Term
| what is the goal of psychotropic drugs? |
|
Definition
to reverse the physiological alterations
involved with mental illness |
|
|
Term
| why do drugs that affect brain function cause slurred speech and stimulated OR depressed respiration? |
|
Definition
| Because the skeletal muscles that are controlled by the brain such as the diaphragm and the muscles of the throat, tongue, and mouth are all essential for speech. So drugs that affect the brain function stimulate or depress respiration and lead to slurred speech |
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Term
| the ANS along with the _________ system serve as communication links b/t the brain and cardiac muscles, smooth muscle and glands of which the internal organs are composed |
|
Definition
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Term
| the Autonomic Nervous System is divided into categories. What are they and characterize them in regards to anxiety. |
|
Definition
the sympathetic nervous system and the parasympathetic nervous system.
SNS:dominant in stress situations such as anger and fear known as the fight or light response
Anxiety:
SNS: vasoconstriction
PNS: increase GI motilty causing diarrhea |
|
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Term
| describe the process of how the brain influences the release of hormonal secretions using the correct sequence. Use Gonadotropin-releasing hormone as an example. |
|
Definition
The brain stimulates the hypothalamus to release releasing factors which are then carried to the pituitary gland which is either stimulated or inhibited in releasing it's own hormone depending on the releasing factor.
1. Hypothalamus secretes gonadotropin-releasing hormone.
2. Stimulates the release of 2 gonadotropins from the pituitary: follicle stimulating hormone and luteinizing hormone, FSH & LH
3. These lead in the activation of either the ovaries or the testes during puberty |
|
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Term
| Explain the CRH, corticotropin, and cortisol system and tell what two disorders it is often related to and what the problem is. |
|
Definition
The hypothalamus release corticotropin releasing hormone which stimulates the pituitary to release corticotropin which stimulates the adrenal cortex of each kidney to secrete cortisol as a normal response to mental and physical stress.
But in anxiety and depression, there is no response to negative feeback |
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Term
| disturbances in the sex and hunger and sleep disturbances may individually or together indicate an underlying |
|
Definition
| psychological problem since these play a role in molding behavior |
|
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Term
| disturbances in alertness and ability to focus may indicate |
|
Definition
|
|
Term
|
Definition
| an enhanced state of sensory sensitivity accompanied with exaggerated intensity of behaviors whose purpose is to detect threats. Seen in schizophrenics. |
|
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Term
| many psychiatric drugs interfere with normal regulation of sleep and alertness. what drugs affect alertness? what should be done for the safety of the patient? |
|
Definition
sedative hypnotics (benzodiazepines) blunt the degree of alertness.
give them at night before client goes to sleep |
|
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Term
| alteration in alertness can also form a component in ADHD. What is it? |
|
Definition
| Attention deficit hyperactivity disorder; child/adult has difficulty maintaining focus on one source and is constantly searching for intense stimuli |
|
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Term
| there is evidence that this plays a part in neurotransmitter secretion and in psychological disease is altered especially in the mood |
|
Definition
|
|
Term
| what is word salad? what is looseness of association? who are these seen in? |
|
Definition
word salad- a jumble of words
looseness of association- unconnected phrases
seen in schizophrenics |
|
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Term
|
Definition
| the ability to retain and recall past experience |
|
|
Term
what disorder has this characteristic:
cannot recall what happened 8 years ago, but can recall something vividlay from 80 years ago |
|
Definition
|
|
Term
| why are interpersonal relationships so important? what is their relation to mental illness? |
|
Definition
an important part of learning involves the social skills that cement interpersonal relationships.
In almost all mental illnesses there difficulties in interpersonal relationships |
|
|
Term
| what are 3 characteristics of neurons? |
|
Definition
1. respond to stimuli
2. conduct electrical impulses
3. release neurotransmitters |
|
|
Term
| how do neurons conduct an electrical impulse from one end of the cell to another? and why? |
|
Definition
through a self-propagating change in membrane permeability, by first allowing Na in and then K out.
