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95 Cards in this Set

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___________are chemical messengers between neurons that directly and indirectly control the opening or closing of ion channels
neurotransmitters
___________ are chemical messengers that make the target cell membrane more or less susceptible to the effects of the primary neurotransmitter
neuromodulators
________can reduce the membrane potential and enhance the transmission of the signal between neurons
-quickens in response
Excitatory neurotransmitters
_________ can slow down nerve impulses, hold it back so you don't get as much quickness in response
Inhibitory neurotransmitters
______(proteins) for the released neurotransmitters are embedded in the postsynaptic membrane. each neurotransmitter has a protein receptor for which it and only it will fit.
-make the membrane permeable and the chemical conduction begins
receptors
_______- is the primary cholinergic neurotransmitter. there are two groups of receptors. the receptors we're are concerened with are the muscarinic.
Functions: motor behavior
mood regulation
sleep/arousal
stimulates PNS
Acetylcholine (ACh)
Drugs that block the receptors (________) cause the common side effects of dry mouth, blurred vision, constipation, urinary retention and tachycardia (pulse rate increases)
anticholinergic drugs
Biogenic Amines-
______ is an excitatory neurotransmitter and is involved in cognition, motor and neuroendocrine functions. influences emotions, motivation, social conscience, judgment and reasoning.
Dopamine
A secone major pathway for Dopamine involves the _______ motor system, which serves and voluntary and involuntary motor movements.
extrapyramidal
a third major pathway for dopamine involves the ________ gland. It has an impact on hunger, thirst, sexual function, circadian rhythms, digestion and temperature control.
drugs that block the receptors cause EPS. problems with the third major pathway activities, and problems with the first major pathway.
pituitary gland
_________ is an excitatory neurotranmitter that plays a major role in the generation and maintenance of mood states. also involved in wakefulness and sleep and are responsible for vasoconstriction necessary to maintain BP in upright position.
Norepinephrine
receptors are called ________ receptors.
adrenergic
drugs that block the reuptake of norepinephrine (tricyclic antidepressants)may also block muscarinic receptors (__________ effects) and alpha-1 adrenergic receptors (producing orthostatic hypotension)
anticholinergic
________ is primarily an excitatory neurotransmitter that plays a role in emotions, cognition, sensory perceptions and in the essential biologic functions such as sleep, appetite, sexual behavior, hormone secretion and thermoregulation.
Serotonin
______________is a recently identified neurotransmitter. Functions not known but thought to be involved in autonomic and neuroendocrine regulation.
Histamine
Drugs that block the receptors (antihistamines) may produce the side effect of ________.
Sedation
________________ is primarily an inhibitor. it has a major role in the control of neuronal excitability throughout the body.
GABA- Gamma-Aminobutyric Acid
________ antianxiety drugs and sedative barbiturate drugs work because of their affinity for GABA receptor sites.
Benzodiazepine
__________ is the most widely distributed excitatory neurotransmitter. It may play a role in the long lasting enhancement of synaptic acitivity. However, too much _______ is harmful to neurons. May be involved in schizophrenia.
Glutamate
_________ drugs -
-act specifically at receptor sites
-structure similar to neurotransmitter
-when attached may produce similar results to neurotransmitters (agonists)
-when attached may block biologic response (antoagonists)
-may act as agonist on one receptor site and antagonist at another
Psychotropic drugs
_______- degree of chemical attraction or bond between drug and receptors.
-if weak; are easily reversed when drug is discontinued
-if strong; drug effects may take weeks to resolve when drug is discontinued.
affinity
__________-ability of a drug to produce a biologic response once it attaches to receptor.
-if high_______ effect or good biologic response- agonist (moves it along)
-if low _____ effect or weak biologic response- antagonist (hold back)
intrinsic activity
__________- block the electrical transmission through channels (secondary messenger system) to main body cell.
some calcium ____________ are being tried with mania.
channel blockers
____________- facilitate opening of channels.
benzodiazepines facilitate GABA to open chloride ion channel
Channel openers
_________- targets for some drugs.
MAOI's act by developing strong bond between medication and MAO enzyme which causes MAO enzyme to be inactivated and thereby ineffective in breaking down neurotransmitter after it has acted at the receptor site.
enzymes
Carrier _____- carry neurotransmitter back across cell membrane of pre-synaptic call (re-uptake). Medications may block or inhibit this process.
