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71 Cards in this Set
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Acute dystonia |
A syndrome of abnormal muscle contractions that produces repetitive, involuntary twisting movements and abnormal posturing of the neck, trunk, face, and extremities. Can have an onset within a few hours of initial drug administration. This is a crisis that requires the addition of anticholinergic agents such as benztropine which works by blocking acetylcholine, to counter dopamine blockade effects, to relieve the crisis. One of Extrapyramidal symptoms (EPS) - adverse effects associated with use of first-generation antipsychotic meds |
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Agranulocytosis |
A reduced white blood count and leukocyte count that can be caused by psychiatric medications. |
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Akathisia |
Unpleasant sensations of “inner” restlessness that manifest as an inability to sit still or remain motionless |
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Antihypertensive |
Having the effect of lowering blood pressure. When FGAs are combined with anti hypertensive agents, there is an increased risk of hypotension and changes in cardiac rhythms due to blockade of alpha1-adrenergic receptors. |
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Antipsychotics |
Group as a class of drugs used to treat a broad range of disorders including schizophrenia, psychoses, delusional disorders, bipolar disorder, and depression. Also they are used to treat remiss, Tourette syndrome, and Huntington’s chorea. Antipsychotic medications are classified as either first-generation antipsychotics (FGAs), sometimes called typical antipsychotics, or second-generation antipsychotics (SGAs), otherwise known as atypical antipsychotics. These meds do not cure schizophrenia or other psychotic disorders, but rather offer partial or complete relief of symptoms. Length of treatment determined by which psychotic episode he is experiencing. 1st episode, usually treated for at least one year. Could be lifelong if multiple episodes |
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Anxiety |
A normal reaction to stress that in some situations can be beneficial. In about 18% of adults in the US, it can become excessive and about 1/4 of these people, anxiety can become so severe that it negatively affects day-to-day living. Characterized by worry, fear, muscle tension, irritability, sleep changes, arousal, fatigue, breathing changes and concentration difficulties. Anxiety triggers the endocrine system connected to the amygdala and the hypothalamus to increase the level of the adrenal hormone cortisol. Autonomic nervous system is also triggered which causes the fight-or-flight response. Chronic increases in cortisol can lead to coronary disease, type 2 diabetes, and stroke. |
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Anxiety disorders - 6 major categories |
1.generalized anxiety disorder 2.panic disorder 3.obsessive-compulsive disorder 4.phobic disorders 5.post-traumatic stress disorder 6.acute stress disorder |
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Treating anxiety disorder |
Use of medications is one modality for treatment of depression and anxiety. FOUR major types of antidepressant meds: 1.tricyclic antidepressants (TCAs), 2.SSRIs 3.SNRIs 4.monoamine oxidase inhibitors (MAOIs) In general, anxiety responds well to benzodiazepines and/or SSRIs or SNRIs. |
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Ataxia |
Unsteadiness when walking Common side effect while on benzodiazepines |
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Atypical antipsychotics |
Second-generation antipsychotic medications. |
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Auditory hallucinations |
A psychotic symptom that causes sounds or voices to be heard. Can occur in schizophrenia or manic episodes |
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Barbiturates |
A class of CNS depressant medications that produce sleepiness and relaxation. Historically, Used in the treatment of anxiety, epilepsy, as a esthetics, and to induce sleep. They bind GABA receptors, but they have a high abuse potential and can be fatal with overdosage, so they are not normally considered drugs of choice for sleep disorders and are rarely prescribed for these indications. They may be cautiously considered if other treatments have failed. A sleep hypnotic drug Used on patients with dyssomnics and parasomnias. Abrupt cessation should be avoided and instead tapering of dosages over weeks or months. Withdrawal symptoms include rebound anxiety and rebound insomnia, lack of tearfulness, orthostatic hypotension, confusion, and disorientation. Serious cases of withdrawal, hypertension, paranoia, seizures, cardiovascular collapse and death. |
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Benzodiazepines |
A class of drugs that act primarily on the central nervous system and are often the first-line treatment for anxiety. They enhance the inhibitory effects of gamma-aminobutyric acid (GABA) and abundance to benzodiazepine receptors at the GABA-a ligand-gated chloride-channel complex. (BZD) are one of the most widely prescribed pharmacological categories in the US. Prescribed for anxiety, insomnia, muscle relaxation, relief from spasticity caused by central nervous system pathology and epilepsy. Used intraoperatively because of their amnesiac and anxiolytic properties. Act primarily on the CNS and are often the first-line treatment for anxiety. They can also be used to augment the anxiolytic effects of SSRIs and SNRIs, as they do not affect serotonin or nonrepinephrine levels and therefore incure no risk of serotonin syndrome. Good for use in insomnia Well tolerated and safe. Long-term use may lead to dependence or tolerance and cause withdrawal symptoms. Slow tapering off Avoid prescribing in pregnant clients. |
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Bipolar disorder |
