EPPP Physiology & Psychopharmacology
Terms
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- Types of neurotransmitters
-
ACh
Catecholamines
Serotonin
GABA
Glutamate
Endorphins - ACh: function
-
voluntary motor movements
memory
* LOW levels ACh in Alzheimer's - Catecholamines: function
-
personality
mood
drive
* catecholamine hypot
* dopamine hypot - Examples of catecholamines
-
norepinephrine
epinephrine
dopamine - Catecholamine hypothesis
-
Depression due to:
LOW levels norepinephrine - Dopamine hypothesis
-
Schizophrenia due to:
HIGH levels dopamine - Serotonin: function
-
hunger
temperature regulation
sexual activity
aggression
onset of sleep - Serotonin hypothesis
-
Schizophrenia & Autism associated with:
HIGH levels serotonin
Depression, PTSD, OCD associated with:
LOW levels serotonin - GABA: function
-
sleep
eating
seizure
anxiety disorder
* LOW levels GABA in Huntington's Disease - Glutamate: function
-
learning
long-term memory
HIGH glutamate in Huntington's & Alzheimer's -
Medulla: function
[brainstem; hindbrain] -
vital ANS functions:
circulation
respiration -
Medulla: damage
[brainstem; hindbrain] - fatal
-
Pons: function
[brainstem; hindbrain] -
transmits motor info from higher brain & spinal cord to cerebellum
integrates movements in R & L sides of body
respiration
feeding
sleep -
Cerebellum: function
[brainstem; hindbrain] -
balance
posture
coordinated & refined motor movements -
Cerebellum: damage
[brainstem; hindbrain] -
"ataxia"
lack of balance
severe tremors
drunken-like movements -
Reticular Activating System (RAS): function
[midbrain] -
screens incoming info & relays to higher centers of brain
arousal -
Reticular Activating System (RAS): damage
[midbrain] -
disrupts normal sleep-wakefulness cyle
possible permanent coma-like sleep -
Thalamus: function
[diencephalon; forebrain] - "relay station" for all sensory input (EXCEPT olfaction)
-
Thalamus: damage
[diencephalon; forebrain] -
Wernicke-Korsakoff syndrome
- caused by thiamine deficiney as a result of alcoholism - Wernicke-Korsakoff syndrome
-
caused by thiamine deficiney as a result of alcoholism
severe anterograde amnesia
retrograde amnesia
confabulation -
Hypothalamus: function
[diencephalon; forebrain] -
maintains body's internal HOMEOSTASIS
controls ANS & endocrine glands
mediates basic drives
regulates emotional expression -
Amygdala: function
[limbic sys; telencephalon; forebrain] -
controls emotional activities
mediates defensive-aggressive bheaviours
attaches emotions to memories -
Amygdala: damage
[limbic sys; telencephalon; forebrain] -
reduced aggressiveness
Kluver-Bucy Syndrome
- compulsive oral behaviours
- hypersexuality
- visual agnosia - Kluver-Bucy Syndrome
-
damage to amygdala
compulsive oral behaviours
hypersexuality
visual agnosia -
Hippocampus: function
[limbic sys; telencephalon; forebrain] - consolidation of memory
-
Hippocampus: damage
[limbic sys; telencephalon; forebrain] - inability to form new memories
-
Frontal lobe: function
[cerebral cortex] -
emotion & personality
planning
decision making - Cerebral cortex makes _____ % of the brain's total weight
- 80%
-
Frontal lobe: damage
[cerbral cortex] -
changes in personality
loss of a sense of "self"
inability to carry out plans -
Parietal lobe: function
[cerbral cortex] -
somatosensory cortex
pain
pressure
heat
cold -
Parietal lobe: damage
[cerbral cortex] -
impairments in:
spatial orientation
touch
facial recognition
* can cause Gerstmann syndrome -
Temporal: function
[cerbral cortex] - auditory perception
-
Occipital: function
[cerbral cortex] - visual perception
- limbic system is primary associated with ___________
- emotion
- 4 lobes of cerebral cortex
-
frontal
parietal
temporal
occipital -
Basal Ganglia: function
[telencephalon; forebrain] -
planning
organizing
voluntary movement
regulating motor actions -
Basal Ganglia: associated disorders
[telencephalon; forebrain] -
Parkinson's
Tourette's
Mania
Depression
OCD
Psychosis - hemispheric specialization
-
LEFT (dominant)
verbal activities
analytical, logical thought
positive emotional states
RIGHT
visual-spatial activities
e.g. facial recognition
spatial interpretation
memory for shapes
negative emotions - corpus callosum
- major pathway for info travelling between hemispheres
- 2 branches of nervous system
-
central nervous system
peripheral nervous system - structures of CNS
-
brain
spinal cord - Autonomic Nervous System: function
-
controls internal glands/organs, including:
heart
bladder
stomach
endocrine glands -
sympathetic nervous system: function
[autonomic nervous sys; peripheral nervous sys] -
active during stress & excitement
promotes energy expenditure by:
inc blood sugar
accelerating breathing
raising blood pressure & heart rate -
parasympathetic nervouse system: function
[autonomic nervous sys; peripheral nervous sys] -
operates during states of relaxation
helps body conserve energy by:
slowing heart rate & blood flow
inhibiting glucose release
constricting blood vessels - suprachiasmatic nucleus (SCN): location & function
-
hypothalamus
mediates sleep-wake cycle
mediates circadian rhythms
*involved in Seasonal Affective Disorder -
Broca's area: location & function
[premotor cortex; frontal lobe; cerebral cortex] -
premotor cortex
speech production -
Broca's area: damage
[premotor cortex; frontal lobe; cerebral cortex] -
Broca's (expressive) aphasia
- difficulties in producing spoken & written language -
Prefrontal cortex: function
[frontal lobe; cerebral cortex] -
complex behaviours
emotion
semory
self-awareness
executive functions -
Prefrontal cortex: damage
[frontal lobe; cerebral cortex] -
pseudodepression
pseudopsychopathy
probs w/ abstract thinking, planning, decision-making
perseveration - apraxia
- inability to perform skilled motor movements in absence of impaired motor functioning
- anosognosia
- inability to recognize one's own neurological sx or other disorder
-
Wernicke's area: location & function
[temporal lobe; cerebral cortex] -
dominant temporal lobe
comprehension of language - visual agnosia
- inability to recognize familiar objects
- simultanagnosis
- inability to see more than one thing or one aspect of an object at a time
- prosopagnosia
- inability to recognize familiar faces
- contralateral representation
- L side of brain controls R side of body, and vice versa
- "split-brain" patients
-
sever corpus callosum to control severe epilepsy
deficits in ability to verbally identify info presented to RIGHT hemisphere only. - types of colour blindness
-
Trichromats
normal colour vision
Dichromats
lack 1 of 3 pigments
usually red-green blind
Monochromats
no colour vision - 3 theories of emotion
-
James-Lange theory
Cannon-Bard theory
two-factor (cognitive) theory - James-Lange theory of emotion
-
emotions represent perceptions of bodily reactions
e.g. you are afraid because your knees are skaking
support from quadriplegics experiencing less intense emotions following injury - Cannon-Bard theory of emotion
- emotional & bodily reactions to stimuli occur simultaneously
- Two-factor (cognitive) theory of emotion
-
emotion a consequence of:
1. physiological arousal
2. cognitive interpretation
3. enviornmental context
support from Schachter & Singer's epinephrine study - general adaptation syndrome (Selye)
-
human response to stress mediated by adrenal-pituitary secretions & involves 3 stages
alarm reaction
resistance (ACTH/cortisol)
exhaustion - gonadotropic hormones
-
estrogen (ovaries)
progesterone (ovaries)
testosterone (testes)
androstenedion (testes) - androgens
-
testosterone
androstenedione - closed-head injury
-
loss of consciousness (coma)
post-traumatic (anterograde) amnesia
sometimes retrograde amnesia
cognitive probs if PTA > 24 hrs - hyperthyroidism vs. hypothyroidism
-
HYPER (Grave's Disease)
fast metabolism
high body temp
inc appetite w/ weight loss
nervousness
HYPO
slow metabolism
dec appetite w/ weight gain
lethargy
depression
apathy - Broca's Aphasia
-
"expressive, motor, and nonfluent aphasia"
slow speech w/ difficulty
poor articulation
omissions
anomia
probs repeating phrases
comprehension of language OK
aware of deficits
frustration & depression - Wernicke's Aphasia
-
"receptive, sensory, and fluent aphasia"
probs understanding
speech devoid of content
anomia
paraphasia
unaware that speech is meaningless - Conduction (Associative) Aphasia
-
damage to structure that connects Wernicke's & Broca's areas
anomia
inability to repeat words
know what they want to say, but have difficulty - Global Aphasia
-
total or near-total loss of language
some automatic speech - Transcortical Aphasia
-
lesion that isolates Broca's leads to:
transcortical MOTOR aphasia
lesion that isolates Wernicke's leads to:
transcortical SENSORY aphasia - 2 types of antipsychotic drugs
-
1. Traditional (conventional)
2. Atypical (novel) - Ex: traditional antipsychotics
-
phenothiazine
thioxanthene
butyrophenone - Use: traditional antipsychotics
-
+ve sx of schizophrenia
acute mania
NOT -ve sx of schizophrenia - Action: traditional antipsychotics
- blocks dopamine (D2) receptors, therefore dec dopamine
- Side effects: traditional antipsychotics
-
1. tardive dyskinesia (esp w/ Haloperidol)
- can add benzo or other GABA agonist to treat
2. neuroleptic malignant syndrome (NMS)
rapid autonomic sx
potentially fatal
stop meds immediately - Ex: Atypical antipsychotics
-
clozapine
resperidone
olanzapine
quetiapine - Use: Atypical antipsychotics
-
schizophrenia
bipolar
alc & drugs
huntington's
parkinson's
note: helpful for +ve & -ve sx of schizophrenia, but SLOWER ONSET - Mode: Atypical antipsychotics
- block D2, serotonin & glutamate
- side effects: Atypical antipsychotics
-
1. NMS
2. agranulocytosis (blood disorder)
NOT tardive dyskinesia - advantage of atypical vs traditional neuroleptics?
