Pharmacology and Developmental Adaptations from Infancy to Old Age

Biofeedback

  • Definition: A technique that involves training individuals to improve their health by controlling certain bodily processes that normally happen involuntarily, such as heart rate, blood pressure, and muscle tension.

  • Applications: Widely used in stress management, pain relief, and various psychological disorders.

Brain Stimulation Treatment

  • Overview: Refers to therapies that involve stimulation of the brain using various methods.

  • Types: Include transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS).

Pharmacology for Mental Health Disorders

Pharmacologic Agents Used for Mental Disorders

  1. Selective Serotonin Reuptake Inhibitors (SSRIs)

    • Function: Primarily increase levels of serotonin in the brain.

    • Examples: Fluoxetine, Sertraline, and Escitalopram.

  2. Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

    • Function: Affect both serotonin and norepinephrine levels.

    • Examples: Venlafaxine and Duloxetine.

  3. Novel Serotonergic Drugs

    • Mechanism: These drugs may target new receptors or pathways in the serotonergic system.

  4. Mood Stabilizers

    • Function: Used to treat mood disorders, particularly bipolar disorder.

    • Examples: Lithium and certain anticonvulsants (e.g., Lamotrigine).

  5. Antipsychotics

    • Types: Include atypical and typical antipsychotics.

    • Function: Primarily used to manage symptoms of psychosis, such as delusions and hallucinations.

  6. Antidepressant-Psychotic Combinations

    • Usage: For patients exhibiting both mood and psychotic symptoms.

  7. Benzodiazepines

    • Function: Used for anxiety relief, muscle relaxation, and sedation.

    • Mechanism: Enhance the effect of the neurotransmitter GABA.

    • Examples: Diazepam, Lorazepam.

  8. Stimulants

    • Usage: Primarily for Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy.

    • Examples: Amphetamines and Methylphenidate.

  9. Hypnotics

    • Function: Induce sleep and manage insomnia.

    • Examples: Zolpidem and Eszopiclone.

  10. Tranquilizers

    • Definition: A general category for medications that reduce tension or anxiety.

Developmental Stages: Infancy to Old Age

Neonatal Period

Apgar Scoring

  • Purpose: Assess the health of newborns immediately after birth.

  • Components: Five signs scored at 1 and 5 minutes after birth.

    1. Activity (muscle tone)

      • Score: 0 (limp), 1 (flexed limbs), 2 (active movement).

    2. Pulse

      • Score: 0 (no pulse), 1 (below 100 beats/min), 2 (above 100 beats/min).

    3. Grimace (responsiveness)

      • Score: 0 (no response), 1 (grimace), 2 (pulls away).

    4. Appearance (skin color)

      • Score: 0 (blue-gray), 1 (pink with blue extremities), 2 (pink all over).

    5. Respiration

      • Score: 0 (no breathing), 1 (weak cry), 2 (strong cry).

Neonatal Adaptations

  • Congenital Cardiovascular Defects

    • Patent Ductus Arteriosus (PDA): A condition where the ductus arteriosus fails to close after birth.

    • Septal Defects: Include:

    1. Atrial Septal Defect (ASD)

    2. Ventricular Septal Defect (VSD)

    • Cyanosis: A bluish color of the skin due to poor oxygenation.

    • Tetralogy of Fallot (TOF): A combination of four heart defects.

Neonatal Adaptations - Respiratory System

  • Respiratory Distress Syndrome (RDS): Caused by insufficient surfactant in the lungs.

  • Hyaline Membrane Disease (HMD): Related to RDS, often in premature infants.

  • Additional conditions:

    • Meconium Aspiration Syndrome (MAS): Occurs when meconium is inhaled into the lungs at birth.

    • Transient Tachypnea of Newborn (TTN): Rapid breathing in newborns shortly after birth.

    • Sudden Infant Death Syndrome (SIDS): An unexplained death of a seemingly healthy baby.

Thermoregulation Adaptations

  • Definition: The process by which infants maintain their body temperature.

  • Issues: Hypothermia is a primary concern in newborns.

Brain & Neurologic Adaptations

  • Common reflexes: Kicking, grasping, rooting, and crying.

