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Cerebrum
Largest part of brain (accounts for 70% of neurons in the CNS)
Composed of cerebral cortex, limbic system, and basal ganglia.
divided into two halves called cerebral hemispheres
corpus callosum (large bundle of white matter) connects the 2 hemispheres.
LOBES: frontal, temporal, occipital, parietal
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Dopamine
(monoamine)
- Functions:
- sleep
- arousal
- pain perception
- coordination of movement (voluntary muscles)
- memory (CNS)
- Increase:
- Schizophrenia
- Mania
- Decrease:
- Parkinson's disease
- Depression
-
Norepinephrine
(monoamine)
- Functions (Excitatory):
- Mood
- Attention and arousal
- Stimulates sympathetic branch of autonomic nervous system for “fight or flight” in response to stress
- Increase:
- Mania
- Anxiety
- Schizophrenia
-
Serotonin
(monoamine)
- Functions (Excitatory):
- Mood
- Sleep regulation
- Hunger
- Pain perception
- Aggression
- Hormonal activity
-
Histamine
(monoamine)
- Functions (Excitatory):
- Alertness
- Inflammatory response
- Stimulates gastric secretion
- Increase:
- Hyperactivity
- Compulsivity
- Suicidal depression
- Decrease:
- Sedation
- Weight gain
- Hypotension
-
Acetylcholine
(cholinergic)
- Plays a role in learning, memory
- Regulates mood: mania, sexual aggression
- Affects sexual and aggressive behavior
- Stimulates parasympathetic nervous system
- Decrease:
- Alzheimer's disease
- Huntington's chorea
- Parkinson's disease
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GABA
(amino acid)
- Functions (Inhibitory):
- Reduces anxiety, excitation, aggression
- May play a role in pain perception
- Anticonvulsant and muscle-relaxing properties
- Increase:
- Reduction of anxiety
- Decrease:
- Mania
- Anxiety
- Schizophrenia
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A nurse administering a benzodiazepine should understand that the therapeutic effect results from the benzodiazepine binding to receptors adjacent to receptors for the neurotransmitter:
1. GABA.
2. dopamine.
3. serotonin.
4. acetylcholine.
- Rationale: Figure 4-13 demonstrates that
- benzodiazepines bind to specific receptors adjacent to the GABA receptors.
- Because of their ability to bind benzodiazepines, these receptors are called
- benzodiazepine receptors. Binding of benzodiazepines to these receptors at the
- same time that GABA binds to its receptors allows GABA to inhibit more
- forcefully than it would if binding alone.
Text pages: 63-64
-
Fluoxetine
(an SSRI) exerts its antidepressant effect by blocking the reuptake of:
1. GABA.
2. dopamine.
3. serotonin.
4. norepinephrine.
Rationale: Fluoxetine (Prozac) preferentially blocks the reuptake of serotonin. Fluoxetine has little or no effect on the other monoamine transmitters.
Text page: 62
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A psychiatric nurse routinely administers the following drugs to patients in the community mental health center. The patients who should be most carefully assessed for untoward cardiac side effects are those receiving:
1. lithium.
2. clozapine.
3. diazepam.
4. sertraline.
Rationale: Lithium is thought to act by stabilizing electrical activity in neurons. It is a positively charged ion similar in structure to sodium and potassium. Lithium’s potential to impact electrical function explains its foremost danger: the induction of a cardiac dysrhythmia.
Text page: 60
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Which of the following classes of psychotropic medications could trigger the development of parkinsonian movement disorders among individuals who take therapeutic doses?
1. SSRIs
2. DRAs
3. Benzodiazepines
4. Tricyclic
antidepressants
- Rationale: DRAs (dopamine receptor antagonists)
- are strong blockers (antagonists) of the D2 receptors for dopamine. Although it is unclear if this antagonism plays a role in the beneficial effects of the drugs, it is certain that antagonism is responsible for some of the major side effects. Thus, because dopamine (D2) in the basal ganglia plays a major role in the regulation of movement, it is not surprising that dopamine blockage can lead to motor abnormalities such as extrapyramidal side effects including parkinsonism, akinesia, akathisia, dyskinesia, and tardive dyskinesia.
Text pages: 57-58
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Atypical antipsychotic medications have which of the following effects? Select all that apply.
1. Reduction of
positive symptoms of schizophrenia
2. Reduction of
negative symptoms of schizophrenia
3. Reduction of body
mass
4. Possible
improvement in cognitive function
Rationale: Atypical antipsychotic agents target both the positive and negative symptoms of schizophrenia. In addition, there is research evidence that atypicals may improve cognitive function for schizophrenic patients. Atypicals frequently cause an increase in body weight and mass; thus, answer 3 is incorrect.
Text page: 59
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