Neurobiology and Pharmacotherapy PDF

Neurobiology and Pharmacotherapy  Short term Bipolar ↑ ↑ Antidepressants I Anxiety  - in patient end in"am" or Antianxiety is Hypnotic...

Neurobiology and Pharmacotherapy  Short term Bipolar ↑ ↑ Antidepressants I Anxiety  - in patient end in"am" or Antianxiety is Hypnotic Medications Benzodiapines for (short term anxiety or panic - - Diazepam (Valium) - Benodpinsom -Furazepam (Dalm) Clonazepam (Klonopin) - - TamzepHeston Trazdam Halon) Alprazolam (Xanax) - - Bas for Alcoho - LorazepamtAtivan) - Chlordzepidlibum) -DiazepamValu Temazeam Hestori) - - - TorazepamCattva of class of medications used for their primarily sediative ,anti anxiety muscle , relaxant,and anticonvulsant properties.They enhance the Effect of the Neurotransmitter acid (GABA) gamma-aminobutyric effect in the brain producing a calming Side Effects - Drowsiness - Dizziness Fatigue Confusion Memory Impairment - - Physical dependence is Tolerance wh long-term use - I -Risk ofoverdose especially , when combined wit a ↑ p+ 2 Special Considerations Dependence and Withdrawal · - Benzodiazepines can cause physical dependence withdrawal symptoms wel prolonged use , leading to when discontinued o Tolerance Over time the body may require higher - doses to achieve the same therapeutic effect " Risk of Overdose when combined rol other central nervous -Especially like alcohol or opiods system depressants  Melatonin Receptor Agonists Ramelteon (Rozere · · Doxepin (Silenor) - Orexin receptor antagonists (promote sleep surovexant ~ Hemborexant Buspirone (tuSpar) -  Serotonin Morepinephrine Reuptake Inhibitors · Desvenlafaxine (Pristia and choice Duloxetino (Cymbalta) · Levomilnacipranfettima) · Venlafaxine (Effexor) · oftwo work by increasing the levels They - : Serotonin norepinephrine Neurotransmitters in the brain are often Thesechemicals help regulate mood and - imbalanced in individuals with depression or anxiety Side Effects - naused dizziness - - insomnia - increased sweating mouth dry - - sexual dysfunction  SSRTsebra ( is , favorable Least of effects amount side side effect - escitalopram (Lexapro) bloodtestTo ) wo fluoxetineProzac) lend in ine) - paroxetine Paxil) - sertralinezolift) side Effects - nausea Insomnia - or drowsiness libido ,difficulty reaching organism Sexual dysfunction(decreased - Dry Mouth - Increased - sweating Dianhea - loss) weight changelgain or - - headache first few - risk of increased anxiety in the week ( weeks patient will feel worse first I I effects of drug - - 4 toowks to receive positive  Tricyclic Antidepressants (Stronger Suit block the reuptake of serotonin & and They 1 nonepinephrine inpresynaptic terminalsiless commonly used due tose but still used for depression Amitriptyline - end in "tyline) - Imipramine (Tofranill Hotriptyline (Pamelor) -  MAUI Inhibitors Antidepressants - who do not respond to - used with patients Stodrestrictions other treatments don't work Phenelzine (Mardil) - Tranylcypromine (Parnate - side effects still need to know ? - Abmpt cessation can result in antidepressant discontinuation syndrome Anxiety , agitation insomnia chills diaphoresis , - , , , headache initability , malaise, nausea Sexual dysfunction, insomnia weight gain - Avoid foods high In Tyramine lagedcheeset) - smoked or processed meats , such as not dogs, , bacon, corned beef or smoked fish bologna - Pickled or fermented foods ,such as sauerkraut , Kimichi ,Tofu - sauces: soy sauce, Shrimp sauce, fish sause ,  Atypical Antidepressants that work in various ways and often Diverse group · don't work used whenother meds Common Atypical Antidepressants Bupropion (Wellbutrin) : Affects dopamine Shoepinephrine o often used for depression and smoking cessation Mirtazapine (Remeron) : Increases serotonin and noepinephrine · often used in individuals rol depression and insomnia -Trazodone : Often prescribed as a sleep did in addition to treating depression Beta Blockers (for Anxiety) children > - cuse for cardiovascular