NURS 6630 MIDTERM EXAM STUDY GUIDE
Non-compliant patients
Neurotransmitters- are chemical messengers that allow signals to cross synapses to
transmit information from a nerve cell or neuron to a target cell. Nerve
...
NURS 6630 MIDTERM EXAM STUDY GUIDE
Non-compliant patients
Neurotransmitters- are chemical messengers that allow signals to cross synapses to
transmit information from a nerve cell or neuron to a target cell. Nerve transmitters
coordinate behavor by stiulating an action or inhibiting an impulse. Example of
neurotransmitters: dopamine. Used by the brain to help regulate breathing,
heartbeat, and digestion. It can also affect concentration, sleep, and mood.
Neurons- have many sizes, lengths, and shapes that determine their function based
on where they are in the brain; and are the cells of chemical communication in the
brain. Human brains are comprised of tens of billions of neurons, and each is linked
to thousands of other neurons. Thus, the brain has trillions of specialized
connections known as synapses. * The anatomically addressed brain is thus a
complex wiring diagram, ferrying electrical impulses to wherever the “wire” is
plugged in (synapses). **When neurons malfunction behavioral symptoms may
occur. When drugs alter neuronal function, behavioral symptoms may be relieved,
worsened, or produced. Neurons are some of the longest-lived cells in your body;
neurons are irreplaceable, and neurons have huge appetites (glucose and appetites).
Neurons transit signals when stimulated by sensory input or triggered by
neighboring neurons.
Gene Expression
Cytochrome P450 Enzyme System
Pharmacokinetics- the way the body does to the drug.
Mechanisms of receptors including:
G-Protein linked receptors- (see notes)
nicotine cholinergic
Serotonin- present in the brain and digestive tract; inhibitory neurotransmitter has
been identified as an important factor in mood, depression, anxiety, sleep,
emotions, and regulation in appetite and temperature. Serotonin imbalances are
involved in depression, impulse behavior, sleep, and emotional disorders.
Dopamine- functions as both an inhibitory and excitatory neurotransmitter; critical
for memory and motor skills. (Behavior, learning, sleep, mood, focus, attention,
immune health, and pleasurable rewards). Ex: excessive amounts are linked to
schizophrenia- a long term psych disorder of a type involving a breakdown in the
relation between thought, emotion, and behavior; also linked to addictive or
impulsive behaviors.
Norepinephrine- widely distributed throughout the body, acts as a neuromodulatory
optimizing brain performance; as part of the bodies flight or fight
response, it quickly provides an accurate assessment of danger or stressful
situations. Obsessive amounts of this chemical, especially when no actual danger
exists can lead to anxious and hyperactive.
Epinephrine- widely known as adrenaline; is both a neurotransmitter and hormone
that is essential to metabolism, attention, focus, stress, fear, anger, panic, and
excitement. Abnormal levels of epinephrine are linked to sleep disorders, anxiety,
hypertension, and lowered immunity.
Acetylcholine- this widely distributed excitatory neurotransmitter was the 1st to be
identified, and triggers voluntary muscle contraction, controls heartbeat, and
stimulates hormones; enables muscle action, learning, and memory; research
NURS 6630 MIDTERM EXAM STUDY GUIDE
suggest that ACH may be critical for sleep, attentiveness, sexuality, and memory.
Ex: Alzheimer’s patients have a deterioration in their acetylcholine neurons.
GABA (y-aminobutyric acid)-as the major inhibitory neurotransmitter widely
distributed through the brain; GABA is considered a significant mood modulator.
When GABA levels are too low or GABA action is impaired, neurons can become
overexcited which can lead to restlessness, anxiety, or irritability.
Glutamate- the most common neurotransmitter in the central nervous system;
glutamate is an excitatory relative of GABA that is involved in most aspects of
brain functioning, including cognition, learning, memory, and is considered a major
mediator of the excitatory signals, regulating the brain development as well as the
elimination and formation of nerve synapses.
D2 receptors
glycine receptors
ionotropic receptors
Hormones- chemical messengers that are manufactured by the endocrine glands,
travel through the bloodstream, and affect other tissues. They are chemically
identical to some neurotransmitters (Control: attraction, appetite, and aggression)
While the nervous and endocrine system are similar that they produce chemicals
destined to hit up certain receptors; they operate at different speeds. (Ex: if nervous
system wants to get in touch with you- sends a text; endocrine system- send
through the mail).
*** 6 key neurotransmitter systems targeted by psychotropic drugs: serotonin, norepinephrine,
dopamine, acetylcholine, glutamate, and GABA.
Stahl’s Essential Psychopharmacology
Chapter 1 – Chemical Neurotransmission
Anatomical versus chemical basis of neurotransmission
What is neurotransmission? Neurotransmission can be described in many ways: anatomically, chemically,
and electrically. The anatomical basis of neurotransmission is neurons and the connections between them,
called synapses, sometimes also called the anatomically addressed nervous system, a complex of “hardwired”
synaptic connections between neurons, not unlike millions of telephone wires within thousands
upon thousands of cables. The anatomically addressed brain is thus a complex wiring diagram, ferrying
electrical impulses to wherever the “wire” is plugged in (i.e., at a synapse). Synapses can form on many
parts of a neuron, not just the dendrites as axodendritic synapses, but also on the soma as
axosomatic synapses, and even at the beginning and at the end of axons (axoaxonic synapses). However;
such synapses are said to be “asymmetric” since communication is structurally designed to be in one
direction.
Neurotransmitter is packaged in the presynaptic nerve terminal like ammunition in a
loaded gun, and then fired at the postsynaptic neuron to target its receptors.
General structure of a neuron: All neurons have a cell body known as the soma, which is
the command center of the nerve and contains the nucleus of the cell. All neurons are also
set up structurally to both send and receive information. Neurons send information via an
axon that forms presynaptic terminals as the axon passes by (en passant) or as the axon
ends. Neurons also receive information through dendrites (spines on dendrites, and often
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