Also known as manic-depressive disorder Psychiatric disorder characterized by mood swings between depression and mania. Onset usually occurs between ages 15-25. 82.9% of adult bipolar disorder is classified as severe, characterized by severe mood swings between depression and mania. Only 48.8% diagnosed are receiving treatment Often unrecognized or misdiagnosed and therefore, not treated or medicated properly. Symptoms : energy, activity levels, and ability to carry out daily activities can be significantly increased or decreased according to the mood. Manic episodes may last hours to days to months: easily distracted, reduced need for sleep, poor judgment, loss of temper, reckless behavior, poor impulse control, hyperactivity, excessive energy, grandiose thoughts, racing thoughts, excessive talking, and agitation or irritability. Psychotic symptoms such a as auditory and visual hallucinations and delusional thoughts. Hypomania is defined as a mild form of mania. Patient’s mood tend to be elevated, and irritability and agitation are often prominent. |
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Bipolar disorder symptoms |
Manic episodes may last hours to days to months: easily distracted, reduced need for sleep, poor judgment, loss of temper, reckless behavior, poor impulse control, hyperactivity, excessive energy, grandiose thoughts, racing thoughts, excessive talking, and agitation or irritability. Psychotic symptoms such a as auditory and visual hallucinations and delusional thoughts. Hypomania is defined as a mild form of mania. Patient’s mood tend to be elevated, and irritability and agitation are often prominent. Major depressive episodes include sadness, fatigue, appetite changes, sleep changes (evidenced by either excessive or inadequate sleep), isolation, thoughts of death or suicide, and feelings of hopelessness and worthlessness. Mixed episodes include mood swings between manic and depression. Symptoms include agitation and irritability as well as feelings of depression and/or mania. Drugs of choice for treatment: Two categories: mood stabilizers and antipsychotics |
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Bradykinesia |
Slow movement and muscle rigidity A symptom of a side effect known as Parkinsonism symptoms from benztropine. |
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Cognitive symptoms |
Symptoms of schizophrenia that include difficulties with the ability to pay attention and to focus, as well as the presence of significant learning and memory problems and disordered thinking. (This is one of three distinct categories of schizophrenia symptoms - others include Positive symptoms and negative symptoms.) |
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Comorbid |
Co-occurring Ie:Depression and anxiety are often comorbid conditions. They share many symptoms in common, making it difficult to separate the diagnoses in many cases. |
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Delusional disorders |
Unreal, often unfounded thoughts that can include paranoia, grandiose, sexual, or somatic beliefs that are not found to be based in reality. Ie: schizophrenia and other psychoses. |
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Delusions |
False beliefs and one’s self or other people or objects that persist despite the facts, occurring in some psychotic states. |
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Dependence |
The physical and behavioral need to continue a substance due to addition and tolerance. Discontinuing the substance could cause physiological symptoms of withdrawal. |
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Depression |
A common mental disorder that presents with a depressed mood, loss of interest in daily activities, lack of pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration, and possibly, suicidal thoughts. Can lead to substantial impairments in an individual’s ability to take care of his or her everyday responsibilities. Effects 300 million people worldwide, leading cause of disability Thought that depression is caused by deficiencies in the monoamine neurotransmitters, norepinephrine, dopamine, and serotonin, at CNS receptors. Thus the focus of pharmacological treatment is to increase the concentrations/levels of these neurotransmitters. General: all antidepressants boost the synaptic action of one or more of these neurotransmitters, in most cases by blocking the presynaptic transporters, which normally act to decrease, or recycle, the neurotransmitter. (Fig 4.1) |
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Diaphoresis |
Excessive sweating A symptom of serotonin syndrome (a disorder that can develop with the use of any medication that prevents the reuptake of serotonin) |
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Distorted thinking |
Inaccurate thoughts, often including negative thinking, that result in a poor self-image. Seen in Positive symptoms (one of 3 categories of schizophrenia) |
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Dyssomnias |
Sleep disorders characterized by a disturbance in the amount of quality of sleep. Pertains to the improper amount, quality or timing of sleep. |
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Extrapyramidal symptoms (EPS) |
Adverse effects associated with use of first-generation antipsychotic medications; acute dystonia, Parkinsonian symptoms, mask-like Davies, shaking palsy, trembling past, akathisia, and tardive dyskinesia. |
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Generalized anxiety disorder |
A disorder of excessive anxiety and worry often including physiological symptoms and depression One of 6 major classes of anxiety disorders 1.generalized anxiety 2.panic 3.obsessive-compulsive 4.phobic 5.post-traumatic stress 6.actuate stress |
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Huntington’s chorea |
Continuous involuntary, jerky movements of the limbs or facial muscles that can be associated with the long-term use of antipsychotic medications. |
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Hypertensive crisis |
A life-threatening side effect of MAOIs caused by eating tyramine-containing foods and beverages. High levels of tyramine cause a significant increase in the neurotransmitter norepinephrine in the gut, leading to excessively high blood pressure. Can’t eat for example: aged cheese, yeast products, aged fish or meat, chocolate, some vegetables, some alcoholic beverages and some fruits. |
