Southwestern Pharmacology Unit 3 Ch 13-20

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central nervous system

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The brain and signal cord make up the central nervous system.

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afferent nerves

Back 2

Nerves of the CNS that transmit signals from sensory receptors to the spinal cord and brain.

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efferent nerves

Back 3

Nerves that the CNS uses to process signals and control body response, and carry impulses to other parts of the body.

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peripheral nervous system

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The motor and sensory nerves outside the brain and spinal cord; contains the efferent and afferent nerves.

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motor nervous system

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A subdivision of the efferent system; it controls skeletal muscle contractions.

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autonomic nervous system

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The portion of the nervous system that helps regulate such body functions as heart rate, blood pressure, thermal control, light regulation by the eyes, and many other activities.

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neuron

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A series of segments that make up each nerve of the central and peripheral nervous systems.

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synapse

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Anatomic relation of one nerve cell to another; the point of contact between processes of two adjacent neurons, forming the place where a nervous impulse is transmitted from one neuron to another; also called synaptic junction.

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neurotransmitters

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Chemical substances that transmit nerve impulses.

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norepinephrine

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One of the two major neurotranmitters of the autonomic nervous system.

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acetylcholine

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Acetic acid ester of choline chloride, normally present in many parts of the body and having many important physiologic functions (e.g., the transmission of nerve impulses in the central nervous system). As a drug, it is administered subcutaneously and intravenously to relax peripheral blood vessels.

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cholinergic fibers

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Nerve endings of the autonomic nervous system that liberate the neurotransmitter acetylcholine.

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adrenergic fibers

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Nerve endings of the autonomic nervous system that secrete the neurotransmitter norepinephrine.

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cholinergic agents

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Medications that cause effects in the body similar to those produced by acetylcholine are called cholinergic agents or parasympathomimetic agents because they mimic the action produced by stimulation of the parasympathetic division of the autonomic nervous system.

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adrenergic agents

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Medications that cause effects similar to those produced by the adrenergic neurotransmitter are called adrenergic agents, or sympathomimetic agents.
(See page 209-1st column-2nd paragraph)

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anticholinergic agent

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Drug that inhibits the actions of acetylcholine by occupying the acetylcholine receptors.

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adrenergic blocking agent

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Drug that inhibits the adrenergic system.

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catecholamine

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Dopamine, norepinephrine, and epinephrine synthesized, stored, and metabolized in the brain, adrenal glands, and autonomic nervous system.

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alpha receptor

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Stimulation of alpha-1 receptors by norepinephrine causes vasoconstriction of blood vessels. Alpha-2 receptors mediate negative feedback, preventing further release of norepinephrine.

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beta receptor

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Stimulation of beta-1 receptors causes an increase in the heart rate; stimulation of beta-2 receptors causes relaxation of smooth muscle in the bronchi (bronchodilation), uterus (relaxation), and peripheral arterial blood vessels (vasodilation).

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dopaminergic receptors

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Receptors that are stimulated by dopamine. Stimulation of the dopaminergic receptors improves the symptoms associated with Parkinson's disease. Dopamine also increases urine output because of stimulation of specific receptors in the kidneys that results in better renal perfusion.

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REM sleep

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A phase of normal sleep with rapid eye movement. The early episodes of REM sleep only last a few minutes, but as sleep progresses, REM sleep increases.

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insomnia

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Inability to fall asleep or stay asleep.

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hypnotic

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Any agent that will produce sleep.

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sedative

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Quieting or calming type of drug.

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rebound sleep

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Compensatory rapid eye movement (REM) sleep that occurs when there is a strong tendency to "make up" decreased REM sleep.

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Parkinson's disease

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Disease marked by slowing and weakness of voluntary movement, muscular rigidity, and tremor; caused by a deficiency of dopamine.

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dopamine

Back 28

An intermediate product in the synthesis of norepinephrine; it acts as a neurotransmitter in the central nervous system.

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neurotransmitter

Back 29

Chemical substances that transmit nerve impulses.