Proteins
__________- the interaction of the endocrine and nervous systems and the role that the endocrine glands and their respective hormones play in behavioral functioning
Neuroenocrinolgy
___________- regulation of biochemical functioning over periods of rhythmic cycles and their influence in predicting certain behaviors
Circadian Rhythms (chronobiology)
_______- hereditary factors that predispose individuals to certain psychiatric disorders
Genetics
_________- the influence of stress on the immune system and it's role in the susceptibility to illness.
Psychoimmunology
_________-electrodes are placed on the scalp. amplitude and frequency of beta, alpha,theta and delta brain waves are graphically recorded on paper.
-measures brain electrical activity
-identifies dysrhythmias, asymmetries or suppression of brain rhythms.
-used in dx of epilepsy, neoplasm, stroke, metabolic or degenerative disease.
Electroencephalography (EEG)
_______- used with or without contrast medium. x-rays are taken of various transverse planes of the brain while a computerized analysis produces a precise reconstructed image of each segment.
-measures accuracy of brain structure to detect possible lesions, abscesses, areas of infarction or aneurysm.
Computer Tomography (CT)
______-within a strong magnetic field, the nuclei of hydrogen atoms absorb and reemit electromagnetic energy that is computerized and transformed into image information. No radiation or contrast median is used.
measure anatomical and biochemical status of various segments of the brain. detects brain edema, ischemia, infection,neoplasm,trauma and demyelination.
Magnetic Resonance Imaging (MRI)
_______- Iv injection of a radioactive substance. The head is surrounded by detectors that relay data to a computer that interprets the signals and produces the image.
measures specific brain functioning such as glucose metabolism, oxygen utilization, blood flow and neurotransmitter- receptor inteaction.
Positron Emission Tomography (PET)
________-similar to PET but longer acting radioactive substance must be used to allow time for a gamma camera to rotate about the head and gather the data, which are then computer assembled into a brain image.
-measures various aspects of brain functioning as with PET; has also been used to image activity of CSF circulation.
Single Photon Emission (SPECT)
_______theories-
intergenerational pattern of increase susceptibilty. Ex: alcoholism more likely to occur in children of alcoholic parents than non-alcoholic parents.
-alcohol and drug use seem to have effect on certain neurotransmitters- GABA, dopamine, serotonin- in producing morphine like substances with alcohol metabolism
Biological theories
______theories-
-no known addictive personality type exists, however, certain traits seemed to predominate: intolerance of frustration/pain, lack of success in life, lack of affectionate and meaningful relationships, low self esteem, and risk taking propensity.
Psychological theories
Examples of _________-
pain relievers
vicodin
percocet
Opiates
Examples of ___________-
sleeping pills
nebutol
sedatives
examples of _________-
-cocaine
-meth
-caffeine
stimulants
examples of ________-
LSD
Ecstasy
Hallucinogens
examples of _____-
activan
valium
xanax
anxiolytics
Substance_____- using a drug despite negative consequences (social, physical, vocational or legal)
Abuse
Substance ____________- using a drug despite negative consequences plus at least three of the following;
Tolerance
withdrawel
substance taken in larger amounts than was intended
unsuccessful efforts to control or cut down use
great deal of time spent obtaining substance
important social, occupational,or recreational activities are reduced or given up because of use
Dependency
_______- marked increase of amounts to achieve same desired effect.
Tolerance
_______- characteristic withdrawel symptoms exists with alleviation of withdrawel symptoms with use of the substance of closely related substance.
withdrawel
______abuse- abuse of more than one substance which is obtained either legally or illegaly
Poly-substance abuse
________- using a disease model, it is a progressive disease, chronic, incurable,treatable, and characterized by loss of control, cravings, withdrawel, biochemical changes and genetic factors.
addiction
____________- need for drug in order to feel good; it dominates thinking and leads to compulsive behavior to get drug (craving)
Psychological Dependency
_______-(used by both the used and user's family)
-denies-refuses to admit a problem exists
-minimizes problem(I am in control and I can stop any time I want)
Projects- blames others for the use
-Reationalizes- gives justification. People are overreacting.
