Behavioral Health Exam 2: Neurobiologic Theories, Psychopharmacology, and Legal Issues

Flashcards covering neurobiologic theories, psychopharmacology, legal/ethical issues, aggression management, and trauma-related disorders as outlined in the Behavior Health Exam 2 Blueprint.

GABA

An inhibitory neurotransmitter that modulates other neurotransmitters; drugs like benzodiazepines increase it to treat anxiety and induce sleep.

Serotonin

An inhibitory neurotransmitter that controls food intake, sleep, temperature regulation, pain control, sexual behaviors, and emotional regulation; it is implicated in anxiety, mood disorders, and schizophrenia.

Dopamine

An excitatory neurotransmitter that controls complex movements, motivation, and cognition, and regulates emotional responses; it is implicated in schizophrenia and movement disorders like Parkinson's.

Antipsychotics

Medications used to treat symptoms of psychosis such as delusions and hallucinations in schizophrenia and the manic phase of bipolar disorder.

SSRIs

The first choice in treating depression, PTSD, and OCD; they typically take 4 weeks for effect and should not be taken with St. Johns Wort.

TCAs (Tricyclic Antidepressants)

Used for MDD, anxiety, and insomnia; they are cardiotoxic, lethal in overdose, and have anticholinergic effects, taking 4-6 weeks for full effect.

MAOIs (Monoamine Oxidase Inhibitors)

Used for atypical or treatment-resistant depression; patients must avoid foods with tyramine to prevent a hypertensive crisis.

Tyramine-containing foods

Foods to avoid with MAOIs including mature or aged cheese, meats, yogurt, sour cream, peanuts, brewers yeast, banana peel, and avocado.

Neuroleptic Malignant Syndrome (NMS)

A life-threatening reaction to antipsychotics characterized by muscle rigidity, high fever, autonomic instability (unstable BP, diaphoresis, pallor), and delirium.

Metabolic Syndrome

A cluster of conditions associated with atypical antipsychotics that increase the risk for heart disease and diabetes, including weight gain, hypertension, high blood sugar, and high cholesterol.

Aksthisia

A type of Extrapyramidal Symptom (EPS) characterized by internal restlessness.

Dystonia

Severe muscle spasms that often start with the eyes and progress down the body.

Tardive dyskinesia

An irreversible condition characterized by lip smacking, tongue rolling, pill rolling, truncal twisting, and pelvic rocking.

Pseudoparkinsonism

A side effect presenting with a mask-like face, shuffling gait, cogwheel rigidity (ratchet-like joint movements), tremor, and drooling.

Anticholinergic Crisis

A life-threatening toxicity characterized by hyperthermia, delirium, mydriasis, flushed skin, and hallucinations; treated with the antidote physostigmine.

Competence

The ability of a patient to understand information, make a decision, and communicate that decision.

Involuntary Admission (1013)

An admission that lasts $72$ hours without the patient signing; if extended, it moves to a 1014 ($5$ days) and then a 1021 (court date).

Duty to Warn

A legal obligation for mental health professionals to protect identifiable persons if a patient makes a credible threat against them.

Psychiatric Advance Directives

A legal document completed by a competent individual stating their preferences for future psychiatric treatment during a potential mental health crisis.

Seclusion and Restraint Protocol

Requires a 1:1 evaluation within $1$ hour, physician orders every $4$ hours, and nurse documentation every $1-2$ hours.

Triggering Phase

The stage of aggression where an environmental event initiates a response characterized by restlessness, pacing, and anxiety.

Escalation Phase

The stage of aggression where behaviors move toward a loss of control, involving yelling, swearing, and clenched fists.

Crisis Phase

The stage of aggression where the client loses control and may hit, kick, or throw objects; seclusion or restraints are used as a last resort.

Recovery Phase

The stage where the client regains physical and emotional control and is encouraged to talk about triggers.

Postcrisis Phase

The stage where the client attempts reconciliation and returns to prior functioning; often involves remorse or crying.

Cycle of Abuse

A repeating pattern in domestic violence consisting of the tension-building phase, the acute/explosion phase, and the honeymoon phase.

Shaken Baby Syndrome

A medical emergency involving whip-lash like head and neck injuries in infants, leading to retinal bleeding, bulging panels, and intracranial hemorrhage.

Factitious disorder (Munchausen’s Syndrome)

Injuries or illnesses in a child that are induced or fabricated by a caregiver to meet the caregiver's need for positive reinforcement.

Lethality Assessment

A series of questions to determine the risk of fatal violence, such as asking if the victim feels safe or if the perpetrator owns guns.

Safety Plan (Go Bag)

A prepared pack of essentials (ID, money, medication) and a strategy for safe shelter used by victims planning to leave an abusive environment.

PTSD (Posttraumatic Stress Disorder)

A pattern of behavior following a traumatic event involving reexperiencing the trauma, avoidance of reminders, negative cognitions, and hyperarousal.

Dissociative Fugue

A type of amnesia where the client suddenly moves to a new location, assumes a new identity, and has no memory of past events.

Secondary PTSD

A condition developed by individuals, such as nurses, who are indirectly exposed to trauma by caring for or witnessing the suffering of others.

Lithium

A first-line mood stabilizer for bipolar disorder with a therapeutic blood level of $0.5-1.5$; requires monitoring of salt intake.

Valproic acid

A mood stabilizer that increases GABA to treat bipolar disorder and seizures; requires blood level monitoring and pregnancy tests for female patients.

Buspirone

An anxiolytic used for generalized anxiety disorder that takes $2-6$ weeks for effect and carries no risk of sedation or dependence.

Beta-Blockers

Medications like Atenolol or Propranolol used for performance anxiety, which may cause side effects like bradycardia or hypotension.