Congenital Neurologic Abnormalities

  1. Anencephaly: A severe neural tube defect resulting in incomplete development of the brain and skull.

  2. Microcephaly: Smaller than normal head size associated with abnormal brain development.

  3. Encephalocele: A type of neural tube defect where the brain protrudes through the skull.

  4. Hydrocephalus: A condition characterized by an accumulation of cerebrospinal fluid (CSF) in the brain.

  5. Spina Bifida: A condition where the spinal cord does not properly form:

    1. Spina Bifida Occulta: A mild form that may not cause any symptoms.

    2. Spina Bifida Cystica: More severe and often involves a sac of fluid protruding from the spine.

Neonatal Seizures

  • Types: Classified as either primary (due to intrinsic brain abnormalities) or secondary (due to external factors such as infections or trauma).

Skeletal Adaptations & Craniofacial Malformations

  • Craniofacial Malformations:

    1. Cleft Lip: A congenital split in the upper lip.

    2. Cleft Palate: A condition where the roof of the mouth does not fully form.

  • Developmental Dysplasia of the Hip: A condition where the hip joint doesn’t properly form in infants.

Growth Adaptations

  • Causes for concerns: Inadequate nutrition, Premature labor, and Failure to Thrive (FTT).

Congenital Urinary Tract Disorders

  1. Renal Agenesis: Lack of kidney development.

  2. Hydronephrosis: Swelling of the kidney due to urine buildup.

  3. Polycystic Kidney Disease: A genetic disorder characterized by the growth of numerous cysts in the kidneys.

  4. Hypospadias: A condition where the urinary opening is on the underside of the penis.

Neonatal Adaptations - Digestive System

  • Esophageal Atresia: The esophagus does not develop properly and is blocked.

  • Colic: Excessive crying due to immature digestive systems.

  • Food Intolerance: For example, lactase deficiency leads to inability to digest lactose.

Hematologic Adaptations

  • Jaundice: A condition caused by an excess of bilirubin in the blood.

Immunologic Adaptations

  • Importance of immunization in early childhood and the implications of food allergies.

Hearing and Visual Adaptations

  • Importance of early detection of congenital malformations affecting these senses.

Developmental Disorders of Childhood and Adolescence

Disorders in Early Childhood

  1. Enuresis: Involuntary urination, commonly known as bedwetting.

  2. Encopresis: Involuntary defecation, often occurring in children.

  3. Eating Disorders:

    • Pica: Eating non-food items.

    • Rumination Disorder: Regurgitation of food, which may be re-chewed and swallowed or spit out.

    • Feeding Disorder of Infancy: Babies may refuse to eat or have feeding difficulties.

Eating Disorders in Adolescence

  1. Anorexia Nervosa: A serious mental health condition characterized by an obsessive fear of gaining weight and a distorted body image.

  2. Bulimia Nervosa: Cycles of binge eating followed by purging behaviors to prevent weight gain.

  3. Binge-Eating Disorder: Regularly eating large amounts of food with a sense of loss of control.

Developmental Disorders

  1. Attention Deficit/Hyperactivity Disorder (ADHD):

    • Core Symptoms: Inattention, Hyperactivity and Impulsiveness.

  2. Learning Disabilities: Variabilities in acquiring academic skills affecting learning.

  3. Oppositional Defiant Disorder (ODD): A pattern of angry mood, argumentative behavior, and vindictiveness.

  4. Conduct Disorder: A more severe form of behavioral issues characterized by aggression and violation of rules.

  5. Obsessive-Compulsive Disorder (OCD): Involves unwanted recurring thoughts (obsessions) and/or repetitive behaviors (compulsions).

  6. Autism Spectrum Disorder (ASD):

    • Includes: Autism, Asperger's Syndrome, and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS).

Aging, Senescence, and Death

Concepts of Aging

  • Life Expectancy: The average period that a person may expect to live.

  • Life Span: The maximum age reached by an individual.

  • Longevity: Living beyond typical life expectancy.

  • Senescence: The gradual deterioration of functional characteristics in organisms with age.

Senescence of Organ Systems

  • Systems affected include:

    • Integumentary System

    • Sensory Systems

    • Skeletal System

    • Muscular System

    • Nervous System

    • Cardiovascular System

    • Respiratory System

    • Urinary System

    • Immune System

Definitions Related to Aging

  • Geriatrics: A medical specialty focused on health care of elderly people.

  • Hospice: Provides care for the terminally ill, focusing on comfort and quality of life.

  • Palliative Care: Specialized medical care that focuses on providing relief from symptoms and stress from serious illness.

Brain Death and States of Consciousness

  1. Persistent Vegetative State (PVS): Loss of all cognitive functions but retention of non-cognitive function.

  2. Minimally Conscious State (MCS): Severely altered consciousness but with minimal but definite evidence of self or environmental awareness.

Autopsy

  • Definition: Examination of a deceased person's body and organs to determine cause of death.