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acetylcholine

Back 30

Acetic acid ester of choline chloride, normally present in many parts of the body and having many important physiologic functions (e.g., the transmission of nerve impulses in the central nervous system). As a drug, it is administered subcutaneously and intravenously to relax peripheral blood vessels.

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tremors

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An involuntary trembling or quivering. Emotional stress and fatigue may increase the frequency of tremors.

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dyskinesia

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Impaired ability to perform voluntary movements.

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propulsive, uncontrolled movement

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Uncontrolled movement forward or backward.

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akinesia

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An abnormal state of motor and psychic hypoactivity or muscular paralysis.

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livedo reticularis

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Skin mottling. A dermatologic condition occasionally observed with amantadine therapy.

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anticholinergic agents

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Amantadine may exacerbate the side effects of anticholinergic agents that may also be used to control the symptoms of parkinsonism. Confusion and hallucinations may gradually develop. The dosage of amantadine or the anticholinergic agent should be reduced. (See page238-column 1-6th paragraph)

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levodopa

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An antiparkinsonian drug.

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anxiety

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A normal human emotion, similar to fear, that is characterized by an unpleasant feeling of apprehension or nervousness caused by the perception of potential or actual danger that threatens a person's security

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generalized anxiety disorder

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A psychological/physical condition described as excessive and unrealistic worry about two or more life circumstances for 6 months or more.

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panic disorder

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A type of anxiety disorder that begins as a series of acute or unprovoked panic attacks involving an intense, terrifying fear. There are usually feelings of impending doom or a fear of losing control.

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phobias

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Any persistent dread or fear.

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obsessive-compulsive disorder

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An anxiety disorder characterized by recurrent obsessions or compulsions that cause significant distress and interfere with normal occupational responsibilities, social activities, and relationships.

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compulsion

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A repetitve, intentional, purposeful behavior performed to decrease the anxiety associated with an obsession.

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anxiolytics

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Antianxiety medications, also known as tranquilizers, prescribed to treat anxiety.

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tranquilizers

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Antianxiety medications, also known as anxiolytics, prescribed for treating anxiety.

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mood

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A sustained, emotional feeling perceived along a normal continuum of sad to happy. Mood is an individual's perception of his or her surroundings.

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mood disorder

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Affective disorder present when certain symptoms impair a person's ability to function for a time and characterized by abnormal feelings of depression or euphoria.

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neurotransmitters

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Chemical substances that transmit nerve impulses.

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depression

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A mood disorder in which patients display varying degrees of emotional, physical, cognitive, and psychomotor impairment. Emotionally, the depression is characterized by a persistent, reduced ability to experience pleasure in life's usual activities such as family, hobbies, and work.

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cognitive symptoms

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Symptoms that include the inability to concentrate, slowed thinking, confusion, and poor memory of recent events; these are particulary common in older adults with depression

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psychomotor symptoms

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Symptoms of depression that include slowed or retarded movements, thought processes, and speech, or conversely, agitation manifesting as purposeless, restless motion.

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bipolar disorder

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A mood disorder characterized by distinct episodes of mania (elation, euphoria) and depression, separated by intervals without mood
disturbances. Formerly known as manic depression.

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mania

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Phase of bipolar disorder marked by elation, agitation, hyperexcitability,
expansiveness, hyperactivity, and increased speed of thought and speech.

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euphoria

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Physical comfort; well being; absence of pain or distress.

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labile mood

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A symptoms of acute mania that often includes rapid shifts toward anger and irritability.

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grandiose delusions

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Psychotic symptoms of bipolar disorder pertaining to exaggerated belief or claims of one's importance or identity.

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suicide

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The intentional taking of one's own life. People with mood disorders have a high incidence of attempting suicide.

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antidepressants

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Several classes of drugs used for treating patients who have symptoms of moderate to severe depression.

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psychosis

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Disease or disorder of the mind characterized by disintegration of the personality and its break with reality.

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delusion

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A false or irrational belief that is firmly held despite evidence to the contrary.

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hallucinations

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are false sensory perceptions that are experienced without an external stimulus but that nevertheless seem real to the patient. Auditory hallucinations, experienced as “voices” characteristically heard that are commenting negatively about the patient in the third person, are prominent in schizophrenia. Hallucinations of touch, sight, taste, smell, and bodily sensation also occur.

