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78 Cards in this Set

  • Front
  • Back
what disease is paired with each transmitter?
1. ACH
2. NE
3. Serotonin
4. Dopamine
5. GABA
1. ACH - alzheimers and Downs
2. NE - affective (mood) disorders and stress
3. Serotonin - violence and mood disorders
4. Dopamine - schizophrenia
5. GABA anxiety
what drug?
improves negative symptoms in schiz, works with patients resistant to typical medications, associated with agrnulocytosis, more activity at D3 and D4 receptors than typical drugs
CLOZAPINE for schizophrenia - new drug
enzymatic degradation is the most important means for termination of the action of ...
ACh
GBA receptor complex opens CL channels causing ___ and has receptors for barbituates and benzodiazapines
Benzo's increase GABA binding useful for anxiety, convulsions and alcohol WD

GABA is ___ at cellular and behavioral levels
GBA receptor complex opens CL channels causing _HYPERPOLARIZATION_ and has receptors for barbituates and benzodiazapines
Benzo's increase GABA binding useful for anxiety, convulsions and alcohol WD

GABA is CALMING_ at cellular and behavioral levels
which drugs produces similar effects to those seen in schiz?
which drugs produces similar effects to those seen in schiz?

PCP AND AMPHETAMINES
Dysregulation of which structure can be involved in panic attacks?

anti anxiety drugs block this increase and can suppress firing - turning off ___ neurons due to GABA facilitation
Dysregulation of which structure can be involved in panic attacks?
LOCUS CERULEUS

anti anxiety drugs block this increase and can suppress firing - turning off NE neurons due to GABA facilitation
NMDA receptors regulate the release of ___, and can be blocked by ___.

NMDA is a receptor for Glutamate - and has effects concerning : ___
anoxia of cells causes release of glutamate which to other cells in prolonged periods of time is ___ and can cause ___
NMDA receptors regulate the release of _DOPAMINE_, and can be blocked by _PCP_.

NMDA is a receptor for Glutamate - and has effects concerning : __MEMORY LTD AND LTP_
anoxia of cells causes release of glutamate which to other cells in prolonged periods of time is __TOXIC_ and can cause __CELL DEATH_
A neuro-anatomical model of schizophrenia was presented in the course. In that model,
the primary deficit is a(n) ________ in dopaminergic stimulation of the prefrontal cortex,
and a secondary ________ in dopaminergic stimulation of the limbic area
A neuro-anatomical model of schizophrenia was presented in the course. In that model,
the primary deficit is a(n) __DECREASE__ in dopaminergic stimulation of the prefrontal cortex,
and a secondary _INCREASE_ in dopaminergic stimulation of the limbic area
LESION ---- effect
1. nucleus accumbens (hypothalamus)
2. limbic system
3. dorsolateral convexity -
4. reticular system -
5. limbic system -
6. orbital prefrontal
7.parietal-temporal-occipital association cortex
LESION ---- effect
1. nucleus accumbens (hypothalamus) - reward
2. limbic system - fear response
3. dorsolateral convexity - planning, apathy, inactivty
4. reticular system - attention and arousal, wakefulness
5. limbic system - emotions (emotional learning, expression and affect)
6. orbital prefrontal - "limbic" euphoria, release, inappropriate behavior
7.parietal-temporal-occipital association cortex: Left - language, arithmetic, sequences; Right - spatial, facial recognition - lesion here would result in neglect syndrome of right side
what is it?
qualitative impairment in social interaction, qualitative impairment in communication, restricted, repetitive stereotyped pattern of behaviors, onset prior to age 3, not retts or ccd
what is it?
