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PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example
| Name: ___________________________________ Anticipated Graduation Term/Year: ____________ |
| Psychiatric Mental Health Nurse Practitioner Clinical Practice Portfolio |
Table of Contents
NU670 Psychopharmacology and Health promotion
Neurotransmitter Chart (Unit 1)
Antipsychotics Chart (Unit 2)
Antidepressants, Anxiolytics, & Mood Stabilizers Chart (Unit 3, 4, 5)
Substance Use Resources (Chart links) (Unit 6)
Additional Resources List
| Neurotransmitters Chart | |||||||
| Function (Excitatory or Inhibitory) | Locations | Receptors | Effects of Deficient | Effects of Surplus | Agonist Drug | Antagonist Drug | |
| Acetylcholine | Excitatory | Several different locations of the brain including striatal complex, the basal forebrain and the medulla.(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | Acetylcholine receptors either nicotinic and muscarinic subunits | Memory impairment and brain disorders | Having excess acetylcholine accumulated at the synapses and neuromuscular junctions triggers symptoms of muscarinic and nicotinic toxicity. These symptoms include cramps, lacrimation, and blurry vision amongst others.(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | Include nicotine, choline, epibatidine,obeline, varenicline and cysteine mimic the action of acetylcholine | Compete with actions of acetylcholine for example atropine competes for a common binding site on all muscarinic receptors |
| Dopamine | Both excitatory and inhibitory | Located in the mid brain at the substania nigra and ventra tegmental area. Also found in hypothalamus and arcuate nucleus(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | There are five types of dopamine receptors with each having a specific function or functions. They are D1, D2, D3, D4, and D5. The functions of D1 include memory, attention, locomotion, regulation of renal function and impulse control.(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | Aches and pains, tremors, spasms, tremors, muscle cramps and muscle stiffness(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | One becomes aggressive, competitive, and have poor impulse control. It can lead to gambling, addiction, binge eating and ADHD. | Include Bromocriptine, cabergoline, Rotigitine and Apomorphine. | Clozepine, Chlorpromazine, promethazine and risperidone. |
| Endorphins | Inhibitory | Are released from the pituitary gland in response to pain and can act in both the central nervous system and the peripheral nervous system. | Bind with μ-receptors of peripheral nerves thus inhibiting the transmission of pain signals | Leads to depression and headaches | Besides decreased feelings of pain, secretion of endorphins leads to feelings of euphoria, modulation of appetite, release of sex hormones, and enhancement of the immune response. | .methadone and buprenorphine intramuscular heroin | Naloxone and naltrexone used in opioid antagonists drugs and as competitive antagonists bind to the opioid receptors without activating the receptors. |
| GABA | inhibitory | The Limbic system where personal feelings and emotional memories are generated and stored.(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | There are two classes of GABA receptors namely ionotropic receptors( GABAA) and metabotropic receptors(GABAB | Lower than normal levels of GABA in the brain is associate with sleep disorders, anxiety. Depression and schizophrenia | Causes hypersomnia or daytime sleepiness. | GABA (a) receptor agonists are like alcohol, barbiturates and benzodiazepine. GABA(b) receptor agonists include propofol, sodium oxybate and Baclofen. GABA analogs are like gabapentin, pregabalin and Valproic acid | Include bicuculline, securinine and metrazol Conventionally, these drugs generate a stimulant and convulsant effects hence their use to counter overdose of sedative drugs. |
| Glutamate | Excitatory | Occurs in protein- containing foods like cheese milk and mushrooms but is also produced by the human body.in the CNS | Glutamate receptors are found on the dendrites of postsynaptic cells and bind with glutamate released in into the synaptic cleft by presynaptic cells(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | Causes insomnia, mental exhaustion and difficulties in concentration. | Increase cellular activity, leading to over excitation on nerve cells which eventually causes cell death. | Cycloutylene AP5 and DCG IV Kainic acid and Quisqualic acid | Amantadine, |