-manipulation- uses others for own end
-anger-response to others questions
Defense mechanism
__________(enables a person to use)
-in charge of seeing user is protected
-in charge of seeing family survives
-in charge of seeing that family secrets are kept (don't talk,don't tell)
-attempts to control user's use
-feels guilty
-gets promises to change
-bails out the user
-assumes duties and responsibilities of user
Codependency
__________-
-hero(strong one) tries to take care of everything
-clown(mascot) lessens tension by eliciting laughter
-lost child- quiet one
-scapegoat- blamed for family's problems, takes attention away from user
Family roles
Similar amounts of alcohol
12 oz beer
______oz of wine
1 oz of whiskey
3.5 oz of wine
1 drink of alcohol has about 0.5 ounces of alcohol and each drink takes about 1 hour to metabolize ______ounce.
0.5 ounce
________Phase- used to relieve every day stress.
acceptable
medicating self, tolerance developing
Pre-alcoholic phase
________Phase- begins to experience blackouts.
-begins to need drink
-moved over to dependency, dysfunctions arise
Early alcoholic Phase`
_________- lost control, physiological dependency, binge drinking is common, and drinking is the total focus.
-compulsion
-very dependent, major consequences in life
Crucial phase
_______phase- intoxicated more than sober, emotional/physical problems may be life threatening
-organ deterioration (liver, brain)
Chronic Phase
individuals with _______ can have higher alcohol blood levels and less symptoms
Tolerance
Symptoms of _________ include: impaired judgment, poor coordination, unsteady gait, slurred speech, inability to focus and impaired memory.
-labile or angry/sad
-flushed face- peripheral vasodilation
Intoxication
Effects of alcohol on the ___________:
-damage to lining of esophagus, stomach, small intestine
-lining erosion, sometimes bleeding
-increase in gastric secretion
-decrease in gastric emptying
-epigastric pain
-possible nausea and vomiting
Gastrointestinal
Effects of alcohol on ___________:
-decrease in appetite which leads to malnutrition
-vitamin/mineral deficiencies
-serious thiamine and folic acid defieiencies
appetite/nutrition
Effects of alcohol on___________
-alcohol modifies pancreatic enzymes (amylase, lipase) increase levels mean pancreatitis
-proteolytic enzymes released that damage pancreas
-constant, severe epigastric pain with nausea/vomiting/abdominal distention
Pancreas
Liver involvement-
_______-revisible
-decrease in metabolism of fat with increase metabolism of alcohol
-fat build up in cells
-increase in size of liver
-pain/tenderness in right upper quadrant
-leads to hepatitis (inflammation)
Fatty liver
Liver involvement-
___________-revisible
-liver enzymes increase
-damage to liver cells
-10-30% mortality rate
-jaundice/dark urine
-increased bleeding
-increased bilirubin that leads to jaundice
Alcoholic Hepatitis
________- scarring, irreversible
-increase pressure in portal circulation
can result in gastric or esophageal varices which can rupture with significant bleeds (hole in vessel)
-liver cells destroyed and replaced with scarring
-fluid seeps from surface of liver into abdominal cavity from portal hypertension resulting in ascites (pot-belly abdomen)
inability of liver to convert ammonia to urea for excretion, increased ammonia levels leads to brain damage
-
Cirrhosis
___________- (nerve damage)
-resultant of deficiency in vitamin B
-symptoms of pain, tingling, burning sensation
Peripheral Neuropathy
____________-(nerve damage in brain)
-caused by thiamine deficiency
-ataxis, sleepiness, stupor, death
Treatment: always thiamine before any IV glucose to minimize brain damage.
-confusion and nerve damage to brain
Wernicke's encephalopathy
_______________- brain (neuron) damage
-psychosis, confusion, disorientation
-tactile, visual hallucinations
Korsakoff's psychosis
_______effects-
-dilation of superficial vessels of skin especially on face and neck
-percipitates rosacea with "rum nose"