qualitative impairment in social interaction, qualitative impairment in communication, restricted, repetitive stereotyped pattern of behaviors, onset prior to age 3, not retts or ccd
AUTISM
what is it
qualitative impairment in social interaction, repetitive, restrictive steretyped pattern of behaviors and interests, disburance causes clinically significant impairment in social, occupationsal or other areas of functioning, no clinically significant general delays in language, no clinically significant delays in cognitive development or curiosity about the environment - however deficit is pragmatics and prosody of language, usually males
what is it
qualitative impairment in social interaction, repetitive, restrictive steretyped pattern of behaviors and interests, disburance causes clinically significant impairment in social, occupationsal or other areas of functioning, no clinically significant general delays in language, no clinically significant delays in cognitive development or curiosity about the environment
ASPERGERS
**LANGUAGE NOT IMPAIRED HERE
what is it
normal prenatal and perinatal development upto 5 months, at 5-8 months deceleration of head growth, loss of purposeful hand motion, loss of social interaction, poor coordination or gait, severely impaired language, usually female, severe or profound mental retardation
what is it
normal prenatal and perinatal development upto 5 months, at 5-8 months deceleration of head growth, loss of purposeful hand motion, loss of social interaction, poor coordination or gait, severely impaired language, usually female, severe or profound mental retardation
RETT
what is it
normal development for the first 2 years, clinically significant loss of previous acquired skills by age 10, language, social skills, play, motor skills, bowel and bladder control; abnormalities in functioning; males, severe mental retardation, onset usualy 3-4
what is it
normal development for the first 2 years, clinically significant loss of previous acquired skills by age 10, language, social skills, play, motor skills, bowel and bladder control; abnormalities in functioning; males, severe mental retardation, onset usualy 3-4
CHILDHOOD DISINTEGRATIVE DISORDER
what pervasive developmental disorders are associated with severe mental retardation?
Retts, Childhood disintegrative disorder
what is it
subaverage intellectual functioning, iq of >7-, impairments in adaptive functioning, onset before age 18
what is it
subaverage intellectual functioning, iq of >7-, impairments in adaptive functioning, onset before age 18
MENTAL RETARDATION
can be mild, moderate,severe, profound
what is it;
achievement on standardized test is substantially below that expected for age, schooling and level of intelligence AND interferes with academic achievement or activities of daily living.
what is it;
achievement on standardized test is substantially below that expected for age, schooling and level of intelligence AND interferes with academic achievement or activities of daily living.
LEARNING DISORDER
WHAT IS IT
repetitive and persistent behavior where basica rights of others or social norms are violated, aggression to people and animals, destruction of property, deceitfulness or theft, violations of rules and impairment in social academic or occupation functioning, if 18 or older criteria not met for antisocial personality disorder
WHAT IS IT
repetitive and persistent behavior where basica rights of others or social norms are violated, aggression to people and animals, destruction of property, deceitfulness or theft, violations of rules and impairment in social academic or occupation functioning, if 18 or older criteria not met for antisocial personality disorder
CONDUCT DISORDER, MILD MODERATE OR SEVERE
what is it
1. six or more symptoms of in attention and or 6 or more symptoms of hyperactivity impulsivity for at least 6 months AND present before age 7, two or more setting are impaired (school work home), impairment in social, academic or occupational functioning, do not occur exclusively during the course of another mental disorder
what is it
1. six or more symptoms of in attention and or 6 or more symptoms of hyperactivity impulsivity for at least 6 months AND present before age 7, two or more setting are impaired (school work home), impairment in social, academic or occupational functioning, do not occur exclusively during the course of another mental disorder
ADHD - combined attention and hyperactivity or inattentiive type or hyperactive impulsive type
what is it
disturbance of consciousness and change in cognition that develop over a short period of time - due to general medical condition, substance induced, multiple etiologies, NOS
what is it
disturbance of consciousness and change in cognition that develop over a short period of time - due to general medical condition, substance induced, multiple etiologies, NOS
DELIRIUM
what is it
multiple cognitive deficits that include impairment in memory and one or more: apraxia, aphasia, agnosia, or loss of executive functioning
-vascular (treatable) due to alzheimers, due to other general medical condition, substance induced, multiple etiologies
what is it
multiple cognitive deficits that include impairment in memory and one or more: apraxia, aphasia, agnosia, or loss of executive functioning
-vascular (treatable) due to alzheimers, due to other general medical condition, substance induced, multiple etiologies
DEMENTIA
memory impairment in absence of other significant accompanying cognitive impairments
memory impairment in absence of other significant accompanying cognitive impairments
AMNESTIC DISORDERS
disturbance that lasts for at least 6 months and includes 1 month of active phase symptoms (two or more of: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms)
subtypes?
disturbance that lasts for at least 6 months and includes 1 month of active phase symptoms (two or more of: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms)
subtypes?