To communicate with other neurons |
|
|
Term
| once the electrical impulse reaches the end of the neuron, |
|
Definition
| a chemical neurotransmitters is released from the axon terminal of the presynaptic neuron |
|
|
Term
| a neurotransmitters travels along the synapse to receptors on the post synaptic neuron where it either |
|
Definition
| inhibits or stimulates the post synaptic neuron |
|
|
Term
| what are the 4 main types of neurotransmitters? |
|
Definition
1. monomamines
2. amino acids
3. cholinergics
4. peptides (neuromodulators) |
|
|
Term
| which neurotransmitters are monoamines? |
|
Definition
| dopamine, norepinephrine (noradrenaline), serotonin, and histamine (5-HT) |
|
|
Term
| what are the amino acid neurotransmitters? |
|
Definition
|
|
Term
| what neurotransmitter is a cholinergic? |
|
Definition
|
|
Term
| what neurotransmitters are peptides (neuromodulators)? |
|
Definition
| substance P (SP), somatostatin (SRIF), and neurotensin (NT) |
|
|
Term
what are the receptors for these neurotransmitters? Monoamines:
-Dopamine
-Norepinephrine
-Serotonin (5-HT)
-Histamine
Amino Acids:
-GABA
-Glutamate
Cholinergics:
-Acetylcholine (ACh)
Peptides (Neuromodulators)
-Substance P (SP)
-Somatostatin (SRIF)
-Neurotensin (NT) |
|
Definition
-Dopamine: D1,D2,D3,D4
-Norepinephrine: α1,α2,β1,β2
-Serotonin (5-HT): 5-HT1,5-HT2,5-HT3,5-HT4
-Histamine: H1,H2
Amino Acids:
-GABA: GABA1,GABA2
-Glutamate: NMDA,AMPA
Cholinergics:
-Acetylcholine (ACh): Nicotonic and Muscarinic (M1, M2, M3)
Peptides (Neuromodulators)
-Substance P (SP):SP
-Somatostatin (SRIF): SRIF
-Neurotensin (NT): NT
|
|
|
Term
Neurotransmitter:Dopamine
Class:
Receptors:
Effects:
Association with Mental Illness:
-Increase:
-Decrease: |
|
Definition
Neurotransmitter:Dopamine
Class: Monoamine
Receptors: D1,D2,D3,D4
Effects:
1. Fine muscle movements
2. Emotions and thoughts
3. Decision making
Association with Mental Illness:
-Increase: Mania and schizophrenia
-Decrease: Depression and Parkinson's disease |
|
|
Term
Neurotransmitter: Norepinephrine, NE, or Noradrenaline
Class:
Receptors:
Effects:
Association with Mental Illness:
-Increase:
-Decrease: |
|
Definition
Neurotransmitter: Norepinephrine, NE, or Noradrenaline
Class:Monoamine
Receptors:Alpha 1 and 2, and beta 1 and 2
Effects:
1. Affects mood
2. Fight or flight stress response
Association with Mental Illness:
-Increase: mania, anxiety, schizophrenia
-Decrease: depression |
|
|
Term
Neurotransmitter: Serotonin
Class:
Receptors:
Effects:
Association with Mental Illness:
-Increase:
-Decrease: |
|
Definition
Neurotransmitter: Serotonin
Class: Monoamine
Receptors: 5-HT1, 5 HT2, 5HT3, 5HT4,
Effects:
1. Sleep regulation, hunger, mood, and pain perception
Association with Mental Illness:
-Increase: mania, anxiety, and schizophrenia
-Decrease: depression and anxiety state |
|
|
Term
Neurotransmitter: GABA
Class:
Receptors:
Effects:
Association with Mental Illness:
-Increase:
-Decrease: |
|
Definition
Neurotransmitter: GABA
Class: Inhibitory
Receptors: GABA 1 and GABA 2
Effects:
1. Inhibitory
2. reduces anxiety, excitation, and aggression
Association with Mental Illness:
-Decrease: depression and anxiety disorder |
|
|
Term
|
Definition
| a true disease or inability to control one's emotions |
|
|
Term
| what happens to a neurotransmitter after it exhibits an effect on the postsynpatic cell? |
|
Definition
it is destroyed by two mechanisms:
1. destroyed by enzymes at the postsynaptic cell like Acetylcholine is by acetlycholinesterase
2. taken back into the presynaptic cell by cellular reputake and then either recycled or destroyed by intracellular enzymes like the monoamines (dopamine, serotonin, histamine, and norpepinephrine) are destroyed by monoamine oxidase (MOA) |
|
|
Term
| how do the neurons exhibit negative feedback? |
|
Definition
| the neurotransmitters attach to presynaptic receptors in the synapse to then exhibit negative feedback for excessive release |
|
|
Term
| proteins and gases like CO and N2O that are released by postsynaptic cell that influences shape, growth, and activity of presynaptic cells |
|
Definition
|
|
Term
| is cellular communication unidirectional? |
|
Definition
|
|
Term
| a hypersecretion of cortisol in Cushing's disease causes |
|
Definition
|
|
Term
| voluntary motor ability start in the |
|
Definition
|
|
Term
| where is the limbic system located? |
|
Definition
|
|
Term
| Why is that drugs that are used to treat emotional disturbances may cause movement disorders, and drugs used movement disorders may cause emotional changes? |
|
Definition
| because there is an overlap of these various area both anatomically and in types of neurotransmitters employed |
|
|
Term
PET
1. What is it?
2. What is it used for?
3. What does it show in:
a. Schizophrenics?