| Glycine | inhibitory | In the brain stem and spinal cord. | Glycine receptors have the function of fast inhibitory transmission in the CNS. Suppress neural firing through hyper polarization that occurs when glycine activates anion channels. (PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | Means the body produces less glutathione that negatively impacts on how one body handles oxidative stress over time. | Elevated glycine levels within the brain and cerebrospinal fluid cause’s seizures, breathing difficulties, movement disorders and intellectual disability. | D- Alanine L- Serine | Can either be selective like Brucine, Tutin and Strychnine or non-selective like Pitrazepin, Caffeine, Pictrotoxin and Bicuculine |
| Glutamate | excitatory | Occurs in protein- containing foods like cheese milk and mushrooms but is also produced by the human body.in the CNS | Glutamate receptors are found on the dendrites of postsynaptic cells and bind with glutamate released in into the synaptic cleft by presynaptic cells | Causes insomnia, mental exhaustion and difficulties in concentration. | Increase cellular activity, leading to over excitation on nerve cells which eventually causes cell death. | Cycloutylene AP5 and DCG IV Kainic acid and Quisqualic acid | Amantadine, |
| Norepinephrine | Excitatory | Produced in the inner part of the adrenal glands called the adrenal medulla | Norepinephrine binds to alpha- and beta-adrenergic receptors or adrenoceptors in different tissues. For example in the blood vessels it triggers vasoconstrictive thus increasing blood pressure. | Low levels of Norepinephrine is associated with ADHD, lack of concentration, lethargy and even depression. | Can lead to panic attacks, elevated blood pressure, euphoria ,and general hyperactivity | Epinephrine | Tricyclic antidepressant, beta blockers and antipsychotics |
| Serotonin | inhibitory | Primarily found in the enteric nervous system whose location is within the gastrointestinal tract though its production occurs in the CNS.(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | Serotonin membrane depolarization occurs after fast mediation and excitatory responses by 5-HT3 receptors located on neurons in both PNS and CNS.(PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO-comprehensive Nursing Paper Example) | Serotonin Levels below normal are associated with depression, anxiety and sleep | Excessive levels of Serotonin causes mild shivering and diarrhea to severe muscle rigidity , fever, and seizures | Serotonin 5-HT-Receptor Agonists Addyi.almotriptan.Amerge.Axert.eletriptan.flibanserin.Frova.frovatriptan. | 5-HT3 antagonists include Dolasetron. Granisetron. Ondansetron. Palonosetron. |
Notes:
| Antipsychotics | ||||||||||||||
| First Generation | Side Effects (L=Low, M=Moderate, H=High) | |||||||||||||
| Generic Name | Trade Name | Route(s) of Administration | LAI option | Starting Dose | Half Life | Indications (s/sx & diagnosis) | MOA (neurotransmitter effects) | EPS | Hyperlipidemia | T2DM | Weight Gain | Cognitive Issue | Other SE | Costs |
| Second Generation | ||||||||||||||
Notes:
| Antidepressants, Anxiolytics & Mood Stabilizers | ||||||||||||||
| Antidepressants | Side Effects (L=Low, M=Moderate, H=High) | |||||||||||||
| Generic Name | Trade Name | Route(s) of Administration | LAI option | Starting Dose | Half Life | Indications (s/sx & diagnosis) | MOA (neurotransmitter effects) | EPS | Hyperlipidemia | T2DM | Weight Gain | Cognitive Issue | Other SE | Costs |
| SSRIs | ||||||||||||||
| SNRIs | ||||||||||||||
| TCAs | ||||||||||||||
| MAOIs | ||||||||||||||
| Atypical | ||||||||||||||
| Anxiolytics | ||||||||||||||
| Benzodiazepines | ||||||||||||||
| Barbiturates | ||||||||||||||
| Mood Stabilizers | ||||||||||||||
Notes:
Substance Use Resources
Commonly Used Drugs and Treatment Information Charts:
https://www.drugabuse.gov/sites/default/files/nida_commonlyuseddrugs_final_printready.pdf
Withdrawal Sx Chart
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