SCHIZOPHRENIA
paranoid, disorganized, catatonic, undifferentiated, residual
characterized by symptomatic presentation equivalent to schiz except for its duration - 1-6 mo and doesnt have to be a decline in functioning
characterized by symptomatic presentation equivalent to schiz except for its duration - 1-6 mo and doesnt have to be a decline in functioning
SCHIXOPHRENIFORM
disturbance in which a mood episode and active phase symptoms of schiz occur together and were preceded or followed by at least 2 weeks of delusions, hallucinations without the mood disorder
disturbance in which a mood episode and active phase symptoms of schiz occur together and were preceded or followed by at least 2 weeks of delusions, hallucinations without the mood disorder
SCHIZOAFFECTIVE
disorder with 1 month of non bizarre delusions without other active phase symptoms of schizophrenia
disorder with 1 month of non bizarre delusions without other active phase symptoms of schizophrenia
DELUSIONAL
one or more __ episodes and at least 4 of the following for 2 weeks:
sleep up or down
interest down
guilt up or down
energy down
concentration down
appetite up or down
psychomotor activity up or down
suicidal ideation up
one or more __ episodes and at least 4 of the following for 2 weeks:
sleep up or down
interest down
guilt up or down
energy down
concentration down
appetite up or down
psychomotor activity up or down
suicidal ideation up
MAJOR DEPRESSIVE DISORDER
at least 2 years of depressed mood for more than days, not as severe as MDD
at least 2 years of depressed mood for more than days, not as severe as MDD
DYSTHYMIC
one or more mixed or manic episodes with a major depressive episode
one or more mixed or manic episodes with a major depressive episode
BIPOLAR 1
one or more MDepisodes with at least one hypomanic episode
one or more MDepisodes with at least one hypomanic episode
BIPOLARII
2 years of numerous periods of hypomanic symptoms that do not meet criteria for manic, and numerous periods of depressive symptoms that do not meet major depressive episode criteria
2 years of numerous periods of hypomanic symptoms that do not meet criteria for manic, and numerous periods of depressive symptoms that do not meet major depressive episode criteria
CYCLOTHYMIC
sex education, communication skills training, anxiety reduction through sensate focus exercises
sex education, communication skills training, anxiety reduction through sensate focus exercises
DUAL SEX THERAPY
P-LI-SS-IT
Permission
Limited Information
Specific Suggestions
Intensive Therapy
sexually dimorphic brain structure that is different in GID males is?
sexually dimorphic brain structure that is different in GID males is?
BED NUCLEUS OF THE STRIA TERMINALIS
4 criteria for anorexia nervosa
1. refusal to maintain body weight
2. intense fear of gaining
3. distorted judgment about weight
4. amenorrheic for at least 3 mo

restricting - excess exercise
binging/purging
4 criteria for bulimia nervosa
1. binge eat
2. inappropriately compensate for binge
3. binge/compensation >2 week for 3 months
4. weight has large influence
purging type
non purging type
drugs prescribed for anorexia:

for bulimia:
anorexia: antidepressants and appetite stimulants

bulimia, ssri's and prozac for impulsiveness
ventral tegmental area --> medial forebrain bundles --> nucleus accumbens is the pathway for:
ventral tegmental area --> medial forebrain bundles --> nucleus accumbens is the pathway for:
MESOLIMBIC DOPAMINERGIC PATHWAY - drug addiction
low dopamine
age at first use
method of drug administration
cultural factors
occupancy biases
personality disorders
mental illnesses
ALL INFLUENCE?
low dopamine
age at first use
method of drug administration
cultural factors
occupancy biases
personality disorders
mental illnesses
ALL INFLUENCE?
VULNERABILITY TO DRUG ADDICTION
the ___ componnet for therapy for drug addiction includes: importance of abstinance, identify and correct self defeating thoughts leading to relapse, have an action plan ready

the __ component includes: stimulus control (removal of cues), contingency contracts, aversion therapy
the __COGNITIVE_ componnet for therapy for drug addiction includes: importance of abstinance, identify and correct self defeating thoughts leading to relapse, have an action plan ready

the _BEHAVIORAL_ component includes: stimulus control (removal of cues), contingency contracts, aversion therapy
is the development of a reversible substance-specific syndrome due to recent ingestion of a drug. The syndrome is due to drug effects on the CNS and causes significant maladaptive behavioral or psychological changes.
is the development of a reversible substance-specific syndrome due to recent ingestion of a drug. The syndrome is due to drug effects on the CNS and causes significant maladaptive behavioral or psychological changes.