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disorganized thinking

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Thought disorders commonly associated with psychosis that may consist of a loosening of associations so that the speaker jumps from one idea or topic to another unrelated one in an illogical way.

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loosening of associations

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Thought disorder where the person jumps from one idea or topic to another unrelated one in an illogical, inappropriate, or disorganized way.

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disorganized behavior

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A common characteristic of psychosis where problems may be noted in any form of goal-directed behavior, leading to difficulties in performing activities of a daily living, such as organizing meals or maintaining hygiene.

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changes in affect

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Often a symptom of psychosis, characterized by diminished emotional expressiveness, poor eye contact, reduced spontaneous movement, and withdrawal from interpersonal relationships.

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target symptoms

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Critical monitoring parameters that are used to assess change in clinical status and response to medications.

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typical (first generation)antipsychotic agents

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The typical antipsychotic agents antagonize the neurotransmitter dopamine in the central nervous system (CNS).

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atypical (second generation) antipsychotic agents

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The atypical antipsychotic agents inhibit dopamine receptors, but also inhibit serotonin receptors to varying degrees. However, the exact mechanism by which these actions prevent psychotic symptoms is unknown. There is substantially more to the development of psychotic symptoms than elevated dopamine levels. There are at least five known types of dopamine receptors and several more types of serotonin receptors in various areas of the CNS. Antipsychotic agents also stimulate or block cholinergic, histaminic, nicotinic, and alpha and beta adrenergic neurotransmitter receptors to varying degrees, accounting for many of the adverse effects of therapy.

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equipotent doses

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Medication doses that have the same therapeutic potential.

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extrapyramidal symptoms (EPS)

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Symptoms of side effects of antipsychotic agents that consist of four categories: dystonic reactions, pseudoparkinsonism, akathisias, and tardive dyskinesia

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dystonia

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Spasmodic movements (prolonged tonic contractions) of muscle groups such as tongue protrusion, rolling back of the eyes (oculogyric crisis), jaw spasm (trismus), or neck torsion (torticollis).

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pseudoparkinsonian symptoms

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Tremor, muscular rigidity, mask-like expression, shuffling gait, and loss or weakness of motor function that typically begin after 2 to 3 weeks of antispsychotic drug therapy but may occur up to 3 months after starting therapy.

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akathisia

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A syndrome consisting of subjective feelings of anxiety and restlessness and objective signs of pacing, rocking, and inability to sit or stand in one place for an extended periods. It occurs more commonly with the administration of high-potency antispsychotic agents.

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tardive dyskinesia

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A syndrome of persistent and involuntary hyperkinetic abnormal movements. All antipsychotic agents have the potential to produce tardive dyskinesia.

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abnormal involuntary movement scale

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A scale that rates dyskinetic movements but is not exclusively diagnostic for tardive dyskinesia

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dyskinesia identification system: condensed user scale

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(DISCUS) rates the presence and severity of abnormal movements and considers other variables when formulating a conclusion. The DISCUS evaluation specifically describes the type of tardive dyskinesia and allows diagnoses to change over time (See page 288-Bottom of 2nd column)

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neuroleptic malignant syndrome

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A syndrome that can occur in patients receiving antipsychotic therapy; it is characterized by fever, leadpipe rigidity, trismus, choreiform movements, autonomic instability (e.g., tachycardia), and alterations in consciousness (e.g., coma, stupor).

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depot antipsychotic medicine

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Injectable, slow-release dose form of antipsychotic agents

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seizures

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Symptoms of an abnormality in the nerve centers of the brain. They are brief periods of abnormal electrical activity in the brain.

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epilepsy

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Nervous system disease with convulsive features.

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generalized seizures

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Seizures that affect both hemispheres of the brain, are accompanied by loss of consciousness, and may be subdivided into convulsive and nonconvulsive types.

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partial seizures

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Seizures that can be subdivided into complex and simple symptom types. Partial seizures begin in a localized area in one hemisphere of the brain.