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Hyponatremia |
Abnormally low sodium level |
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Involuntary movements |
Uncontrollable twitches and jerks and movements of the limbs, trunk, or facial muscles associated with use of antipsychotic medications. A symptom of TD tardive dyskinesia. No reliable treatment for TD but the use of benzodiazepines and reduction of dosage of the FGAs can be beneficial |
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Mania |
A mental disorder that presents with the following symptoms: being easily distracted, reduced need for sleep, poor judgment, loss of temper, reckless behavior, poor impulse control, hyperactivity, excessive energy, grandiose thoughts, racing thoughts, excessive talking, and agitation or irritability. Psychotic symptoms, such as auditory and visual hallucinations and delusional thoughts, may also be present. |
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Mesolimbic |
An area of the brain associated with dopamine activity, located in the midbrain. FGAs work primarily by blocking dopamine-2 (d2) receptors in the mesolimbic are of the brain. |
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Metabolic syndrome |
The combination of obesity, diabetes, and dyslipidemia Side effect to a atypical antipsychotic which features include weight gain, there is a concomitant increase in incidence of diabetes and dyslipidemia. |
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Monoamine oxidase inhibitor (MAOI) |
Drugs that block the breakdown of monoamine oxidase; used for the treatment of depression and anxiety. Block the action of MAO which is the enzyme that degrades the neurotransmitters norepinephrine, serotonin, dopamine, epinephrine, and tyramine and makes these neurotransmitters less available in the brain. Side effects: include symptoms of CNS stimulation such as anxiety, insomnia, agitation, and elevated mood, in addition to the more troubling side effects such as reduced sleep, constipation, dry mouth, nausea, diarrhea, weight gain, changes in appetite orthostatic hypotension, and sexual dysfunction. Life-treating side effect can be hypertensive crisis caused by eating certain foods and beverages that contain tyramine. |
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Mood stabilizers |
Often first choice of medications to treat bipolar disorder. Goal of treatment is to stabilize the patient’s mood and eliminate mood swings, or make them less frequent and less severe. 3 meds are indicated to treat the symptoms of bipolar disorder: 1. Lithium 2. Valproic acid 3. Carbamazepine |
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Motor tics |
Sudden contractions of muscle groups often involving the face or upper arms. They often are associated with a dopamine overload. FGAs can be effective for control of these tics. (Symptom of Tourette syndrome) |
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Negative symptoms |
Include poor insight and judgment, lack of self-care, emotional and social withdrawl, apathy agitation, blunted affect, and poverty of speech. One of the three distinct categories of schizophrenia symptoms. |
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Neuroleptic malignant syndrome |
Adverse effects associated with use of first-generation antipsychotic medications; characterized by high fever, stiffness off the muscles, altered mental status (paranoid behavior) wide swings of blood pressure, excessive sweating, and excessive secretion of saliva. Dopaminergic-mediated adverse effects that can occur with the use of FGAs |
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Neuropathic pain |
Chronic pain resulting from nervous system injury, either in the CNS (brain and spinal cord) or PNS (periphery) |
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neurotransmission |
The transmission of nerve signals in the brain caused by the release of brain chemicals dopamine, serotonin, and norepinephrine. |
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Obsessive-compulsive disorder |
An anxiety disorder characterized by recurring, intrusive thoughts that lead to repetitive (compulsive) behaviors. One of the six anxiety disorder categories. |
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Orthostatic hypotension |
A rapid drop in blood pressure that can occur after moving from the lying to standing position resulting in dizziness and light headedness. An adverse effect related to FGA |
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Palsy |
A form of EPS (extrapyramidal symptoms A condition involving uncontrollable body tremors of one or multiple parts of the body. |
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Panic disorder |
A severe anxiety attack that can include tremors, tachycardia, shortness of breath, diaphoresis, and fear of dying. Persistent fear of reoccurring attacks can cause significant changes in behavior. One of the six major classes of anxiety disorders |
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Paranoia |
A delusion involving suspiciousness or a belief that others are out to harm you. Often the delusion triggers self-protective actions. A positive symptom that could be present as a symptom of schizophrenia |
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Parasomnias |
A sleep disorder (one of two categories) Are defined as abnormal behavioral or physiological events that occur while sleeping. |
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Parkinson’s Ian symptoms |
Dopamine-mediated Rhythmic muscular tremors, rigidity of movement, and droopy posture. Also mask-like Davies, characterized by an immobile, expressionless face with staring eyes and slightly open mouth. An Extrapyramidal symptoms (EPS) |
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Phobic disorders |
An irrational, illogical fear of an object or situation. One of the six major classes of Anxiety disorders |
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Positive symptoms |
