Neurobiologic Theories and Psychopharmacology
Neurobiologic Theories and Psychopharmacology
Neurobiologic Theories and Psychopharmacology
Neurotransmitters
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Norepinephrine, the most prevalent neurotransmitter, is located primarily
in the brain stem. It plays a role in mood regulation.
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Epinephrine is also known as noradrenaline and adrenaline. Epinephrine
has limited distribution in the brain but controls the fight-or-flight response in the
peripheral nervous system.
Serotonin
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A neurotransmitter found only in the brain, is derived from tryptophan, a
dietary amino acid.
o
The function of serotonin is mostly inhibitory, involved in the control of
food intake, sleep and wakefulness, temperature regulation, pain control, sexual
behavior, and regulation of emotions.
o
Some antidepressants block serotonin reuptake, thus leaving it available
longer in the synapse, which results in improved mood.
Histamine
Acetylcholine
o
Acetylcholine is a neurotransmitter found in the brain, spinal cord, and
peripheral nervous system. It can be excitatory or inhibitory. It is synthesized
from dietary choline found in red meat and vegetables and has been found to
affect the sleep-wake cycle and to signal muscles to become active.
o
Studies have shown that people with Alzheimers disease have decreased
acetylcholine secreting neurons.
Glutamate
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Glutamate is an excitatory amino acid that at high levels can have major
neurotoxic effects.
o
GABA is a major inhibitory neurotransmitter in the brain and has been
found to modulate other neurotransmitter systems rather than to provide a
direct stimulus.
o
Drugs that increase GABA function such as benzodiazepines are used to
treat anxiety and to induce sleep.
Current theories and studies indicate that several mental disorders may be
linked to a specific gene or combination of genes but that the source is not solely
genetic; nongenetic factors also play important roles.
Some researchers are focusing on infection as a cause of mental illness.
Studies such as this are promising in discovering a link between infection and
mental illness.
The nurse must ensure that clients and families are well informed about
progess in these areas and must also help them to distinguish between facts and
hypotheses. The nurse can explain if or how new research may affect a clients
treatment or prognosis. The nurse is a good resource for providing information
and answering questions.
Psychopharmacology
Efficacy refers to the maximal therapeutic effect that a drug can achieve.
Half Life is the time it takes for half of the drug to be removed from the
bloodstream. Drugs with shorter half-life may need to be given three or four
times a day, but drugs with a longer half-life may be given once a day.
The FDA may issue a black-box warning when a drug is found to have
serious or life-threatening side effects. This means that package inserts must
have a highlighted box, separate from the text, which contains a warning about
the serious side-effects.