-
no tartive dyskinesia
helps +ve & -ve sx schiz - advantage of traditional vs atypical neuroleptics?
-
faster acting
no close blood monitoring - Ex: anticholinergic side effects
-
dry mouth
blurred vision
tachycardia
constipation
urinary retention
sedation - Ex: extrapyramidal side effects
-
tardive dyskinesia
akathisia
muscle spasms
parkinsonsim - Types of antidepressants
-
TCSs
SSRIs
MAOIs
Newer antidepressants - Ex: TCAs
-
amitriptyline
doxepin
imipramine
clomipramine - Mode: TCAs
-
block reuptake of norepinephrine, serotonin and/or dopamine, therfore increasing these
supporting catecholomine hypothesis - Side effects: TCAs
-
cardiovascular sx
anticholinergic effects - when not to prescribe a TCA
-
high risk for suicide
heart disease - Ex: SSRIs
-
fluoxetine (prozac)
fluvoxamine (luvox)
paroxetine (paxil)
sertraline (zoloft)
citalpram (celexa) - Mode: SSRIs
- blocks reuptake of serotonin, therefore increases it
- Use: SSRIs
-
melancholic depression
etc. - Use: TCAs
- vegetative & somatic depression
- advantages of SSRIs over TCAs
-
less cardiotoxic
safer in overdose
less cognitive impairment
more rapid onset - Ex: MAOIs
-
isocarboxazid
phenelzine
tranylcypromine - Use: MAOIs
-
atypical depression
- anxiety, hypersomnia - Mode: MAOIs
- inhibits enzyme monoamine oxidase, therefore deactivates dopamine, norepinephrine & serotonin
- Side effects: MAOIs
- hypertensive crisis - when taken w/ barbiturates, amphetamines, antihistamines or food w/ TYRAMINE
- Ex: newer antidepressants
-
bupropion (wellbutrin)
venlafaxine (effexor)
nefazodone (serxone)
trazodone (desyrel) - Types of mood stabilizing drugs
-
Lithium
Carbamazepine - Side effects: Lithium
-
toxicity
- serum levels monitored
Must avoid fluctuations in salt intake, caffeine, alcohol - when would you use Carbamazepine instead of Lithium in tx of bipolar disorder
-
rapid cyclers
dysphoric mood
kidney, liver, thyroid or gastrointestinal probs - Types of sedative-hypnotics
-
barbiturates
benzodiazepines
Azapirone - Ex: barbiturates
- ... barbital !!
- Mode: barbiturates
- interrupt impulses to RAS
- Ex: benzos
-
... lam
... pam - Mode: benzos
- inhibits GABA
- advantages & disadvantages of Azapirone
-
non-addictive
no sedation
take for several weeks - Use: Beta blockers
-
high BP
angine
migraines
glaucoma - Types: psychostimulants
-
amphetamines
methylphenidate (ritalin) - Use: psychostimulants
-
narcolepsy
ADHD - Mode: psychostimulants
- inc norepinephrine & serotonin
- Side effects: amphetamines
-
tolerance
dependence
sensitization - side effects: Methylphenidate
-
dysphoria
growth suppression (therefore need drug holidays)
contraindicated for family hx tourette's - Ex: narcotic-analygesics (opioids)
-
NATURAL OPIODS
opium
morphine
codeine
SEMI-SYNTHETIC DERIVATIVES OF MORPHINE
heroin
percodan
dilaudid
PURE SYNTHETICS
demerol
darvon
methadone