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Systems of the brain that controls anxiety and insomnia
Limbic System and Reticular Activating System (RAS)
Stage IV NREM
- deepest stage of sleep and necessary to prevent feeling tired and depressed
- patients who are deprived of this stage experience depression and a feeling of apathy and fatigue
- linked to repair and restoration of the physical body
- sleep walking and nightmares in children happen in this stage
- may take several weeks to see effects
- MOA: unclear, but may be related to dopamine receptors-high affinity for serotonin (inhibitory) receptors and agonistic effect on dopamin (inhibitory) receptors
- SE: dizziness, headache, drowsiness
Major SE of Ambien
Somnambulance- doing things in your sleep and having no recollection
- due to stressful environment
- can motivate ppl to get things done
- most ppl learn to cope and dont get med help
For stress/treatment to be effective
Cause Must be Determined
effective treatment for anxiety
- medication of choice to manage various anxiety disorders and insomnia due to low risk of abuse/dependence
- Alcohol withdraw
- seizure treatment (valium)
- central muscle relaxation
- induction agent in general anesthesia
binds to gamma-aminobutyric acid (GABA) receptor-chloride molecule by intensifying effects of GABA (inhibitory) neurotransmitter
- Very few side effects
- weight gain and sexual dysfunction (2 biggest reasons patients do not comply)
Should be avoided when taking MAOIs
- Tyramine (naturally occuring monoamine acts as a catecholamine) foods containing: aged cheeses, avacadoes, bananas, eggplant, oranges, plums, processed foods, soy
- also avoid caffeine-can cause hypertensive crisis
Why are Barbiturates rarely used to treat anxiety?
b/c they have serious side effects
cycles of mania and depression
Patients just starting on meds for depression are...
highest risk for suicide
- patients must have their levels checked b/c can become too toxic or too low and still have episodes of mania
- Therapeutic range 0.6-1.2
- Stabilized patients should be able to explain the sins and symptoms of toxicity and how to avoid it.
- good choice for bipolar
- children stabilized on meds should be able to have normal play with peers
- avoid appetite suppression by giving med after meals and snacks
Seasonal Affective Disorders
occur during the winter months when there is limited sum exposure
prevent depression by preventing the destruction of Dopamine, Norepinephrine, Epinephrine, and Serotonin
Negative Symptoms of Schizophrenia
being withdrawn, not talking, and not interacting with the environment
Antipsychotic medications for schizophrenia have what type of side effects?
- Anticholinergic side effects
- urinary retention, dry mouth...
unusual tongue and facial movements (lip smacking and wormlike tongue movements) that come with use of anipsychotic meds
- Atypical antipsychotic
- used to treat sschizophrenia
- can cause serious side effects-low white blood count that can be life threatening
- treats positive and negative symptoms
- used to reat overdose of narcotics, including PCA pumps
- completely reverses the effects of the narcotics, including bringing back the pain
Before giving Any pain med, a nurse should first?
assess the patients pain level on a scale of 1-10
Serious side effect of narcotics
- ringing in ears
- an adverse side effect of Aspirin therapy
- contraindicated for patients with liver disease and alcoholics
dull, aching pain
Action of med to stop migraine pain?
vasoconstriction of certain intracranial arteries
example- alcoholic patient requiring additional anesthesia for surgery
Cocaine OD can lead to:
cardiac dysrhythias and death
smoking + oral contraceptives =
higher risk for lung cancer
alcohol withdraw symptoms
tremors, anxiety, confusion, and delirium
most serious side effect of inhaled anethesia
What is added to local anethesia to control bleeding and extend the duration of the anesthetic?
Most common side effect of spinal anesthesia?