b. OCD?
c. Depression? |
|
Definition
PET
1. What is it?
Position Emission Tomography
2. What is it used for?
Helpful in identifying physiological and biochemical changes in living tissue as they occur. Use of a radioactive tracer to trace a compound like glucose can help see certain parts of the brain are being used.
3. What does it show in:
a. Schizophrenics?
A decrease of use of glucose in the frontal cortex, particularly in the area of reasoning skills, which is impaired in schizophrenics.
b. OCD?
An increase in frontal cortex.
c. Depression?
A decrease in prefrontal cortex |
|
|
Term
| a major locus of psychological activity and a target for psychiatric drugs? |
|
Definition
| limbic system and the neurotransmitters |
|
|
Term
| what composes the limbic system? |
|
Definition
| frontal cortex, basal ganglia, and brain stem |
|
|
Term
| what is the biological basis of depression? |
|
Definition
| decrease in serotonin or NE or both |
|
|
Term
| What neurotransmitter is associated with schizophrenia? |
|
Definition
| Dopamine; either an increase in transmission or increase in response or sensitivty |
|
|
Term
| What neurotransmitter is associated with anxiety? |
|
Definition
| GABA. Plays a role in modulatin neuronal excitability. Most anxiolytic or antianxiety medications increase the effectiveness of GABA by increasing receptor responsiveness of this neurotransmitter |
|
|
Term
| Neurotransmitters are used by different neurons for different things. What is dopamine used for? |
|
Definition
| thought processes and movement regulation |
|
|
Term
Drugs used to treat mental dysfunctions affect more than one area of the brain because.....
what types of changes? |
|
Definition
they are all interconnected
changes in basic drives, autonomic functions, body movement, speech, emotions, and sleep and alertness |
|
|
Term
| large scale effects and small scale effects of a drug are examples of drug |
|
Definition
| pharamacodynamics: what the drug does to the body |
|
|
Term
| Given an examples of a large scale effect and a small scale effect of a drug. Would this be pharamacokinetics or dynamics? Why? |
|
Definition
Small: MOA is inhibited
Large: Anxiety is reduced
Dynamics because this is the effect of the DRUG on the BODY |
|
|
Term
| Is questioning how the drug is excreted by the kidney or liver pharamacodynamics or kinetics? Why? |
|
Definition
| Pharamacokinetics because it is what the BODY does to the DRUG |
|
|
Term
| an ideal psychiatric drug |
|
Definition
would relieve mental disturbances without
inducing mental (thinking) or somatic (physical) changes |
|
|
Term
| what is the target of psychiatric drugs? |
|
Definition
neurons, neurotransmitters and receptors.
by increasing or decreasing their effects |
|
|
Term
| drugs that block the D2 receptors for dopamine have been found to reduce. therefore it can be concluded that |
|
Definition
| hallucinations and delusions. it can be concluded that hallucinations and delusions maybe due over activity of dopamine at D2 receptors |
|
|
Term
| what transmitters have been consistently linked to mental activity? |
|
Definition
| Norepinephrine, dopamine, serotonin, GABA, and glutamate |
|
|
Term
Psychotropic Drugs
1. Antipsychotics:
-Typical (First Standard Generation):
-Atypical:
2. Mood Stabilizers:
-Lithium:
-Antiepileptics:
-Antidepressants:
* Standard or Typical:
* Selective Serotonin Reuptake Inhibitors:
* Monoamine Oxidase Inhibitors:
3. Antianxiety (Anxiolytic) Drugs:
-Benzodiazepines:
-Busperone (BuSpar): |
|
Definition
Psychotropic Drugs
1. Antipsychotics: Work by blocking D2 receptors to block dopamine transmission, decreasing [dopamine] to decrease the positive effects of schizophrenia (delusions and hallucinations). Because in the basal ganglia the dopamine receptors play a role in the regulation of movement, dopamine blockage can lead to motor abnormalities (extra-pyramidal effects).
