NSG552 / NSG 552 EXAM 3 STUDY GUIDE Psychopharmacology - Wilkes 100% Guarantee Pass

NSG552 / NSG 552 EXAM 3
STUDY GUIDE
Psychopharmacology - Wilkes

100% Guarantee Pass

This PDF contains:
❖ NSG 552 EXAM 3 STUDY GUIDE

❖ Everything in Here to Pass the Exam III

❖ Anything Highlighted in Yellow on Exam

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● Classic Opioid withdrawal symptoms – wq wq wq wq




yawning, diarrhea, diaphoresis, rhinorrhea, dilated pupils.
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● Remember OTL (Outside the liver)- wq wq wq wq




Oxazepam, Temazepam, and Lorazepam are metabolized outside the liver henc wq wq wq wq w q wq wq wq wq




e making it safe for patients with any hepatic issues.
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● Disulfiram (Antabuse) is the best option for highly motivated patients’ d/t the a
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version reaction it causes. wq wq wq




● Remember that Wellbutrin (Zyban) is prescribed for smoking cessation. wq wq wq wq wq wq wq wq




● Dopamine is the most involved and reward pathways in the brain. wq wq wq wq wq wq wq wq wq wq




● Wernickeencephalopathyischaracterizedbyaclassictriadofsignsand symptom
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s:confusion,cerebellardysfunction(e.g.,ataxia),andoculomotor dysfunction. Themo
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st commonpresenting symptomof Wernicke encephalopathy is mental status ch
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ange, whereas the most common physical examfindingisgaitataxia.T hiamine is o
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ften given with/ improvement of symptoms.
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● The 16-year- wq




old patient is using marijuana for anxiety. The PMHNP should consider Fl
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uoxetine (Prozac) because it is first- wq wq wq wq wq




line for anxiety (SSRI) and approved for this age group –
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● ACIWAscore of >15 isindicativeofsevere withdrawalsymptoms.
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● Wernicke encephalopathy and Korsakoff syndrome are different conditions th
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at often occur together in patients with alcohol use disorder. Both are due to bra
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indamagecaused bya deficiencyof Vitamin B1
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● Naloxone is the drug of choice to reduce the risk of adverse reactions and f
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urther complications in cases of suspected opioid overdose.
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● Lorazepam, Chlordiazepoxide, and Acamprosate are all used in Alcohol use wq wq wq wq wq wq wq wq wq




w disorders. Methadone is used for Opioid use disorder.
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Substance Use Disorders (SUD) wq wq wq

,Each substance use disorder can be categorized into:
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1. Acute intoxication phase wq wq




2. Maintenance phase wq




3. Withdrawal phase wq




Reversible syndrome caused by a specific substance affecting memory, judgement, be
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havior or social or occupational functioning = Intoxication
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Substance specific symptoms that occur after stopping or reducing use = Withdrawal
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Positive rewards of reinforcement associated with SUD is mediated by this neurotransmitter
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= Ventral tegmental area (VTA) and the Nucleus accumbens (NAC) reward center
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● DA release w/in the reward center is enhanced = by the release of natural morphine
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-like neurotransmitters (Neuropeptides- enkephalins, beta-endorphins)
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● Repeated drug use = DA system becomes increasingly sensitized wq wq wq wq wq wq wq wq




NOTE: All addictive drugs increase DA in the nucleus accumbens
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DA, a neurotransmitter, plays crucial role in reward processing et motivation
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● From nucleus accumbens (NAC) + Amygdala to prefrontal cortex = involve
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d in learning “this feels good”
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● From Amygdala to VTA = memory “this felt good last time” wq wq wq wq wq wq wq wq wq wq




● Amygdala to NAC = emotional cues from internal or external triggers (e.g. see wq wq wq wq wq wq wq wq wq w q wq wq




ing a bag of heroin signals an impulsive action to use)
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VTA= reward region
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NA-Nucleus accumbens – connects the limbic system to the motor system
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Prefrontal cortex- executive functioning, impulse control
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, Drugs of abuse act in the brain Reward pathway either
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1. Enhance DA release wq wq




2. Enhance DA effects in the NA or related structures or produce effects similar to DA
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DOPAMINE = primary neurotransmitter involved in pleasure/reward
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● released in nucleus accumbens (NAc) = the release reinforces the behavior (
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more likely to repeat it) wq wq wq wq




Mesolimbic pathway: neural network in the brain plays crucial role in reward, motivation,
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and pleasure = VTA, NAc, and amygdala
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● DA cell bodies originate in the ventral tegmental area (VTA) in the midbrain
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● DA neurons project to the nucleus accumbens (NAc),
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● The amygdala (AMYG), and hippocampus in the ventral striatum, connects t
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o both the VTA and the Nac
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Classes of SUD
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● Stimulants = caffeine, nicotine, amphetamines, cocaine, ectasy wq wq wq wq wq wq




● Depressants = benzodiazepines, alcohol wq wq wq




● Narcotics = opioids wq wq




● Hallucinogens = lysergic acid diethylamide (LSD), marijuana wq wq wq wq wq wq