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What lobe of the brain is involved w/ Schizophrenia?
Frontal...= decr. in abstract reasoning, decision making, socializing, goal planning, insight, motivation
What MH are assoc. w/ the temporal lobe?
Schizophrenia, depressive disorders, PTSD, ETOHism, Alzheimers...temporal lobes connect w/ limbic system which is our "tmotional brain" that allows expression of emotions (eg. sexual, aggressive, fear...)
What is the impact of MAOI on neurotransmitter function?
MAOI= Monoamine oxidase inhibitors destroy monoamine oxidase which is an enzyme that destroys nonrepinephrine, epinephrine, dopamine and serotonin...allowing for more of these neurotransmitters at the synapse
What are the typical antipsychotics?
She Thought Pretty Navels Had Melons
What are some of the atypical antipsychotics?
Always Remember Clean Giraffes See Zebras
What is the gneral emergency tx for agitated pts?
- -Zydis (PO fizzy tab)
- -Geodon (IM)
- -B-52: Haldol, Ativan, Cogentin
- -any injectible older drugs but watch for EPS
What is the s/e of Clozaril?
agranulocytosis, pt. must have weekly CBCs
What is the s/e of Zyprexa?
weight gain, metabolic syndrome
What is the s/e of Risperdal?
What is the s/e of Seroquel?
What is the s/e of Geodon?
orthostatic hypotension, dysrhythmias
What is Abilify?
an atypical....it is a dopamine system stabilizer...in areas of the brain w/ excess dopamine it lowers it, and in areas w/ decr. dopamine it stimulates receptors to raise the dopamine level, acting as a dopamine agonist
What is an oculogyric crisis?
usually result of typicals, a dystonic reaction when the eyes shoot to the top of the head and the pt. can't bring them down
What is the tx for a dystonic rxn?
- congentin or benadryl...
- hold the causatory med until consult w/ MD
When is the highest time of risk for a dystonic rxn?
What is the time of risk for Pseudoparkinsonism? What is the tx?
- -weeks to months
- -tx is cogentin or symmetrel
Cogentin= an Anticholinergic that blocks the EPS of medications, but can cause delirium in the extreme
"hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter"
s/e: dry mouth, blurred vision, hot dry skin and hyperpyrexia, mental statues changes
Discuss Neuroleptic Malignant Syndrome (NMS)
- -occurs from dopamine blockade...main thing we want to watch for is high fever, but also HTN, incr. muscle tone, sweating, tachycardia, drooling...
- -D/C med, tx in ICU w/ Dantrium and Parlodel
What is alogia?
poverty of thought
What is avolition?
lack of motivation
What is anhedonia?
inability to experience pleasure
Discuss the positive symptom of Shizophrenia that is negativism/resistance
- active negativism= pt does the opposite
- passive negativism= pt does not perform basic ADLs
What is the general function of dopamine?
- -abstract thinking
- -integrationof emotions and thoughts
- -decision making
- -stimulates heart, incr. bloodflow to organs
- -controls muscle movement and coordinations
- -fine muscle movement
What are the general functions of noradrenaline?
- noradernaline = excitatory
- -selective attention and cognition
- -stimulates ANS for Fight or Flight
- -pulse and BP regulation
What are the general functions of serotonin?
- -serotonin= excitatory
- -mood regulation
- -sexual function
- -panic attacks
- -sleep/wake cycle
What are the general functions of histamine?
- histamine= excitatory
- -inflammatory response
- -stimulates gastric secretion
What are the general functions of GABA?
- GABA= inhibitory
- -reduces anxiety
- -reduces excitation
- -reduces agression
What are the general functions of Glutamate?
- glutamate= excitatory
- -plays a role in learning
What are the general functions of Acetylcholine?
- -w/ Ach think demintia, Alz....
- a decr. in Ach= decr inhibition, decr memory, euphoria, constipation, tachycardia
-an incr. in Ach =over inhibition, anxiety, depression, diarrhea, bradycardia
Incr. in Dopamine=
Decr. in Dopamine=
Incr. in norepinephrine=
mania, anxiety, Schizophrenia
Decr. in norepinephrine=
Incr. in serotonin=
anxiety, serotonin syndrome (watch for hypertensive crisis!)
Decr. in serotonin=
incr in histamine=
hyperactivity, compulsivity, suicidal depression
decr. in histamine=
sedation, weight gain, hypotension
incr in GABA=
reduction of anxiety
decr. in GABA=
mania, anxiety, Schizophrenia
prolonged activation kills neurons
Alz disease, huntingtons chorea, parkinsons