INTOXICATION
is the development of a substance-specific syndrome following cessation of the substance after heavy/prolonged use. The syndrome causes significant distress or impairment in functioning.
is the development of a substance-specific syndrome following cessation of the substance after heavy/prolonged use. The syndrome causes significant distress or impairment in functioning.
WITHDRAWAL
maladaptive pattern of substance use as demonstrated by three of the following in a 12 month period:
a. Tolerance (physiological)
b. Withdrawal (physiological)
c. Often taken in larger amounts or over a longer period than intended (psychological)
d. Persistent unsuccessful attempts to cut back (psychological)
e. Time consuming (psychological)
f. Reduction in important activities (psychological)
g. Continued use despite physical harm (psychological
maladaptive pattern of substance use as demonstrated by three of the following in a 12 month period:
a. Tolerance (physiological)
b. Withdrawal (physiological)
c. Often taken in larger amounts or over a longer period than intended (psychological)
d. Persistent unsuccessful attempts to cut back (psychological)
e. Time consuming (psychological)
f. Reduction in important activities (psychological)
g. Continued use despite physical harm (psychological
DEPENDENCE
______If a person experiences either tolerance or withdrawal symptoms.
_______compulsive drug taking occurring without tolerance or withdrawal symptoms.
_PHYSIOLOGICAL WITHDRAWAL__If a person experiences either tolerance or withdrawal symptoms.
Psychological dependence: compulsive drug taking occurring without tolerance or withdrawal symptoms.
maladaptive pattern of substance use with recurrent adverse consequences as demonstrated by at least one symptom in a 12 month period:
i. Failure to fulfill major obligations
ii. Use in hazardous situations
iii. Legal problems
iv. Social or interpersonal problems
maladaptive pattern of substance use with recurrent adverse consequences as demonstrated by at least one symptom in a 12 month period:
i. Failure to fulfill major obligations
ii. Use in hazardous situations
iii. Legal problems
iv. Social or interpersonal problems
ABUSE
DEPENDENCE IMPLIES ABUSE AND WITHDRAWAL SYMPTOMS, TOLERANCE OR PATTERN OF REPETITIVE USE
behavioral/psychological change such as sedation, decreased anxiety, disinhibition, labile mood, and impaired judgment plus at least one of the following
i. Slurred speech
ii. Incoordination
iii. Unsteady gait
iv. Nystagmus
v. Attention/memory impairment
vi. Stupor or coma
behavioral/psychological change such as sedation, decreased anxiety, disinhibition, labile mood, and impaired judgment plus at least one of the following
i. Slurred speech
ii. Incoordination
iii. Unsteady gait
iv. Nystagmus
v. Attention/memory impairment
vi. Stupor or coma
SEDATIVE INTOXICATION
At least two of the following:
i. ANS hyperactivity
ii. Hand tremor
iii. Insomnia
iv. Nausea or vomiting
v. Transient hallucinations or illusions
vi. Psychomotor agitation
vii. Anxiety
viii. Seizures
At least two of the following:
i. ANS hyperactivity
ii. Hand tremor
iii. Insomnia
iv. Nausea or vomiting
v. Transient hallucinations or illusions
vi. Psychomotor agitation
vii. Anxiety
viii. Seizures
SEDATIVE WITHDRAWAL
alcohol, benzodiazepines, and barbiturates
SEDATIVES
behavioral/psychological change such as euphoria, grandiosity, hypervigilance, anxiety, paranoia and hallucinations, tension, anger, picking, etc. plus at least two of the folling:
i. Heart rate change
ii. Mydriasis
iii. Blood pressure change
iv. Perspiration or chills
v. Nausea and vomiting
vi. Loss of appetite
vii. Psychomotor change
viii. Muscular weakness, respiratory distress, chest pain or cardiac arrhythmia
ix. Confusion, seizures, dyskinesias, dystonias, or coma
behavioral/psychological change such as euphoria, grandiosity, hypervigilance, anxiety, paranoia and hallucinations, tension, anger, picking, etc. plus at least two of the folling:
i. Heart rate change
ii. Mydriasis
iii. Blood pressure change
iv. Perspiration or chills
v. Nausea and vomiting
vi. Loss of appetite
vii. Psychomotor change
viii. Muscular weakness, respiratory distress, chest pain or cardiac arrhythmia
ix. Confusion, seizures, dyskinesias, dystonias, or coma
STIMULANT INTOXICATION
dysphoric mood plus at least two of the following:
i. Fatigue
ii. Vivid unpleasant dreams
