-
functional areas of the brain
- reticular
- limbic
- extrapyramidal
-
define reticular activating system
nerve fibers that travel throughout the brainstem and cerebrum
-
reticular activating system controls
- conscious
- arousal
- alertness
- concentration
-
define limbic system
neurons around hypothalamus and lower portion of cerebrum
-
limbic system controls
- emotional and behavioral responses associated with:
- reward/punishment
- sexual
- anger/rage
- fear
- anxiety
- pleasure sorrow
- learning/memory
-
extrapyramidal system
somatic motor pathway located in CNS and controls sk musc. tone and movement
-
-
excitatory neuroT
- acetylcholing
- NE
- EPI
- serotonin
-
neuroT that are out of wack in
depress
mania
anxiety
parkins
bipolar
schitzo
- no NE/Serotonin
- much NE/serotonin
- no GABA
- much Acetylcholine
- -
- much dopamine
-
factors that lower pain threshhold
- anxiety
- sleeplessness
- fatigue
- anger
- fear
- fright
- iso
- discomfort
-
factors that raise pain threshhold
- sleep
- rest
- diversion
- empathy
- meds
- music
-
acute pain
chronic
visceral
somatic
- sudden/subsides
- persistant/6month/hard to treat
- sm musc/diff to treat
- sk musc/ local/easy to treat
-
what are the major receptor sites for opiod analgesics
mu and kappa
-
what is the most potent analgesic
morphine
-
morphine side effects
- sedation
- euphoria
- dysphoria
- constipation
- urinary retention
- miosis
- resp depression
- hypot t
- brady
- bronch constrict
- emesis
- anti emetic
-
morphine is additive w/ ___
decresed with __
shoulnt be given with ___
used caustiously with ___
- alcohol
- smoking
- head injuries
- chronis airway limitations
-
define PCA pump
continuous infusions of opiods
-
-
what are the major non opiod analgesics
- acetemetaphine
- salicylates
- NSAIDS
-
which are analgesic, anti pyretic, anti inflammatory, anti platelet
acetemetaphine=analgesic/ant pyretic
salicylates/NSAIDs/cox-2 inhibitors= all 4
-
define neuroleptanesthesia
general anesthisa admin. IV given with inhalation of a weak ansethetic
-
stages of sleep
- 1 (NREM)- aware, relaxed, 4-5% of sleep
- 2 (NREM)- unaware, easily woke, 50% of sleep
- 3 & 4 (NREM)- slow wave, delta, high amp, low freq, phys rest, 20-25% of sleep
- REM- high autonomic activity,, dreams, mental restoration, 20-25% of sleep
-
define sedative
state of calmness when given in divided doses
-
define hypnotic
given at bedtime in larger doses than a sedative
-
what are the drugs used for hypnotics and sedatives
- barbituates during surgery
- benzo used post-op
-
uses for benzodiaz
- anxiety
- depression
- preanesthesia
- withdrawl
- seizures
-
which drugs can cause physical or phycological dependence
- barbituates
- antianxiety
- opiod analgesics
-
uses for barbituates
- sedative low dose
- hypnotic high dose
- OR
- anesthetic
- anti convulsant
-
-In unibipolar there is a deficiency of__
-in bipolar there is a def of __ in depressive cycle and ___ in manic cyle
- - NE and serotonin
- - NE and serotonin
- - excess
-
in schitzophrenia there is an___
excess of dopamine
-
in drug induced parkinsons there is ___
excess of acetylcholine
-
Narcan only reverses
opiod overdose
-
drug of choice for suicide attempts
barbituates
-
NSAIDs are given for
mild pain
-
most commonly prescribed anticonvulsant
phenytoin(Dilantin)
-
define orthostatic hypertension
adverse effect of MAO inhibitors
-
patients taking MAO inhibitors should
- - rise slowly
- -NO food with tyramine, will cause hypertensive emergency
-
Barbituates
1) MOA
* remember
1) increase GABA, reduce neuro activity(retic form and cereb cortex), depress CNS,
nonselective, habit forming, narrow therap. index
-
barbituates side effects
- CNS depress
- cns excitement
- insomnia