but can also be effective in of rapid heart rate, symptoms , such as anxiety treating and the adrenaline epinephrine) tremors , = sweating ; blocks Propanolol (Inderal · · Atenolol (Tenoumin) Antihistamines (For Anxiety) set sedative effects some can generallyYetatallergiesa promoting relaxation can cause drowsiness isnort term Hydroxyzine Wistaril Atarax) · ,  Serotonin Syndrome Sectionin Syndrome potientally life-threatening A - drug induced condition caused by too much serotonin in the synapses of the brain (MGOI , SNRI, SSRI)  Mood Stabilizer (Bipolar, Schizophrenia) - Lithium (Eskalith , Lithobid) - Anticonvulsant Medications L valproate (Depakote, Depakene) carbamazepine (Equetra, Tegretol ↳ Lamotrigine (Lamictal)  Lithium (some require higher dosage) - mood stabilizer treats thanothers , bipolar disorder Brand names Eskalith, Eskalith Ch Lithobid - safe blood level 0 6-1 2 mEglmlo Lithium.. can happen when level is 1 5 or higher. toxicity. severe leves have to come back to checks as Teaching avoid low sodium diets - and dehydration because this can increase the risk of lithium - avoid over the counters prescription toxicity pain meds that contain NSAIDS/exibuprofennaproxen) caffeinated beverages - avoid excessive as coffected , cola; or energy drinks such Effects Common Side - Headache Dizziness or dowsiness - Dry mouth- in appetite Increased Nausealvomiting change thirst - - - Diawhea - hand tremors Increased - urination p+ 2 Lithium Toxicityseverecanreadseath include tremor, increased reflexes, maytrouble - a walking kidney , problems, altered LOG diawhea, muscle weakness , severe nausea , vomiting of coordination) - , confusion and ataxia (loss ,  Medications /Schizophrenia ,Bipolar Antipsychotic severe Depression First better treatment (severe generation - - second generation (atypical) - -fewer Se - medications used to manage psychosis symptoms, such nallucinations as , and delusions , disorganized thinking ,  First Generation (Conventional) (Antipsychotic First developed and primarly effective at reducing psychosis (hallucinations, delusions) - of positive symptoms common - Haloperidol (Haldol) Chlorpromazine (Thorazine) Fluphenazine (Prolixin) Thioridazine (Wellavil) Side Effects usess Schizophrenia - Acute Psychosis - Agitation - Severe behavioral problem - Extrapyramidal Sedation movement disorders including tremors , rigidity, bradykinesia, movements - , and tardive dyskinesia (involuntary - sedation weight gain - effects (dymouth , constipation, plured vision) anticholinergic - Neuroleptic Malignant Syndromerare but serious - -  Extrapyramidal Symptoms (AM ScoresholdsI * management Acute ; muscle twitches or involuntary Dyskinesias - moves reactions Have to stop med Dystonic - to abnormal muscle contractions leading unvoluntaryand movement (twisting treatment ; Anticholergentic posture Antihistemine - tardive dyskinesian involuntary , repetitive movements that may developafterlongtermantipsyot to in end in zine DeutetrapezineAusedo ↳albenazine (Ingrezza) movements Tongue due to dopamine receptor Parksonism ; resemble Parkinson of movementa bradykinsastroness - blockage itremor ait to direct musclesia state of inner - Akinosiainnable to be in restlessness and uncontrollable urge sit still constant motion - pacing inability to , ; rare but potential -Neuroleptic Malignant syndrome characterized by severe muscle life threatening condition mental , altered feer, rigidity , and autonomic high instability Second Generation (Atypical) Produce fewer extrapyramidal side effects - - often chosen as first-line treatment due to lower extrapyramidal side effects Prominent D2(dopamine) and 5/serotonin - Drugs Side Effects clozapine(Clozan) - Risperidone (Risperdal) - -Schizophrena b disorder - major depressive - Quetiapinel Seroquel) - initability associated / autism - Olanzapine (zyprexal - weight gain - - metabolic syndrome blood cholesterol) sugars Ziprasidone (Geodon) (increased - - sedation Aripiprazole Ablity) - - - hormone