iii. Change in sleep duration (usually hypersomnia)
iv. Increased appetite
v. Psychomotor change
dysphoric mood plus at least two of the following:
i. Fatigue
ii. Vivid unpleasant dreams
iii. Change in sleep duration (usually hypersomnia)
iv. Increased appetite
v. Psychomotor change
STIMULANT WITHDRAWAL
perceptual changes during full alertness must occur (e.g. intensification of perceptions, depersonalization, derealization, illusions, hallucinations, synesthesias. Plus a behavioral/psychological change such as anxiety, depression, ideas of reference, fear of losing mind, paranoid ideation, impaired judgement, decreased attention/memory. Plus at least two of the following:
i. Pupillary dilation
ii. Tachycardia
iii. Sweating
iv. Palpitations
v. Blurred vision
vi. Incoordination
perceptual changes during full alertness must occur (e.g. intensification of perceptions, depersonalization, derealization, illusions, hallucinations, synesthesias. Plus a behavioral/psychological change such as anxiety, depression, ideas of reference, fear of losing mind, paranoid ideation, impaired judgement, decreased attention/memory. Plus at least two of the following:
i. Pupillary dilation
ii. Tachycardia
iii. Sweating
iv. Palpitations
v. Blurred vision
vi. Incoordination
HALLUCINATION INTOXIFICATION
NO WITHDRAWAL SYMPTOMS
amphetamine (major), cocaine (major), nicotine (minor), caffeine (minor), ecstasy (major)
amphetamine (major), cocaine (major), nicotine (minor), caffeine (minor), ecstasy (major)
STIMULANTS
LSD, cannabis, PCP, ketamine
LSD, cannabis, PCP, ketamine
HALLUCINOGENS
behavioral/psychological change that involves an initial euphoria followed by apathy, dysphoria, psychomotor changes, diminished judgement, etc. Signs include papillary constriction (miosis) plus at least one of the following:
i. Drowsiness or coma
ii. Slurred speech
iii. Impairment in attention or memory
behavioral/psychological change that involves an initial euphoria followed by apathy, dysphoria, psychomotor changes, diminished judgement, etc. Signs include papillary constriction (miosis) plus at least one of the following:
i. Drowsiness or coma
ii. Slurred speech
iii. Impairment in attention or memory
OPIOID INTOXICATION
typically causes severe “flu like” symptoms and are not usually life threatening. At least 3 of:
i. Dysphoric mood
ii. Nausea or vomiting
iii. Muscle aches
iv. Lacrimation or rhinorrhea
v. Pupillary dilation, piloerection, or sweating
vi. Diarrhea
vii. Yawning
viii. Fever
ix. Insomnia
18. List the classes of drugs that
typically causes severe “flu like” symptoms and are not usually life threatening. At least 3 of:
i. Dysphoric mood
ii. Nausea or vomiting
iii. Muscle aches
iv. Lacrimation or rhinorrhea
v. Pupillary dilation, piloerection, or sweating
vi. Diarrhea
vii. Yawning
viii. Fever
ix. Insomnia
OPIOID WITHDRAWAL
behavior/psychological change that include disinhibition, apathy, belligerence, assaultiveness, impaired judgment, etc. and at least two of the following:
i. Dizziness
ii. Nystagmus
iii. Incoordination
iv. Slurred speech
v. Unsteady gait
vi. Lethargy
vii. Depressed reflexes
viii. Psychomotor slowing
ix. Tremor
x. General muscle weakness
xi. Blurred vision or diplopia
xii. Stupor or coma
xiii. Euphoria
behavior/psychological change that include disinhibition, apathy, belligerence, assaultiveness, impaired judgment, etc. and at least two of the following:
i. Dizziness
ii. Nystagmus
iii. Incoordination
iv. Slurred speech
v. Unsteady gait
vi. Lethargy
vii. Depressed reflexes
viii. Psychomotor slowing
ix. Tremor
x. General muscle weakness
xi. Blurred vision or diplopia
xii. Stupor or coma
xiii. Euphoria
INHALANT INTOXICATION
Stimulant effects plus mild hallucinogenic effects (perceptual alterations)
Common things look more interesting
Empathogenesis (feeling of emotional closeness)
Concern about neurotoxicity (serotonergic neurons) and other health consequences (e.g. hyperthermia)
Reputation as a “safe” drug despite Schedule I status
Stimulant effects plus mild hallucinogenic effects (perceptual alterations)
Common things look more interesting
Empathogenesis (feeling of emotional closeness)
Concern about neurotoxicity (serotonergic neurons) and other health consequences (e.g. hyperthermia)
Reputation as a “safe” drug despite Schedule I status
ECSTASY
Intoxication: DSM does not recognize a category for intoxication with nicotine.
