia, diarrhea, nausea, vomiting, weight gain, ataxia, polydipsia, polyuria, psoriasis nursing considerations: monitor levels frequently b/c of the narrow therapeutic index, monitor renal function, may feel excitatory high or increased energy, never take 2 doses if one is forgotten, patient should be drinking 2-3 L of water/day

benodiazepines

uses: panic attacks, insomnia, OCD, to prevent alcoholism withdrawals, anxiety (sometimes) mechanism of action: anti-anxiety, amnesic, anticonvulsant, hypnotic, sedating, muscle relaxant side effects: sedation, anterograde amnesia, ataxia nursing considerations: these are not prescribed for long (1-2 weeks), may decrease reaction time, high risk for addiction, extremely hard to deal w/ withdrawals, do not mix w/ other CNS depressants (alcohol)

antipsychotic

uses: schizophrenia, bipolar, violent/aggressive behaviors by blocking the attachment of dopamine & preventing excitement of body system common side effects: extrapyramidal symptoms, ataxia, weight gain, sedation nursing considerations: be aware of low compliance rates b/c of significant weight gain, first generation only target + symptoms, second generation target both + & - symptoms

normal: 0.6-1.2 toxicity: > 1.5

what is the lithium lab value range?