Week 3 Lecture- Behavioral Health

What is neurobiologic research?

Research that studies the relationship between the brain, nervous system, and mental illness.

What are neurotransmitters?

Chemical substances manufactured in neurons that transmit information throughout the body.

What neurotransmitter controls complex movement and motivation?

Dopamine.

What neurotransmitter affects attention, learning, memory, sleep, wakefulness, and mood?

Norepinephrine.

What neurotransmitter is responsible for the fight-or-flight response?

Epinephrine.

What neurotransmitter regulates mood, sleep, appetite, and sexual behavior?

Serotonin.

What neurotransmitter controls alertness and allergic responses?

Histamine.

What neurotransmitter can be excitatory or inhibitory and signals muscles to be alert?

Acetylcholine.

What is the major excitatory neurotransmitter that can cause neurotoxicity when elevated?

Glutamate.

What is the primary inhibitory neurotransmitter in the brain?

GABA.

What medications increase GABA function?

Benzodiazepines.

What is the cerebrum responsible for?

Thinking, reasoning, memory, emotions, and voluntary movement.

What is the cerebellum responsible for?

Balance, posture, and coordination.

What is the brain stem responsible for?

Breathing, heart rate, blood pressure, and sleep.

What is the limbic system responsible for?

Emotions, memory, motivation, and behavior.

What imaging study uses x-rays to create slices of the brain?

Computed Tomography (CT).

What imaging study uses magnets to create detailed brain images?

Magnetic Resonance Imaging (MRI).

What imaging study shows brain metabolism and activity?

Positron Emission Tomography (PET).

What imaging study evaluates cerebral blood flow and activity?

Single Photon Emission Computed Tomography (SPECT).

What is psychoimmunology?

The study of how stress and the immune system influence mental illness.

What role do genetics play in mental illness?

They contribute to risk but are not the sole cause.

What are psychotropic drugs?

Medications that affect mood, behavior, and mental processes.

What is efficacy?

The maximum therapeutic effect of a drug.

What is potency?

The amount of drug needed to produce a desired effect.

What is half-life?

The time required for half of a drug to be eliminated from the body.

What is off-label drug use?

Using a medication for a condition not approved by the FDA.

What is the FDA responsible for?

Approving medications for safe use.

What is the goal of psychopharmacology?

To reduce or eliminate target symptoms of mental illness.

Why should psychotropic medications be tapered instead of stopped abruptly?

To prevent rebound symptoms, withdrawal, or recurrence of illness.

What are antipsychotic drugs primarily used to treat?

Psychotic disorders such as schizophrenia.

How do antipsychotic drugs work?

By blocking dopamine receptors.

What are first-generation antipsychotics?

Conventional antipsychotics such as haloperidol and fluphenazine.

What are second-generation antipsychotics?

Atypical antipsychotics such as clozapine, risperidone, and olanzapine.

What is a third-generation antipsychotic?

Aripiprazole.

What are depot injections?

Long-acting injectable antipsychotic medications.

What are extrapyramidal symptoms (EPS)?

Neurologic side effects caused by antipsychotic medications.

What is acute dystonia?

Sudden muscle spasms of the face, neck, or back.

What is torticollis?

A neck spasm causing the head to twist.

What is an oculogyric crisis?

Upward deviation of the eyes.

How is acute dystonia treated?

Anticholinergic medications or diphenhydramine.

What is pseudoparkinsonism?

Parkinson-like symptoms including shuffling gait and mask-like face.

What is akathisia?

Severe restlessness and inability to sit still.

What is neuroleptic malignant syndrome (NMS)?

A life-threatening reaction to antipsychotics characterized by fever, rigidity, and autonomic instability.

What is tardive dyskinesia?

Permanent involuntary movements caused by long-term antipsychotic use.

What are common anticholinergic side effects?

Dry mouth, constipation, urinary retention, and blurred vision.

Which antipsychotic is associated with agranulocytosis?

Clozapine.

What is agranulocytosis?

A severe decrease in white blood cells.

What is metabolic syndrome?

A cluster of conditions including obesity, hypertension, and insulin resistance.

What is the major use of antidepressants?

Treatment of depression and anxiety disorders.

What are SSRIs?

