NCM117-PSYC NOTES
MENTAL HEALTH- state of emotional,psychological and Neurobiologic Theories and
social wellness Psychopharmacology
MENTAL HEALTH IN PSYCHIATRIC NURSING Psychopharmacology- use medications to treat mental
-concerned w/ the promotion of mental health, prevention of illness
mental disorders and the nursing care of patients during
mental illness and rehabilitation Brain consists: cerebrum, cerebellum, brain stem, limbic
system
Mental Illness- A disturbance in person’s thoughts,
feelings and behavior. 2hemispheres: left/right hemisphere
CAUSES: 1. Left hemisphere- controls the right side of the body
1. GENETIC/HEREDITY- indicate several mental -center for logical reasoning and analytic functions:
disorder that may linked to specific gene. rading, writtin, and mathematical tasks
2. STRESS AND IMMUNE SYSTEM 2. Right hemisphere- controls the left side of the body
(PSYCHOIMMUNOLOGY)-examines the effect of -center for crative thinking, intuition,and artistics
psychosocial stressors on the body’s immune system abilities
3. INFECTION-VIRAL
Cerebral hemisphere are divided in four lobes:
MULTI-AXIAL CLASSIFICATION SYSTEM 1. Frontal lobes
-control the organization of thought, body
1. AXIS 1- identifying all major psychiatric disorder
movement , memories, emotion and moral bhavior.
except mental retardation
Abnormalities: schizophrenia, ADHD, dementia
2. AXIS II- reports mental retardation and personality
2. Parital lobe
disorder
3. AXIS III- reports current medical conditions that are -interpret sensations of taste and touch and assist in
potentially relevant spatial orientation.
4. AXIS IV- reports psychosocial and environmental 3. Temporal Lobe
problems -center for the senses of smell and hearing and for memory
HISTORY OF MENTAL ILLNESS and emotional expression
Ancient Times: mental disorders were viewed being 4. Occipital Lobe
DEMONIC- ostracized, punished, sometimes burned -assist in coordinating language in generation and visual
Common to people with bipolar disorders interpretation such as depth perception.
DIVINE- were worshipped /adored
Cerebellum-center for coordinatiom of movements and
Aristotle (382-322BC)- relates mental disorders to physical postural adjustments
disorders developed his theory that the amount of blood, -inhibited the transmission of dopamine
water, yellow and black bile in the body controlled emotions -lack of smooth coordinated movements in disease such as
PARKINSONS DISEASE and Dementia
Early Christians (1-1000AD) – primitive beliefs and
superstitious were strong BRAIN STEM
Medulla- vital centers for respiration and cardiovascular
Renaissance (1300-1600)- people w/ mental illness were functions.
distinguish from criminals in England. Dangerous lunatics
were thrown in prison chain and staved. Drugs:
1970’s- period of enlightment concerning person’s with
NEUROTRANSMITTERS- are the chemical substance
mental illness began
manufactured in the neuron that aid in the transmission of
information throughout the body.
Sigmund Freud (1856-1939)- period of scientific study and
tx. Of mental disorders began MOA: excitatory (excite or stimulate an action), inhibitory (
-He studied the mind its order and their treatment inhibit or stop an action)
Emil Kraepelin (1856-1926)- began classifying mental Monoamine oxidase(MAO)- use reuptake p metabolized
disorders according to their symptoms and inactivated by enzymes
NCM117-PSYC NOTES
Drugs: MAJOR IN NEUROTRANSMITTERS Antipsychotic Drugs
1. Dopamine Conventional or first generation antipsychotics
-control of complex movements, motivation, cognition, and Phenothiazine
regulation of wmotional responses. Chlorpromazine
MOA: excitatory Perphenazine PHECHLOPERFLUMESTRI
Implication: Schizophrenia and other psychoses movement Fluphenazine
disorders such as Parkinsons Disease Mesoridazine
2. Norepinephrine(noradrenaline) Triflouperazine
-changes in attention, learning and memory, sleep and
