NR 326 Exam #1
Fast excitatory neurotransmitters - -strong, immediate action
- ex. Dopamine (monoamines)
-Fast inhibitory neurotransmitters - -balance the nervous system
ex. GABA (Amino Acid)
-Slow neuromodulators - -slow long-lasting action
-Cholinergic Neurotransmitters - -acetylcholine - memory and muscle
movement
-decreased acetylcholine - -Alzheimer's disease
-Monoamines - -norepinephrine, dopamine, serotonin, histamine
-Monoamines: Norepinephrine - --mood, cognition, arousal
-Want more available to treat depression
-Too little: depression
-NSRI
-Too much: mania, anxiety states - never put a pt. Who has bipolar disorder
on an SSRI
-Monamines: Serotonin - --mood, sleep, arousal, appetite, libido
-Want more available to treat depression
-Too little: depression
-SSRI
-Monoamines: Dopamine - --movement and coordination
-increased: schizophrenia
-Antipsychotics to treat schizophrenia block dopamine
-Movement and coordination. Too much is Schizophrenia
-EPS: Pseudoparkinsonism, dystonia, akathisia(can't sit still).
-EPS sx are more common with first generation antipsychotics
-Second gens still can but lower incidence
-Monamines: Histamine - --Inflammatory response
-Use antihistamines to help treat anxiety
-Amino Acids - --GABA
-slows down body activity
-we want GABA to decrease anxiety
-decreased levels = anxiety
-benzodiazepines help to increase
, -SSRI and NSRI Reuptake - -the process by which neurotransmitters are
released into the synaptic cleft and returned to presynaptic neurons by
reuptake.
-MAOI's - --phenelzine
-need to monitor diet for tyramine, since intake can cause a hypertensive
crisis
-Antipsychotics: 1st Generation - Typical - --target dopamine
-Haloperidol
-Fluphenazine
-Chlorpromazine
-Target blocking dopamine but cause EPS sx
-Good at blocking positive symptoms: hallucination, delusions, motor
changes, thought processes
-Nursing Considerations Typical Antipyschotics - --minimize anticholinergic
effects
-minimize postural/orthostatic hypotension
-monitor for EPS
-How can we monitor for EPS? - -use the AIMS scale (abnormal involuntary
movement scale)
-Major adverse effects of antipsychotics - --EPS
-Tardive dyskinesia (if this occurs stop medication, it is a late sign of EPS, we
want to prevent this)
-NMS
-EPS - --drug induced acute movement disorders
-pseudoparkinsonism
-akathisia
-dystonia
-How do we treat EPS? - -benztropine, diphenhydramine
-Haloperidol (Haldol) - -typical antipsychotic
-Fluphenazine (Prolixin) - -typical antipsychotic
-Chlopromazine (Thorazine) - -typical antipsychotic
-Antipsychotics: 2nd Generation - Atypical - --target dopamine and
serotonin
-Clozapine
Fast excitatory neurotransmitters - -strong, immediate action
- ex. Dopamine (monoamines)
-Fast inhibitory neurotransmitters - -balance the nervous system
ex. GABA (Amino Acid)
-Slow neuromodulators - -slow long-lasting action
-Cholinergic Neurotransmitters - -acetylcholine - memory and muscle
movement
-decreased acetylcholine - -Alzheimer's disease
-Monoamines - -norepinephrine, dopamine, serotonin, histamine
-Monoamines: Norepinephrine - --mood, cognition, arousal
-Want more available to treat depression
-Too little: depression
-NSRI
-Too much: mania, anxiety states - never put a pt. Who has bipolar disorder
on an SSRI
-Monamines: Serotonin - --mood, sleep, arousal, appetite, libido
-Want more available to treat depression
-Too little: depression
-SSRI
-Monoamines: Dopamine - --movement and coordination
-increased: schizophrenia
-Antipsychotics to treat schizophrenia block dopamine
-Movement and coordination. Too much is Schizophrenia
-EPS: Pseudoparkinsonism, dystonia, akathisia(can't sit still).
-EPS sx are more common with first generation antipsychotics
-Second gens still can but lower incidence
-Monamines: Histamine - --Inflammatory response
-Use antihistamines to help treat anxiety
-Amino Acids - --GABA
-slows down body activity
-we want GABA to decrease anxiety
-decreased levels = anxiety
-benzodiazepines help to increase
, -SSRI and NSRI Reuptake - -the process by which neurotransmitters are
released into the synaptic cleft and returned to presynaptic neurons by
reuptake.
-MAOI's - --phenelzine
-need to monitor diet for tyramine, since intake can cause a hypertensive
crisis
-Antipsychotics: 1st Generation - Typical - --target dopamine
-Haloperidol
-Fluphenazine
-Chlorpromazine
-Target blocking dopamine but cause EPS sx
-Good at blocking positive symptoms: hallucination, delusions, motor
changes, thought processes
-Nursing Considerations Typical Antipyschotics - --minimize anticholinergic
effects
-minimize postural/orthostatic hypotension
-monitor for EPS
-How can we monitor for EPS? - -use the AIMS scale (abnormal involuntary
movement scale)
-Major adverse effects of antipsychotics - --EPS
-Tardive dyskinesia (if this occurs stop medication, it is a late sign of EPS, we
want to prevent this)
-NMS
-EPS - --drug induced acute movement disorders
-pseudoparkinsonism
-akathisia
-dystonia
-How do we treat EPS? - -benztropine, diphenhydramine
-Haloperidol (Haldol) - -typical antipsychotic
-Fluphenazine (Prolixin) - -typical antipsychotic
-Chlopromazine (Thorazine) - -typical antipsychotic
-Antipsychotics: 2nd Generation - Atypical - --target dopamine and
serotonin
-Clozapine