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anticonvulsants

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Epilepsy is treated almost exclusively with medications known as anticonvulsants. (See page 296-2nd column-last 2 sentences)

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antiepileptic drug (AED)

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Medication used to treat epilepsy

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tonic phase

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Phase of an epileptic seizure where the person suddenly develops intense muscular contractions that cause them to fall to the ground, lose consciousness, and lie rigid.

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clonic phase

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Epileptic phase manifested by bilaterally symmetric jerks alternating with relaxation of extremities. The clonic phase starts slightly and then gradually becomes more violent, involving the entire body.

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postictal state

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Resting, recovery phase of an epileptic seizure that involves flaccid paralysis and sleep lasting 2 to 3 hours; follows the clonic phase.

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status epilepticus

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A series of rapidly repeated epileptic convulsions with no periods of consciousness. This is a medical emergency requiring prompt treatment.

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atonic seizure

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An absence seizure characterized by a sudden loss of muscle tone.

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myoclonic seizures

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Seizures involving lightning-like repetitive contractions of the voluntary muscles of the face, trunk, and extremities.

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absence (petit mal) epilepsy

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Seizures that occur primarily in children and consist of paroxysmal episodes of altered consciousness lasting for 5 to 20 seconds.

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seizure threshold

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The amount of stimulus necessary to produce a convulsive seizure.

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gamma-aminobutyric acid (GABA)

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An inhibitory neurotransmitter that counterbalances the effect of excitatory neurotransmitters.

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gingival hyperplasia

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Gum overgrowth associated with hydantoins (e.g., phenytoin, ethotoin), which can be reduced by good oral hygiene, frequent gum massage, regular brushing, and proper dental care.

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nystagmus

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An involuntary rapid movement of the eyeball, which may be horizontal, vertical, rotary, or mixed (i.e., of two varieties).

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urticaria

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Hives.

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pain experience

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An unpleasant sensation that is part of a larger situation that is highly subjective and influenced by behavioral, physiologic, sensory, emotional (e.g., attention, anxiety, fatigue, suggestion, prior conditioning), and cultural factors for a particular person under a set of circumstances.

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pain perception

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Also known as nociception. An individual's awareness of the feeling or sensation of pain.

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pain threshold

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The point of which an individual first acknowledges or interprets a sensation as being painful.

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pain tolerance

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The individual's ability to endure pain.

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nociception

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Pain perception

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acute pain

Back 102

Pain that arises from sudden injury to the structures of the body (e.g., skin, muscles, viscera).

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chronic pain

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Pain that has slower onset and lasts longer than 6 months beyond the healing process. It is often subdivided into malignant (cnacer) or nonmalignant (causes other than cancer) pain.

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nociceptive pain

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Pain resulting from a stimulus (e.g., chemical thermal, mechanical) to pain receptors.

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somatic pain

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Pain that originates from the skin, bone, or muscles (e.g., arthritis pain).

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visceral pain

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Pain that originates from the abdominal and thoracic organs.

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neuropathic pain

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Pain that results from injury to the peripheral or central nervous system; often described as stabbing or burning.

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idiopathic pain

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Nonspecific pain of unknown origin, often associated with anxiety, depression, and stress.

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analgesics

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are drugs that relieve pain without producing loss of consciousness or reflex activity. The search for an ideal analgesic continues, but it is difficult to find one that meets this definition. It should be potent so that it will afford maximum relief of pain; it should not cause dependence; it should exhibit a minimum of side effects such as constipation, hallucinations, respiratory depression, nausea, and vomiting; it should not cause tolerance; it should act promptly and over a long period with a minimum amount of sedation so that the patient is able to remain conscious and responsive; and it should be relatively inexpensive. (See page 317-Last paragraph)

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opiate agonists

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A group of naturally occurring semisynthetic and synthetic drugs that have the capability to relieve severe pain without the loss of consciousness.

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opiate partial agonists

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A class of drugs whose pharmacologic actions depend on whether an opiate agonist has been administered previously and the extent to which physical dependence has developed to that opiate agonist.

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opiate antagonists

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Medicine that will counteract the effects (e.g., respiratory depression, hypotension, sedation) of opiates. Nalmefene, naloxone, and naltrexone are opiate antagonists.