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Exam 4 Nurse 660
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Exam of 16 pages for the course 4 Nurse 660 at 4 Nurse 660 (Exam 4 Nurse 660)
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3EXAM 4 NURSE 660 QUESTIONS WITH
COMPLETE SOLUTION
adverse 3effects 3of 3desipramine 3(norpramin) 3- 3increased 3BP 3and 3HR, 3orthostatic 3hypotension,
3prolonged 3QT 3interval The core symptoms of ADHD are linked to what area of the brain? - prefrontal
cortex
Selective attention is due to what area of the PFC malfunctioning? - dorsal ACC (anterior cingulate
cortex)
sustained attention and problem solving linked to what area of the brain? - DLPFC
hyperactivity is linked to what area of the brain? - prefrontal motor cortex
what test assessing sustained attention? - N-back test
where is sustained attention modulated in brain? - CSTC loop in the DLPFC
insufficient activation in the DLPFC can cause inattention
"sustaiNed attention- N back"
what test assesses selective attention? - Stroop test
"Selective, Stroop, Cingulate"
where in the brain is selective attention modulated? - the CSTC loop, Dorsal anterior cingulate cortex
issues with sustained attention are: - difficulty completing tasks
disorganization
trouble sustaining mental effort
issues with selective attention are: - difficulty with detail
carless mistakes
not listening
losing things
,being distracted
forgetting things
what part of the brain modulates impulsitivity? - orbitofrontal cortex
what symptoms of impulsitivity are observed? - talking excessively
blurting things out
not waiting ones turn
interrupting
what part of the brain modulates hyperactivity? - prefrontal cortex
what are some key observations in the prefrontal cortex as it relates to ADHD? - orbitofrontal cortex
(OFC)-- impulsivity and hyperactivity
DLPFC/DaCC-- sustained/selective attention issues
how do NE and DA amounts manifest in relation to fatigue/anxiety? - too little NE and DA = fatigue
too much = anxiety
what two receptors in the PRC are thought to be involved with ADHD treatment? - alpha 2 a
D1
how does ADHD affect NE and DA levels? - NE levels low, signal reduced
DA levels low, noise increased
results in: fidget and inattention
how should you treat NE and DA in adhd? - increase NE
Increase DA
what receptors does NE stimulate in the postsynapse? - alpha 2 a; even better effect when beta1
receptors also stimulated
what effect does DA have on receptors and what does this cause? - decreases the noise and prevents
inappropriate connections from taking place through stimulating D1 receptors
, what effect does NE have on receptors and what does this cause? - increases the incoming signal and
allows for increase connections between prefrontal networks through stimulation of alpha 2A receptors
what effect do slow dose stimulants have? - amplify tonic NE and DA signals
block NET in PFC
block DAT in nucleus accumbens
why do slow dose stimulants have less abuse potential? - they dont occupy DAT too quickly or
extensively, which is thought to reduce abuse potential
what is salience provoked phasic firing? - - bursts of DA release
this can reinforce learning and reward conditioning which can lead to motivation to pursue rewarding
experiences (education, career development)
Can also lead to drug abuse....
how do pulsatile stimulants affect NE and DA? - rapid increase in both
can lead to feelings of euphoria and abuse
ex: methylphenidate and amphetamine
what is a big factor in if stimulants are abused? - route and dose
what stimulant is a competitive inhibitor of DAT and NET? - amphetamine
are both methylphenidate and amphetamine taken into the DA terminal? - no, only amphetamine
this is bc amphetamine and VMAT
what happens when amphetamine is taken in to the terminal? - can go into the vesicle and displace DA;
this can lead to a fast release of DA which causes euphoric (and abuse causing)
what is the MOA of methylphenidate on DA neurons? - works on DAT similarly to SSRI
(blocks reuptake of DA into terminal)
this leads to more DA availability
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