- anxiety
- hypersensitivity
- resp. depress
- toxicicty
- chronic poison
-
CNS stimulants are used to treat
- restore mental alertness
- stimulate resp center
- hyperactivity
-
agents used therapeutically as CNS stimulants
- amphetamine
- anorexiants
- analeptics
-
define epilepsy
chronic neurologic disorders charecturized by sporadic recurrent episodes of convulsive seiz, sensory disturbances, ab. behavior, loss of conscious,
-
define status epilepticus and treatment
- -last at least 15 min
- -benzos and valium via IV, Ativan, cerebyx
-
drug of choice for absence seizures
Zarontonin
-
most causes of epilepsy are
unknown
-
mu, kappa and delta are
major receptors for opiod agonist
-
amphetamines
- stimulate relase of NE
- increased alertness, less fatigue, elevated mood
-
typical antiphycotics
- -block dopamine type 2 receptors in brain
- -control only + symptoms of schitzo
-
typical antiphycotics side effects
- serious movement disorders (EPS)
- dystonia
- akathisisa
- brady and pseudoparkin
- tardive dyskinesia
- weight gain
- sexual
- ADH
-
atypical antiphycotics
- block serotonin receptors and dopamine
- control + and - symptoms
- have few side effects
-
atypical antiphycotics side effects
- movement disorders
- seizures
- metabolic
- endocrine
- sedation
-
shitzo positive symptoms
- delusions
- hallucinations
- dissorginized or catatonic behavior
-
schitzo neg symptoms
- affective
- flattning
- blunting
- alogia
- annedonia
- avolition
- inatentiveness
-
if a patient taking Thorazine developes exces symptoms,
dr can give Cogentin
-
define selegiline
- antidepressant
- treat parkinsons
- selective, ireversablie MAO inhibitor
-
exogenous depression
- reactive
- most common
- in response to real stimuli such as greif and illness
-
enogenous depression
- major
- unipolar
- manifested by inability to experience pleasure or cope with life
-
enogenous depression meds
- tricyclic antidepressants ( TCA)
- selective serotonin reuptake inhibitors(SSRI)
- MOA
- atypical depressants
-
most antidepressants act by
inhibiting the reuptake of NE and serotonin
-
lithium
- -antimanic drug
- -narrow therapeutic index
- -monitored for blood concentration toxicity
- -metallic taste is an early sign of toxicity
-
___ are used last to treat depression because__
- MAO inhibitors
- dietary restrictions
-
which drugs are used to treat EPS adverse effects
anti cholenergic
-
what drug is used in acute gout
colchincine
-
which drug is used in prophylaxis gout
-
which drugs are used for gout after first 48 hrs
-
what increases the effect of GABA
-
asprin
should not be given to children under 18 because of reyes syndrome
-
class of seizures
- partial-simple
- complex-impared conscious
- generalized-convulsive,non convulsive
- tonic clonic-grand mal
- tonic- large muscle group
- clonic- dysrythmic
- myoclonic- unaltered conscious, isolated
- absence- brief loss of conscious,
- atonic- head drop
-
-
brain stem
- -thalamus
- hypothalamus
- pons
- medulla
-
-
hypothalamus
temp, water balance, apetite, sleep, ANS, endocrine glands
-
-
-
cerebellum
coordinates movement, posture and equillibrium
-
bipolar disorders
- unrelated to life
- increase catecholamine
-
drugs that stimulate cns
- anorexiants
- cocaine
- amphetamines
- analeptics
- ritalin
-
uriosuric drugs
used to treat gout
-
define gout
- -inborn error of metabolism
- -disorder of metabolism in uric acid that is not -properly excreted from the body
- -deposits in joints
-
meds used to treat acute gout attack
-
meds used to prevent gout attck
-
GABA plays a major role in
-
positive symptoms
excess or distortion
-
negative symptoms
reflection of loss or diminuiton
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