wakefulness,mood Atypical or second-generation antipsychotics
MOA: excitatory Paliperidone
Epinephrine(adrenaline) Iloperidone
-controls fight or flight responses Asenaprine
MOA: excitatory Lurasidone
3. Serotonin Clozapine
-controls food intake,sleep and wakefulness,temperature Olanzapine
regulation, pain control,sexual behavior, regulation of emotion
MOA: inhibitory Third-generation antipsychotics
[Link] Ariprazole
-controls alertness, gastric secretions, cardiac stimulation, Cariprazine
Peripheral allergic responses Brexpiprazole
MOA: neuromodulator
[Link] Side Effects:
- controls sleep and wakefulness cycle; signals muscle to Extrapyramidal symptoms (EPSs)
become alert -serious neurologic symptoms
-neurotransmitter found in neuromuscular joint Major side effects:
MOA: excitatory or inhibitory Acute dystonia, pseudoparkinsonism, and akathisia
6. Neuropeptides Ziprasidone- rarely causing EPSs
-enhance prolong inhibit or limit the effects of principal
neurotransmitters ANTIDOTE OF EPSs:
MOA: neuromodulators P- arlodel
7. Glutamate A- tropine Acute dystonia- muscle
-results in neurotoxicity if levels are too high D- opamine rigidity,laryngospasms and respiratory
MOA: excitatory A- kinetone difficulties
8. GABA D- epakene Pseudoparkinsonism- stiff stooped
-modulates other neurotransmitters A- mantidine posture,maslike facies,decreased arm
MOA: inhibitory B- enadryl swing, shuffling, festinating
gait,cogwheel rigidity,drooling tremor,
DIAGNOSTIC TEST bradycardia,pill-rooling mvt. of thumb
and fingers while at rest.
[Link] tomography (CT)- visualize soft tissues Akathisia- an intense need to move
(20-40 minutes) about. Restless or anxious and agitated,
[Link] resonance imaging (MRI)- measure the size and rigid posture or gaitand lack of
thickness of brain structures (about 45 minutes) spontaneous gestures.
[Link] emission tomography (PET)- radioactive substance
are injected into the blood Neureleptic malignant syndrome (NMS):
-clearer (about 2 to 3 hrs) -potentially fatal idiosyncratic reaction
[Link]-photon emission computed tomography (SPECT)- same Major symptoms: rigidity,high fever,unstable
as PET (1 -2hrs) bp,diaphoresis,pallor,delirium,elevated levels of enzymes
Tardive Dyskinesia(TD):
Antipsychotic drugs- known as neuroleptics. Involuntary movements
-used to traeat the symptoms of psychosis, such as the
delusions and hallucinations seen in schizophrenia,
schizoaffective disorder.
NCM117-PSYC NOTES
Antidepressant drugs- tx in major depressive illness; bipolar Countertrasference= when a nurse develops feelings toward
disorder and psychotic depression a client that are based on the nurse’s past experience
MAOIs caution: e avoid ang mga pagkaon nga nag contain og Psychiatric rehabilation focused on clients strength
tyramine kay maka cause of hypertensive crisis.
Note:
Cyclic compounds-4 to 6 wks to be effective
MAOIs- 2 to 4 weeks for effectiveness
SSRIs- 2 to 3 weeks of effective
Drugs:
MAOIs- most hazardous Trycyclic Antidepressants
Parnate Tofranil
Marplan Nortriptyline
Nardil Elavil
Sinequan
SSRIs- safest
Prozac
Zoloft
Paxil
Foods containing tyramine to avoid when taking MAOIs:
=Mature or aged cheeses
=Aged meat
=All tap beers and microbrewery beers
=Soy sauce or soy beans
=Yogurt or sour cream, peanuts
Serotonin syndrome or serotonergic syndrome= results from
taking MAOIs and SSRIs at the same time.
MOOD -STABILIZING DRUGS= used to treat bipolar disorder by
stabilizing the client mood,preventing or minimizing the highs
and lows that characterize bipolar illnessand treating acute
episodes of mania.
Carbamazepine-c ause rashes and orthostatic hypotention
Valproic acid- cause weight gain,alopecia and hand tremor
Topiramate- causes weight loss
Anxiolytic drugs= used to treat anxiety disorder, insomnia,
obsessive –compulsive dis.
Antianxiety(Anxiolytic )drugs
Benzodiazepines
Alprazolam
Clonazepam
Diazepam
Lorazepam
Flurazepam
Nonbenzodiazepine
Buspirone (Buspar)