Withdrawal: At least four of the following:
1. Dysphoria or depressed mood
2. Insomnia
3. Irritability, frustration, or anger
4. Anxiety
5. Difficulties concentrating
6. Restlessness
7. Decreased heart rate
8. Increased appetite/weight gain
Intoxication: DSM does not recognize a category for intoxication with nicotine.
Withdrawal: At least four of the following:
1. Dysphoria or depressed mood
2. Insomnia
3. Irritability, frustration, or anger
4. Anxiety
5. Difficulties concentrating
6. Restlessness
7. Decreased heart rate
8. Increased appetite/weight gain
NICOTINE
Intoxication: after at least 250 mg of caffeine, five or more of the following occur:
1. Restlessness
2. Nervousness
3. Excitement
4. Insomnia
5. Diuresis
6. GI disturbance
7. Muscle twitching
8. Rambling thoughts
9. Tachycardia/arrhythmia
10. Inexhaustibility
11. Psychomotor agitation
Withdrawal: DSM doesn’t recognize a category for caffeine withdrawal.
Intoxication: after at least 250 mg of caffeine, five or more of the following occur:
1. Restlessness
2. Nervousness
3. Excitement
4. Insomnia
5. Diuresis
6. GI disturbance
7. Muscle twitching
8. Rambling thoughts
9. Tachycardia/arrhythmia
10. Inexhaustibility
11. Psychomotor agitation
Withdrawal: DSM doesn’t recognize a category for caffeine withdrawal.
CAFFEINE
__ Inhibits the enzyme that breaks down the metabolite of alcohol, acetaldehyde. If a person drinks alcohol, accumulation of acetylaldehyde causes a toxic reaction (nausea, hypotension, shortness of breath) lasting 30-60 minutes. A dose is effective for up to two weeks. Ensuring compliance is a major issue to success of this treatment. It is often given on a short-term basis if person is going into a high risk situation.
__An opioid receptor blocker that reduces the pleasurable effects of alcohol so that the person can stop drinking after the first drink (prevents a “full relapse”).
__ An NMDA receptor that reduces craving for alcohol by decreasing the uncomfortable feelings associated with protracted abstinence.
Disulfiram: Inhibits the enzyme that breaks down the metabolite of alcohol, acetaldehyde. If a person drinks alcohol, accumulation of acetylaldehyde causes a toxic reaction (nausea, hypotension, shortness of breath) lasting 30-60 minutes. A dose is effective for up to two weeks. Ensuring compliance is a major issue to success of this treatment. It is often given on a short-term basis if person is going into a high risk situation.
Naltrexone: An opioid receptor blocker that reduces the pleasurable effects of alcohol so that the person can stop drinking after the first drink (prevents a “full relapse”).
Acamprosate: An NMDA receptor that reduces craving for alcohol by decreasing the uncomfortable feelings associated with protracted abstinence.