Selective Serotonin Reuptake Inhibitors.

Name common SSRI side effects.

Anxiety, insomnia, nausea, sexual dysfunction, and weight gain.

What are MAOIs?

Monoamine Oxidase Inhibitors.

What serious reaction can occur if MAOIs are combined with tyramine-containing foods?

Hypertensive crisis.

What foods are high in tyramine?

Aged cheese, wine, beer, and processed meats.

What is serotonin syndrome?

A potentially fatal condition caused by excess serotonin.

What causes serotonin syndrome?

Combining medications such as SSRIs and MAOIs.

What are symptoms of serotonin syndrome?

Agitation, fever, sweating, tachycardia, rigidity, and hyperreflexia.

What are mood stabilizers used to treat?

Bipolar disorder.

What is the most common mood stabilizer?

Lithium.

What is the therapeutic lithium level?

0.6-1.2 mEq/L.

What are signs of lithium toxicity?

Diarrhea, vomiting, drowsiness, muscle weakness, and loss of coordination.

What can untreated lithium toxicity lead to?

Coma and death.

What mood stabilizer may cause Stevens-Johnson syndrome?

Lamotrigine.

What mood stabilizer commonly causes weight gain and tremors?

Valproic acid.

What mood stabilizer commonly causes weight loss?

Topiramate.

What are benzodiazepines used to treat?

Anxiety, insomnia, alcohol withdrawal, and panic disorders.

How do benzodiazepines work?

By increasing GABA activity.

What are common benzodiazepine side effects?

Sedation, dependence, tolerance, and CNS depression.

What should clients taking benzodiazepines avoid?

Alcohol.

What is buspirone used for?

Anxiety disorders.

What are common buspirone side effects?

Dizziness, headache, nausea, and sedation.

What are stimulants used to treat?

ADHD and narcolepsy.

What are examples of stimulant medications?

Methylphenidate, amphetamine, and dextroamphetamine.

How do stimulants work?

Increase release and block reuptake of norepinephrine, dopamine, and serotonin.

What are common stimulant side effects?

Weight loss, irritability, nausea, and decreased appetite.

What teaching is important for stimulant medications?

Take after meals and avoid caffeine.

What is disulfiram used for?

Alcohol use disorder.

How does disulfiram work?

It causes an unpleasant reaction if alcohol is consumed.

What products containing alcohol should be avoided with disulfiram?

Mouthwash, cough syrup, shaving cream, and deodorant.

What cultural consideration exists for African Americans taking psychotropic medications?

They may respond more rapidly and have increased side effects.

What cultural consideration exists for Asian clients taking psychotropic medications?

They may metabolize medications more slowly and require lower doses.

What herbal medications commonly interact with psychotropic drugs?

St. John's Wort, Kava, Valerian, and Ginkgo Biloba.

What is the therapeutic relationship?

A professional relationship focused on the client's needs and goals.

What factors enhance the therapeutic relationship?

Trust, empathy, acceptance, positive regard, and genuine interest.

What is empathy?

Understanding and sharing another person's feelings without taking them on as your own.

What is sympathy?

Feeling pity or sorrow for someone.

What is self-awareness?

Understanding your own values, beliefs, feelings, and attitudes.

What are values?

Personal standards that guide behavior.

What are beliefs?

Ideas or convictions a person holds to be true.

What are attitudes?

Feelings and perspectives about people, situations, or the world.

Who developed the phases of the nurse-client relationship?

Hildegard Peplau.

What are the three phases of the nurse-client relationship?

Orientation, Working, and Termination.

What occurs during the orientation phase?

Establish trust, introduce roles, and identify problems.

What occurs during the working phase?

Problem-solving, behavior change, and goal achievement.

What occurs during the termination phase?

Evaluation of goals and ending the therapeutic relationship.

What factors diminish therapeutic relationships?

Poor boundaries, sympathy, abuse of power, and avoidance.

What are the nurse's therapeutic roles?

Teacher, caregiver, advocate, and parent surrogate.

What is communication?

The exchange of information through verbal and nonverbal messages.

What is therapeutic communication?

Communication focused on the client's needs and well-being.

What are the goals of therapeutic communication?

Build rapport, identify concerns, explore feelings, and promote problem solving.