-Typical (First Standard Generation): Phenothiazines
-Atypical: Clozapine, Olanzapine, Risperidone
2. Mood Stabilizers:
-Lithium: Work to stabilize the electrical activity of neurons. Interacts with Na and K to treat bipolar disorder. Causes dysrhythmias, convulsions, edema, polyuria, and polydipsia.
-Antiepileptics: Decrease the firing of high frequency neurons. Carbamazepine (Tegretol) and Divalproex (Depakote).
-Antidepressants: Work to increase serotonin or norepinephrine or both.
* Standard or Typical: Include the TCAs and work to block the reuptake of norpinephrine and to a lesser extent serotonin. Nortriptyline, Amitriptyline, and Imipramine.
* Selective Serotonin Reuptake Inhibitors: Block the reuptake of serotonin with little effect on other monoamines. Sertraline (Zyrtec), Fluoxetine (Prozac), Paroxetine (Paxil).
* Monoamine Oxidase Inhibitors: Block MAO from degrading monoamines, can lead to accumulation of tyramine which causes life threatening HTN. Avoid aged cheese, smoked or picked fish, and wine. Phenelzine (Nadal) and Trancylpromine (Parnate)
3. Antianxiety (Anxiolytic) Drugs: Work to increase efficiency of GABA to increase inhibition.
-Benzodiazepines: When benzodiazepines bind to their receptors at the same time that GABA binds to theirs, it increases the inhibitory effects of GABA. Diazepam (Valium), Clonazepam (Klonopin), and Alprozolam (Xanax).
-Busperone (BuSpar):blocks the 5-HT1 presynaptic receptors of serotonin to prevent negative feedback to increase serotonin in synapse |
|
|
Term
| why cant disorders like schizophrenia and major affective disorders be healed through therapeutic means? what can be healed through therapeutic means? |
|
Definition
because they have strong biochemical and
genetic components. Can be healed through therapeutic means: emotional problems like low self esteem or poor self image |
|
|
Term
| if a therapeutic relationship is not formed, chances are high for |
|
Definition
| mutual frustration and withdrawal |
|
|
Term
|
Definition
relationships that are primarily initiated for the
purpose of friendship, enjoyment, accomplishment of a task, where advice is given and mutual needs are met |
|
|
Term
|
Definition
between two or more people who have an
emotional commitment to each other |
|
|
Term
| in a healthy family, an individual is allowed to individuate and develop |
|
Definition
| their own self concept that is separate and unique from other family members |
|
|
Term
| in unhealthy boundaries as seen in those with mental illness |
|
Definition
| there are no boundaries or neutral space |
|
|
Term
| insistence on conformity is an example of |
|
Definition
|
|
Term
|
Definition
| nurse examines their own feelings and gathers data |
|
|
Term
|
Definition
| introduction, focus is on patient's needs and establishing a rapport |
|
|
Term
|
Definition
| ASSESS FOR SAFETY, nurse and client work TOGETHER to solve problems, educate, implement and evaluate care plan, and set goal |
|
|
Term
|
Definition
| summarize what has happened, NO promises, and this step is not always possible |
|
|
Term
|
Definition
| when the client unconsciously tranfers thoughts, feelings,and attitudes from someone/thing in the past onto someone/thing that is current |
|
|
Term
|
Definition
| originates from the nurse, both +/-, CANNOT enter the therapeutic relationship! |
|
|
Term
| what is the purpose of a mental status exam? |
|
Definition
to detect any changes or abnormalities in a person's
-intellectual functioning
-thought content
-judgement
-mood and affect |
|
|
Term
| a mental status exam is focused on what time frame? |
|
Definition
|
|
Term
| often have a flat affect and show no change in expression |
|
Definition
|
|
Term
| what are the components of a mental status exam's patient assessment? |
|
Definition
1. appearance
2. speech
3. motor activity
4. mood
5. affect |
|
|
Term
| what is mood? how is it assessed? |
|
Definition
| mood is a subjective self report about how they feel. ask them to report this |
|
|
Term
|
Definition
| is the nurse's observation of the patient's emotional state |
|
|
Term
|
Definition
| chaning from one emotion to the other |
|
|
Term
|
Definition
| alert, confused, sedated, and stupurous |
|
|
Term
| in terms of orientation, a patient with delirium or dementia |
|
Definition
|
|
Term
|
Definition
| ability to recall past experiences |
|
|
Term
| during the concentration and calculation portion of the mental status exam, it is important to remember to not |
|
Definition
| ask to many questions to quickly |
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