Symptoms of schizophrenia that include distortion of reality thinking. Paranoia, auditory and visual hallucinations, and delusions may be present. |
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Post-traumatic stress disorder (PTSD) |
An anxiety disorder caused by a severe traumatic experience that includes symptoms of intrusive memories, flashbacks, nightmares, hyper vigilance, and avoidance of certain stimuli. One of the six classes of anxiety disorders |
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Prolactin |
A protein hormone released by the pituitary gland that is involved with the secretion of milk, stimulates testosterone synthesis, and is involved in the immune system. SGAs are also associated with an increased risk of dangerous arrhythmias and elevated prolactin levels due to their blocking of D2 receptors in the pituitary. |
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Psychosis |
Delusional disorder A positive symptoms category of schizophrenia |
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Psychotropic drugs |
Gained an important role in psychiatry during the mid-20th century. Came about through teamwork among the pharmaceutical industry, federal and state governments, and clinical practice and theory. Drugs used to treat psychiatric disorders |
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Relapse |
Return of symptoms of a disease. The goal of treatment is symptom remission as well as relapse prevention. |
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Remission |
Diminution of symptoms of a disease. The goal of treatment is symptom remission as well as relapse prevention. |
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Schizophrenia |
Effects approximately 24 million people worldwide Treatable disorder, although treatment may be more effective in its early stages. Individuals between ages 15-35 A delusional disorder associated with three types of symptoms; positive, negative, and cognitive. |
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Selective serotonin reuptake inhibitor (SSRI) |
The first-line antidepressant and anxiolytic medication class. SSRIs work by blocking the serotonin reuptake pump in the synaptic space, thereby increasing the concentration of serotonin in the brain. Ie: paroxetine, fluoxetine, carbamazepine, and fluvoxamine. These drugs can cause an increase in serotonin levels and increase the risk of serotonin syndrome because both FGAs and SSRIs inhibit the reuptake of serotonin; thus using them together can lead to a synergistic effect on serotonin levels. Can interact with antipsychotics. |
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Serotonin/norepinephrine reuptake inhibitor (SNRI) |
The first-line antidepressant and anxiolytic medication class. They work by blocking both the serotonin and norepinephrine pumps in the synaptic space, thereby boosting the availability of serotonin and norepinephrine in the brain. |
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Serotonin reuptake pump |
A type of monoamine transporter protein that returns serotonin from the synaptic cleft to the presynaptic neuron; the chemical method by which serotonin is transported within the cell synapse at the cell body and the dendrites. It is associated with the mechanism of antidepressant medications. |
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Serotonin syndrome |
A condition that develops when suppression of serotonin reuptake (eg. from medications) causes an excess concentration of serotonin in the brain stem and spinal cord. Symptoms include alterations in mental status and coordination, diaphoresis (excessive sweating), tremor, rapid heartbeat, muscle spasms, blood pressure fluctuations, and fever. |
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Synaptic space |
The space between nerve cells that are involved with nerve transmission. |
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Tardive dyskinesia (TD) |
Involuntary movement of the facial muscles and tongue. Part of Extrapyramidal symptoms (EPS) TD can progress to the limbs, hands, feet and trunk. TD can have an onset of months to years. And is related to drug dose and duration of treatment. In many cases, this condition is irreversible. Use of benzodiazepines and reduction of dosage of the FGAs can be beneficial. |
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Tolerance |
The state whereby a medication loses its effectiveness and higher doses are needed to produce the same pharmacological effect. It is associated with physical dependence to certain drugs or medications. |
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Tourette syndrome |
A neurological disorder of children involving multiple involuntary motor and vocal tics and the utterance of words or phrases. It can be caused by the use of neuroleptics or stimulant medications. Use antipsychotics to treat |
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Treatment-resistant |
Refers to those disorders that do not respond to, or only partially respond to, multiple trials of medications, and continue to be problematic. |
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Tricyclic antidepressant (TCA) |
A group of antidepressant medications, all of which inhibit the reuptake of norepinephrine and treat a broad range of depression and anxiety disorders. |
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Typical antipsychotics |
First-generation antipsychotic medications |
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Tyramine |
An amino acid involved in the chemical function of the MAOI antidepressants. Ie: aged cheese or meat Makes MAOI drug of last resort |
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Visual hallucinations |
A psychotic symptom that distorts reality and causes a person to see objects or persons that cannot be seen by others. It can occur in schizophrenia or manic episodes One of positive symptoms categories of schizophrenia |
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Withdrawal |
Refers to the symptoms after stopping an addicting substance by an individual in whom dependence has been present. It often includes craving to restart the addicting substance. |
