NURS 216 Midterm Exam (Term 2) – Questions Answered
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Terms in this set (267)
Dopamine -Excitatory or inhibitory NT
-reward pathway
-balance
Serotonin -Inhibitory NT
-required to balance out excitation and mood
GABA -Inhibitory NT
-increases CI influx --> decreasing excitability of cell
Glutamate -Excitatory NT
-potential NMDA agonist for treatment of depression
Ach -NT at the neuromuscular junction
Norepinephrine
Chronic Pain Definition -Over excitation of receptors
-pathologic pain (pain no longer serves a purpose)
-pain pathway modulation
-is a complex process!
What is first line treatment of chronic pain? #1: CBT
Drug?
Drug: Gabapentin (Neurontin)
-increases GABA (calming)
-excreted unchanged
*can see addiction and sedation in high doses
,Types of 'hyper excitation' disorders 1.Seizures (epilepsy)
TX:
-increase GABA transmission + presence
-decrease neuronal excitability
2.Anxiety
TX:
-increase GABA
-increase Serotonin
3.Psychosis
TX:
-Decrease dopamine
4.Chronic Pain
What is psychosis? What are the S+S? Perceptive loss of reality
-can be acute or chronic
S+S:
-hallucinations (sensory- visual and auditory most common)
-delusions (false beliefs in facts or personal status, paranoia)
-lack of awareness + judgment
-mood/affect alterations (could be 'up' or down'
What is the etiology of psychosis? A. Mental health illnesses, EX:
-schizophrenia
-bipolar disorder
-severe depression
B. Drug side effect /OD /alcoholism
C.Electrolyte imbalance
D.Sepsis in elderly
E.Hospital induced (overstimulation) --> need proactive
prevention!
What is schizophrenia? What are the S+S? -dysfunction of thoughts and language expression, chronic
illness
-significant familial link
-can cause state of psychosis
-onset: 10-55 years
S+S:
-abnormal behaviours and movement
-incomprehensible speech
-alterations in function (hallucinations, delusions, paranoia,
disorganized thoughts)
-mood alterations (agitated, withdrawn, apathic)
What is the etiology of schizophrenia? -Structural
-NT dysfunction
-Pathway dysfunction (signaling is interrupted)
How do you diagnose schizophrenia? Need to have:
at least 2 abnormal behaviours and sensations
AND
2 functional deficits
What are hallucinations? Sensory information pathways lead to thalamus
EX. retina via optic nerve --> thalamus --> primary visual
cortex -- visual association cortex --> meaning
GLITCH SOMEWHERE!!
, What is etiology of hallucinations? -Sensory block --> stored images replace intel
EX. sensory deprivation, sensory dysfunction (ex. blindness)
-Neuronal dysfunction= hyperactivity, pathway dysfunction,
end organ failure
What is the target for psychosis treatment? Limbic system D2 receptors
Potential side effects? -mood, behaviour, emotion control
S/E:
-D2 antagonism in basal ganglia --> unwanted motor
movements
Pros and cons of antipsychotics -NOT addictive
-Wide TI
-High PPB
-needs to be taken on a consistent bases (up to 4 times a day)
-Takes a few days for effect --> and can take weeks to be truly
effective
'Typical" antipsychotics -Clorpromazine
-Haloperidol
+ associated 5HT blockade, anticholinergic, sedation
**Will respond better to POSITIVE symptoms (restlessness
and agitation)
What is NMS? Neuroleptic Malignant Syndrome
-reaction to antipsychotic medication
S+S:
-hyperthermia
-unstable BP
-diaphoresis
-incontinence
Chlopromazine Typical antipsychotic
-treat patients with hallucinations
-causes sedation, takes time to work, associated with other
receptor affinity --> serotonin, anticholinergic)
Haloperidol (Haldol) Typical antipsychotic
-given IM in critical situations in hospital
-fast onset, causes sedation
*can be taken orally if used long term
Onset of action of typical antipsychotics? -takes days to improve hallucinations/ delusions
-takes 6-8 weeks for overall improvement
What to consider when stopping treatment Most of the time chronic treatment is required
of typical antipsychotics -SLOWLY withdraw (risk of delirium tremens)
What is drug tolerance? -Requiring higher doses to yield the same effect
-creates withdrawl symptoms if abruptly stopped --> need to
WEAN off
With Expert Insights
Save
Students also studied
Sherpath: Diabetes Mellitus Chapter 21 Test Case Study 4 (Short
30 terms 24 terms 22 terms
jesssbee Preview kenanderson2017 Preview Brittany182
Terms in this set (267)
Dopamine -Excitatory or inhibitory NT
-reward pathway
-balance
Serotonin -Inhibitory NT
-required to balance out excitation and mood
GABA -Inhibitory NT
-increases CI influx --> decreasing excitability of cell
Glutamate -Excitatory NT
-potential NMDA agonist for treatment of depression
Ach -NT at the neuromuscular junction
Norepinephrine
Chronic Pain Definition -Over excitation of receptors
-pathologic pain (pain no longer serves a purpose)
-pain pathway modulation
-is a complex process!
