Psy ch otropic Dru gs: affect your mind
I. Anatomy Review:
A. Neur ons: foundational structure of the neurological system
- Dendrites, axons, synaptic terminals
- Chemical and electrical reactions
- Electrical impulse that creates a chemical reaction with another neuron, muscle,
or other activator
B . Ner ve synapse:
- When they communicate we look at that electrical signal and release
neurotransmitters and pass the space (synapse)
- Postsynaptic effector cell: cause cell to react
- The process has an end:
- Inactivation (MAO enzyme): comes and stops it
- Diffusion: neurotransmitter get absorbed in bloodstream
- Re-uptake: the neurotransmitter that had a reaction get sucked back into
the presynaptic neuron
C. Neur otr ansm itter s:
a. Acetylcholine: communicates btw nerves and muscles, memory and attention
b. Norepinephrine/epinephrine: fight or flight, alertness
c. Dopamine: coordinates impulses and responses in motor and intellect, reward,
pleasure
d. GABA: inhibits nerve activity, excitability and stimulation (sleepy neuron, slows
down)
e. Serotonin: balance in sleep, arousal, motivation, appetite (found in brain and GI
tract)
D. Ner vous System :
a. Hindbrain: vital functions, breathing, heart beat, bp, swallow or vomit (THINK
VITALS)
b. Cerebellum: balance, posture
c. Midbrain -RAS: keeps us awake, and alert, arousal
d. Forebrain: temp reg, pain sensation, limbic system: emotions (thalamus,
hypothalamus)
e. Corpus callosum: speech
A. Anxiety:
a. Nervousness, feeling of apprehension, tension, fear, sweating, tachycardia, rapid
breathing, elevated blood pressure
b. How do w e m easur e the eff ectiven ess? Rem em ber the sym ptom s
B . B enzodiazepines:
,a. Central nervous system depressants to induce calm and sleep. Makes GABA more
effective in the RAS. Suppresses the limbic system
b. Examples:
i. Shor t acting: alprazolam (xanax)
ii. Intermediate: clonazepam, lorazepam
iii. Long acting: diazepam
c. Indication: anxiety, anesthesia, seizures, alcohol withdrawal, muscle spasms
d. Side eff ects:
i. Primary: CNS depression (sedation/drowsiness, dizziness, hypotension)
ii. Wild cards:
iii. Paradoxical (rebound effect): excitement/anxiety
iv. Life threatening: respiratory depression, cardiac arrest,
dependence/abuse, withdrawal (in cr edibly addictive)
e. B enzo W ithdr aw al: I can’t STAND
i. Insomnia, pain HTN
ii. Sweating and seizures (SEIZURES!!! After stopping abruptly)
iii. Tremors and muscle spasms
iv. Anorexia and nausea
v. Nightmares and hallucinations
vi. Dizziness and headaches
1. Important:
a. How long has it been since you had it?
b. How long have you been on the medication
f. B enzo Toxicity: AB USED
i. Altered mental status
ii. Bradycardia
iii. Unable to walk
iv. Speech garbled
v. Experience hallucinations
vi. Decreased respirations
g. Patient teaching:
i. Do not consume ETOH or opioids
ii. Avoid activities that require focus such as driving
iii. Side effects may subside with time
iv. Do not stop medication abruptly
v. Tolerance to drug may develop
vi. Should not be used for everyday stress
vii. Do not use for prolonged periods
h. Nur sing im plication s:
i. PO is ideal route
, ii. If IV: give slow due to risk of respiratory arrest
iii. Taper (lessen the drug overtime) dose to discontinue
iv. Monitor for signs of toxicity - antidote is fl um azen il
v. Assess for hypotension and level of consciousness
vi. Older adults more susceptible to adverse events
vii. Assess effectiveness
viii. Safety measures for falls
ix. Caution with liver disease
A. B ar bitur ates: inhibit impulses in the cerebral cortex, RAS, and cerebellum by
enhancing the GABA receptors
B. Indication: preoperative sedation, anesthesia (brief procedures), anxiety, seizures,
induce coma with IICP
C. Side eff ects:
a. Primary: CNS depression
i. sedation/drowsiness
ii. Hypotension
iii. Bradycardia
iv. vertigo/ataxia
v. Hallucinations
vi. GI: N/V, constipation
b. Paradoxical: excitement
c. Life threatening: dependence, respiratory depression, cardiac arrest
D. Patient teaching:
a. Do not consume ETOH or opioids
b. Avoid activities that require focus such as driving
c. Do not stop medication abruptly
E. Nur sing Im plications:
a. If IV: give slow due to risk of respiratory arrest
b. Arrest IV site frequently - may cause tissue necrosis
c. Taper dose to discontinue
d. Have standby life-support
e. Monitor respiratory status before and after use
f. Seizure precautions
g. Safety measures for falls
F. Contraindication: Who should be cautioned when taking this drug?
a. Older adults
b. History of drug abuse/addiction
c. Cognitive impairment
d. Chronic respiratory conditions
I. Anatomy Review:
A. Neur ons: foundational structure of the neurological system
- Dendrites, axons, synaptic terminals
- Chemical and electrical reactions
- Electrical impulse that creates a chemical reaction with another neuron, muscle,
or other activator
B . Ner ve synapse:
- When they communicate we look at that electrical signal and release
neurotransmitters and pass the space (synapse)
- Postsynaptic effector cell: cause cell to react
- The process has an end:
- Inactivation (MAO enzyme): comes and stops it
- Diffusion: neurotransmitter get absorbed in bloodstream
- Re-uptake: the neurotransmitter that had a reaction get sucked back into
the presynaptic neuron
C. Neur otr ansm itter s:
a. Acetylcholine: communicates btw nerves and muscles, memory and attention
b. Norepinephrine/epinephrine: fight or flight, alertness
c. Dopamine: coordinates impulses and responses in motor and intellect, reward,
pleasure
d. GABA: inhibits nerve activity, excitability and stimulation (sleepy neuron, slows
down)
e. Serotonin: balance in sleep, arousal, motivation, appetite (found in brain and GI
tract)
D. Ner vous System :
a. Hindbrain: vital functions, breathing, heart beat, bp, swallow or vomit (THINK
VITALS)
b. Cerebellum: balance, posture
c. Midbrain -RAS: keeps us awake, and alert, arousal
d. Forebrain: temp reg, pain sensation, limbic system: emotions (thalamus,
hypothalamus)
e. Corpus callosum: speech
A. Anxiety:
a. Nervousness, feeling of apprehension, tension, fear, sweating, tachycardia, rapid
breathing, elevated blood pressure
b. How do w e m easur e the eff ectiven ess? Rem em ber the sym ptom s
B . B enzodiazepines:
,a. Central nervous system depressants to induce calm and sleep. Makes GABA more
effective in the RAS. Suppresses the limbic system
b. Examples:
i. Shor t acting: alprazolam (xanax)
ii. Intermediate: clonazepam, lorazepam
iii. Long acting: diazepam
c. Indication: anxiety, anesthesia, seizures, alcohol withdrawal, muscle spasms
d. Side eff ects:
i. Primary: CNS depression (sedation/drowsiness, dizziness, hypotension)
ii. Wild cards:
iii. Paradoxical (rebound effect): excitement/anxiety
iv. Life threatening: respiratory depression, cardiac arrest,
dependence/abuse, withdrawal (in cr edibly addictive)
e. B enzo W ithdr aw al: I can’t STAND
i. Insomnia, pain HTN
ii. Sweating and seizures (SEIZURES!!! After stopping abruptly)
iii. Tremors and muscle spasms
iv. Anorexia and nausea
v. Nightmares and hallucinations
vi. Dizziness and headaches
1. Important:
a. How long has it been since you had it?
b. How long have you been on the medication
f. B enzo Toxicity: AB USED
i. Altered mental status
ii. Bradycardia
iii. Unable to walk
iv. Speech garbled
v. Experience hallucinations
vi. Decreased respirations
g. Patient teaching:
i. Do not consume ETOH or opioids
ii. Avoid activities that require focus such as driving
iii. Side effects may subside with time
iv. Do not stop medication abruptly
v. Tolerance to drug may develop
vi. Should not be used for everyday stress
vii. Do not use for prolonged periods
h. Nur sing im plication s:
i. PO is ideal route
, ii. If IV: give slow due to risk of respiratory arrest
iii. Taper (lessen the drug overtime) dose to discontinue
iv. Monitor for signs of toxicity - antidote is fl um azen il
v. Assess for hypotension and level of consciousness
vi. Older adults more susceptible to adverse events
vii. Assess effectiveness
viii. Safety measures for falls
ix. Caution with liver disease
A. B ar bitur ates: inhibit impulses in the cerebral cortex, RAS, and cerebellum by
enhancing the GABA receptors
B. Indication: preoperative sedation, anesthesia (brief procedures), anxiety, seizures,
induce coma with IICP
C. Side eff ects:
a. Primary: CNS depression
i. sedation/drowsiness
ii. Hypotension
iii. Bradycardia
iv. vertigo/ataxia
v. Hallucinations
vi. GI: N/V, constipation
b. Paradoxical: excitement
c. Life threatening: dependence, respiratory depression, cardiac arrest
D. Patient teaching:
a. Do not consume ETOH or opioids
b. Avoid activities that require focus such as driving
c. Do not stop medication abruptly
E. Nur sing Im plications:
a. If IV: give slow due to risk of respiratory arrest
b. Arrest IV site frequently - may cause tissue necrosis
c. Taper dose to discontinue
d. Have standby life-support
e. Monitor respiratory status before and after use
f. Seizure precautions
g. Safety measures for falls
F. Contraindication: Who should be cautioned when taking this drug?
a. Older adults
b. History of drug abuse/addiction
c. Cognitive impairment
d. Chronic respiratory conditions