__: An antidepressant that has particular DA agonist properties and is a nicotinic receptor blocker.
__: Partial agonist of nicotine receptor. Side effects include insomnia, abnormal dreams, and suicidal thoughts and erratic behavior.
Buproprion: An antidepressant that has particular DA agonist properties and is a nicotinic receptor blocker.
Varenicline: Partial agonist of nicotine receptor. Side effects include insomnia, abnormal dreams, and suicidal thoughts and erratic behavior.
a. __ difficulty initiating or maintaining sleep for at least one month.
b. __: excessive sleepiness despite sufficient sleep (e.g. 8-12 hours) for at least one month.
c. __: irresistible attacks of refreshing sleep occurring daily for at least three months. Plus the presence of one or more of the following REM abnormalities:
i. Cataplexy: sudden loss of muscle tone while awake, typically precipitated by emotion
ii. Recurrent intrusions of elements of REM sleep into the transition between sleep and wakefulness
a. Primary insomnia: difficulty initiating or maintaining sleep for at least one month.
b. Primary hypersomnia: excessive sleepiness despite sufficient sleep (e.g. 8-12 hours) for at least one month.
c. Narcolepsy: irresistible attacks of refreshing sleep occurring daily for at least three months. Plus the presence of one or more of the following REM abnormalities:
i. Cataplexy: sudden loss of muscle tone while awake, typically precipitated by emotion
ii. Recurrent intrusions of elements of REM sleep into the transition between sleep and wakefulness
__ repeated awakenings with detailed memory of a frightening dream. Characteristics include mild autonomic arousal and awakening during the second half of sleep during REM.
b. __repeated awakenings with intense fear usually with a panicky scream without detailed memory of a dream. Characteristics include high autonomic arousal and awakening during first third of sleep period during slow wave sleep.
c. __ repeated episodes of rising from bed during sleep and walking around, usually occurring during the first third of sleep.
Nightmare disorder: repeated awakenings with detailed memory of a frightening dream. Characteristics include mild autonomic arousal and awakening during the second half of sleep during REM.
b. Sleep terror disorder: repeated awakenings with intense fear usually with a panicky scream without detailed memory of a dream. Characteristics include high autonomic arousal and awakening during first third of sleep period during slow wave sleep.
c. Sleep walking disorder: repeated episodes of rising from bed during sleep and walking around, usually occurring during the first third of sleep.
Dyssomnia, NOS:
i. __ irresistible leg movements prior to sleep due to uncomfortable shock-like sensations, usually deep in the leg. Patient is aware of movements.
ii__repetitive muscle contractions during sleep usually lower limb. Patient is unaware of movements.
Dyssomnia, NOS:
i. Restless leg syndrome: irresistible leg movements prior to sleep due to uncomfortable shock-like sensations, usually deep in the leg. Patient is aware of movements.
ii. Periodic limb movements: repetitive muscle contractions during sleep usually lower limb. Patient is unaware of movements.
treatments:
1. improved sleep hygiene:
2. stimulants (methylphenidate) :
3. stimulants, TCA's, xyrem
4. CPAP
5. Light therapy
6. dopamine agonists
7. benzodiazapines
8. benzodiazapines
9. environmental protection and benzo's
treatments:
1. improved sleep hygiene: PRIMARY INSOMNIA
2. stimulants (methylphenidate) :PRIMARY HYPERSOMNIA
3. stimulants, TCA's, xyrem - NARCOLEPSY
4. CPAP - OSA
5. Light therapy - CIRCADIAN RHYTHM DISORDER
6. dopamine agonists - RESTLESS LEG
7. benzodiazapines - PERIODIC LIMB MOVEMENTS
8. benzodiazapines - SLEEP TERRORS
9. environmental protection and benzo's - SLEEP WALKING
__ CAM therapies that use substances found in nature, including herbals, vitamins, minerals, fatty acids, amino acids, enzymes, pre/probiotics, whole diets, animal derivatives. Most of the substances are considered dietary supplements, which are products that are taken by mouth intended to supplement the diet. These are regulated as foods, not drugs, and are therefore limited in what claims can be made about their side effects.
Biologically-based practices:
__: techniques involving manipulation of energy fields to improve health
1. Acupuncture: manipulating energy by stimulation of anatomic points on the body typically with needles.
2. Qigong: (energy work) manipulating energy through a combination of slow movements, meditation, and controlled breathing.