Cutaneous effects
Decrease ________ count-
-later stages
-high risk for infection
white count
_________- aggressive treatment with substitution therapy will decrease these symptoms.
-depends on person, amount drank and involvement (time)
Alcohol withdrawel
the following symptoms occur ______ hours after cessation of use or decrease in heavy use:
-coarse tremors of hands,tongue,eyelids
-n&v (tx with anti-emetic)
-sweating
-incr.BP (tx with vasodilator-catapres
-irritability/anxiety
-tachycardia (pulse increases)
-labile temperature
-increase risk of seizure activity (dilantin) decrease along with DT's
4-12 hours will see ANS - affects vital signs
___or ____ day (aggressive tx with subsitution therapy will decrease probability of these symptoms)
-alcohol withdrawel delerium (delirium tremors or DT's) become psychotic
-confusion, delusional thinking, visual/
tactile hallucinations (usually paronia)
-increase risk for seizure
-increased mortality rate
2nd or 3rd day
_____________- use of subsitution therapy. determined by how severe liver is damaged.
-may be instituted as routinely scheduled substitution therapy or as PRN substitution therapy
-takes 3 days to taper until body adjust
-benzodiazephines put brain back together
-ammonia level checked- lactulose given to rid ammonia
-get thiamine 1st in ER
Medical detoxification
_________ given for increasing BP
Vasodilator
CAGE questionaire is frequently used:
C
A
G
E
C- cutting down
A- annoyed/angry
G- guilty
E- eye opener
Usual therapy for subsitution therapy
Librium ___mg Q2H PRN
Ativan 1mg Q2H PRN
Valium 10mg Q2H PRN
50 mg
______abuse- usually begins with:
-medical use for chronic pain
-recreational purposes
Opiate abuse
Examples of _________abuse include:
paregoric, lomotil, morphine, codeine, demeral, fentyl, duragesic patch, percodan, vicodin, oxycotin, methodone, heroin
Opiate abuse
Effects of _______ on brain:
-decrease in pain if using for pain control
-euphoria, mental clouding, drowsiness
-decrease in respirations (depressed centers in medulla)
-decrease cgh reflex (suppressed center in medulla)
-pupillary constriction (stimulated oculomotor nerve)
Opiate
Opiate abuse effects on ____system:
-nausea/vomiting
-decreased peristalsis resulting in constipation
GI system
Opiate abuse effects on _______ functioning;
-decreased in libido
-decreased sexual pleasure
sexual functioning
_____ withdrawel symptoms:
-within 6-24 hrs after last dose depending on half life, usually peaks within 1-3 days also depending on the half life
-dysphoric mood
-pupillary dilation
-muscle aches (motrin)
-tearing/running nose
-abdominal cramping/ diarrhea (bentyl)
-piloerection (goose bumps)
-yawning, craving, sweating
-n&v (anti-emetic)
-insomnia (sleep medication)
Opiate withdrawel symptoms
treatment for withdrawel (_____therapy)
-may be routine times or PRN based on severity of symptoms
-examples include: buprenex
ultram
methadone
catapres(clinidine)
Substitution therapy
_____-most lethal because of CNS depressant effects
-mainly barbiturates including seconal, phenobarbital, and Nembutal
Sedatives
________-anti-anxiety excluding buspar
all the benzodiazepines including valium, librium, dalmane, ativan, xanax, klonopin, and restoril
Anxiolytic
Reasons for__________abuse:
-decrease anxiety
-helps alleviate insomnia
-increase feelings of relaxation
-decrease inhibitions
-may be used with other drugs to enhance intoxication
Sedatives
Side effects from _________-
-drowsiness
-motor incoordination
-ataxia
-decrease in REM sleep resulting in nightmares
Sedatives
Side effects of __________-
-drowsiness
-motor incoordination
-ataxia
-decrease in REM sleep resulting in nightmares
Sedatives
Withdrawel symptoms from __________:
-hyperexcitability
-fine hand tremors
-increase in anxiety
-sleep problems
-cravings
-withdrawel seizures that may lead to delirium
Sedatives
________ such as cocaine and amphetamine
(methamphetimine, ICE, Ritalin, Cylert)
effects include:
-promotes high firing rate resulting in euphoria/excitement
-increase HR and BP
-may cause arrythymias in chronic and heavy use
-restlessness and insomnia
-craving with withdrawel
-may cause psychosis
Stimulants
No withdrawel treatment is necessary from _____________ use.
Stimulant
________- enduring traits that don't change. Helps us function successfully in our roles
Personality
Type of personality trait that is positive, makes up our personality
Function