changes -Less risks of EPS compared - Paliperidone (Invega) to typical antipsychotics Eloperidone (fanapt) - - Curasidone (Latuda) Asenapine (Saphris) - Brexipiprazole (Rexultil - Cariprazine (Vaylar - - Lumateperone (Caplyta)  AIMs Assessment AbnormalInvoluntaryMovementsclinicalrating See all - (EPs) evaluating extrapyramidal symptoms and quantify abnormal - Alms is designed to identify can arise from the use movements that involuntary of antipsychotics - Anxiolytics Benzodiazepins , Buspirone Medication for ADHD Stimulants -Methlphenidate (Ritalin , Concerta - -Amphetamines (Adderall ,Vyanese) - Atomoxetine (Strattera - GuanfacinelIntunir) Clonidine (Kapray) - Medication for Alzheimer's Disease-cognitive Enhancers Choline sterase Inhibitors /slow destruction of acetycholine · ↳ Donpezil(Aricept ↳ Galantamine (Mazadynd Rivastigmine(Exelon oGlutamate-blocking agent L Memantine (Namenda, Mamenda XR) Herbal Treatment but L be positive may may lack safety is efficacy FDA data remains Hack of regulation by Examplesist z wartomid on depression tlanziety)  Mental Status Examination tool to evaluate patients structured assessment psychological functioning - emotional and Cognitive, , & components Appearance ~ Behavior - Speech - - Mood and Affect - Thought Process - ThoughtContent - Perception Cognition - - Insight Judgement -  Chapter - Cultural Western Tradition found in - Identity individuality -values Autonomy (Independence (Self-reliance - Mind body-separate entities - Disease hasmeasurable a cause, treatment is aimed at the cause Time is linear - Success is obtained in preparing for the future Eastern Tradition basis for - family identity Body-mind-spirit one entity - circular and Time is recurring -Born into a fateiduty to comply Diseased caused by fluctuations in opposing - Indigenous Cultureon forces - places significance place of humans innatural would - Basis of identity is the tribe in relation to other - Person is an entity only - Disease-lack of harmony between individual environment Culturally Congment Care and Associated Competencies five of effective culturally care · constructs I Cultural Awareness 2) Cultural knowledge cultural encounters I Cultural skill Cultural desire  Chapter C /Legal Ethical Considerations) Ethics : beliefs about what - study of philosophicalor in society is considered right wrong Bioethics' to ethical dilemmas - used in relation health care surrounding Ethical Dilemma : two or more cources ofaction conflict between - 6 Principles of Bioethics self nights - Autonomy ; - Beneficence ; promote good - nonmaleficence; no harm - Justice ; Distribute resources or care equally - Fidelity ; maintaining loyalty's commitment truthfull Veracity ; being - Evolving Ethical Issues in Psychiatric Care Pharmacogenetic Testing · Lissue of normaleficence : If tests are not useful ,then potential harm outweighs benefits Predictive o Psychiatry could Genetic Lstigmatization :an testing individual from prevent getting a job L issue of autonomy ; right to know or not know  Hospital Admission Procedures patientordian Admission Voluntary : sought by commitment: without Involuntary patient's consent ill mentally - to self other danger or - - disabled gravely in need of treatment illness prevents - voluntary help seeking unvoluntary commitment : otmergency commitment (temporary admission) person confused or dementedemergency admission 72 hours ↳ generally  Due Process Commitment in Involuntary don't of habeas corpus Lused when patients believe they have been held without just cause doctrine Least restrictive alternative · or restrictive action the least drastic taking &  Tort Law Tottiany wrongful act intentional , or accidental , that results in to another an injury - Intentional fort ; willful or intentional acts LASSault Invasion of privacy Battery ↳ Defamation of character LFalse Imprisonment Islander or libel) unintental tort junintended acts anst ag - another that produce injury or harm negligence umalpractice