3. Reiki: a therapy in which the practitioner seeks to transmit a universal energy to a person, either by placing their hands on/near that person. The intent is to open channels to promote healing and health
Energy medicine
__ a variety of techniques to enhance the mind’s ability to change bodily function. These techniques try to elicit the “relaxation response”. E.g. meditation, yoga, imagery.
MIND BODY MEDICINE
the focus is on improving bodily function by improving bodily structure. Techniques are based on manipulation and/or movements of parts of the body. E.g. chiropractic adjustments, osteopathic manipulations, and massage
Manipulative and body-based practices: the focus is on improving bodily function by improving bodily structure. Techniques are based on manipulation and/or movements of parts of the body. E.g. chiropractic adjustments, osteopathic manipulations, and massage
complete medical systems for providing medical care based on a specific philosophy of how disease develops and how to treat and prevent disease. E.g. Ayurveda, Traditional Chinese Medicine, Naturopathy, Homeopathy.
Whole medical systems: complete medical systems for providing medical care based on a specific philosophy of how disease develops and how to treat and prevent disease. E.g. Ayurveda, Traditional Chinese Medicine, Naturopathy, Homeopathy.
Philosophy: disease relates to an imbalance of bodily energy (doshas) in an individual. Each person has a unique combination of the three doshas with one most prominent.
Treatment: individualized based on one’s primary dosha (e.g. diet, herbs, tonics, exercise, etc)
Philosophy: disease relates to an imbalance of bodily energy (doshas) in an individual. Each person has a unique combination of the three doshas with one most prominent.
Treatment: individualized based on one’s primary dosha (e.g. diet, herbs, tonics, exercise, etc)
AYURVEDA
Philosophy: disease results from a blockage of “life force” energy known as Qi.
Treatment: Qi blockages are treated through methods such as acupuncture, herbs, massage, diet, and exercise.
Traditional Chinese Medicine
Philosophy: disease results from a blockage of “life force” energy known as Qi.
Treatment: Qi blockages are treated through methods such as acupuncture, herbs, massage, diet, and exercise.
Philosophy: emphasis on the healing powers of nature and the body’s intrinsic ability to heal and maintain itself. The focus is on the prevention of disease, treating the whole person, and use of natural therapies.
Treatment: approaches are eclectic and include nutrition, nutritional supplements, herbs, homeopathy, acupuncture, lifestyle medicine, etc.
Philosophy: emphasis on the healing powers of nature and the body’s intrinsic ability to heal and maintain itself. The focus is on the prevention of disease, treating the whole person, and use of natural therapies.
Treatment: approaches are eclectic and include nutrition, nutritional supplements, herbs, homeopathy, acupuncture, lifestyle medicine, etc.
NATUROPATHY
Philosophy: healing can be stimulated by giving a highly diluted substance that in larger doses would cause the symptoms.
Treatment: a remedy is chosen that best fits the symptoms and personal characteristics of the patient.
Philosophy: healing can be stimulated by giving a highly diluted substance that in larger doses would cause the symptoms.
Treatment: a remedy is chosen that best fits the symptoms and personal characteristics of the patient.
HOMEOPATHY
1X =
1C =
1X =10
1C =100
CAM treatments:
Nausea and Pain:
Depression:
Memory Loss:
Cartilage Loss in Joints:
CAM treatments:
Nausea and Pain: ACUPUNCTURE
Depression:ST JOHNS WORT
Memory Loss:GINKO BILOBA
Cartilage Loss in Joints:GLUCOSAMINE
life-threatening respiratory depression and pin-point pupils
life-threatening respiratory depression and pin-point pupils
OPIOID INTOXICATION
parts of the papez circuit
mamillary bodies, anterior nucleus of the thalamus, cingulate gyrus, hippocampus
limbic system circuit:
association cortex -->___--> amygdala & ____
amygdala --> ___--> prefrontal cortex
___-->prefrontal cortex
limbic system circuit:
association cortex -->_HIPPOCAMPAL FORMATION__--> amygdala & __MAMMILLARY BODIES__
amygdala --> _HYPOTHALAMUS__--> prefrontal cortex
___-->prefrontal cortex