What is first line treatment of chronic pain? #1: CBT
Drug?
Drug: Gabapentin (Neurontin)
-increases GABA (calming)
-excreted unchanged
*can see addiction and sedation in high doses
,Types of 'hyper excitation' disorders 1.Seizures (epilepsy)
TX:
-increase GABA transmission + presence
-decrease neuronal excitability
2.Anxiety
TX:
-increase GABA
-increase Serotonin
3.Psychosis
TX:
-Decrease dopamine
4.Chronic Pain
What is psychosis? What are the S+S? Perceptive loss of reality
-can be acute or chronic
S+S:
-hallucinations (sensory- visual and auditory most common)
-delusions (false beliefs in facts or personal status, paranoia)
-lack of awareness + judgment
-mood/affect alterations (could be 'up' or down'
What is the etiology of psychosis? A. Mental health illnesses, EX:
-schizophrenia
-bipolar disorder
-severe depression
B. Drug side effect /OD /alcoholism
C.Electrolyte imbalance
D.Sepsis in elderly
E.Hospital induced (overstimulation) --> need proactive
prevention!
What is schizophrenia? What are the S+S? -dysfunction of thoughts and language expression, chronic
illness
-significant familial link
-can cause state of psychosis
-onset: 10-55 years
S+S:
-abnormal behaviours and movement
-incomprehensible speech
-alterations in function (hallucinations, delusions, paranoia,
disorganized thoughts)
-mood alterations (agitated, withdrawn, apathic)
What is the etiology of schizophrenia? -Structural
-NT dysfunction
-Pathway dysfunction (signaling is interrupted)
How do you diagnose schizophrenia? Need to have:
at least 2 abnormal behaviours and sensations
AND
2 functional deficits
What are hallucinations? Sensory information pathways lead to thalamus
EX. retina via optic nerve --> thalamus --> primary visual
cortex -- visual association cortex --> meaning
GLITCH SOMEWHERE!!
, What is etiology of hallucinations? -Sensory block --> stored images replace intel
EX. sensory deprivation, sensory dysfunction (ex. blindness)
-Neuronal dysfunction= hyperactivity, pathway dysfunction,
end organ failure
What is the target for psychosis treatment? Limbic system D2 receptors
Potential side effects? -mood, behaviour, emotion control
S/E:
-D2 antagonism in basal ganglia --> unwanted motor
movements
Pros and cons of antipsychotics -NOT addictive
-Wide TI
-High PPB
-needs to be taken on a consistent bases (up to 4 times a day)
-Takes a few days for effect --> and can take weeks to be truly
effective
'Typical" antipsychotics -Clorpromazine
-Haloperidol
+ associated 5HT blockade, anticholinergic, sedation
**Will respond better to POSITIVE symptoms (restlessness
and agitation)
What is NMS? Neuroleptic Malignant Syndrome
-reaction to antipsychotic medication
S+S:
-hyperthermia
-unstable BP
-diaphoresis
-incontinence
Chlopromazine Typical antipsychotic
-treat patients with hallucinations
-causes sedation, takes time to work, associated with other
receptor affinity --> serotonin, anticholinergic)
Haloperidol (Haldol) Typical antipsychotic
-given IM in critical situations in hospital
-fast onset, causes sedation
*can be taken orally if used long term
Onset of action of typical antipsychotics? -takes days to improve hallucinations/ delusions
-takes 6-8 weeks for overall improvement
What to consider when stopping treatment Most of the time chronic treatment is required
of typical antipsychotics -SLOWLY withdraw (risk of delirium tremens)
What is drug tolerance? -Requiring higher doses to yield the same effect
-creates withdrawl symptoms if abruptly stopped --> need to
WEAN off
