Name: Ericka Dawn O.

Mar Date: September 27, 2022

Section: BSN – 2C

Insights

With the given lecture videos I gained a lot of knowledge in terms of the lessons, thus
here are my insights in each chapter:

Chapter 22

 Schizophrenia, the most prevalent psychosis, which is characterized by hallucinations, delusions,

and inappropriate responses to stimuli. Bipolar disorder is a behavioral condition marked by
intense depressive episodes that alternate with episodes of hyperactivity and enthusiasm. A
behavioral illness known as attention deficit disorder is characterized by hyperactivity and a
limited attention span. Daytime sleepiness and an abrupt loss of wakefulness are symptoms of
narcolepsy. The most common antimanic medication is lithium, a membrane stabilizer. Because
it is a salt that is extremely poisonous, serum levels must be closely watched to avoid dangerous
poisoning. CNS stimulants are used to treat narcolepsy and attention deficit disorders by
stimulating cortical levels and the RAS to boost RAS activity.

Chapter 23

 A sudden release of excessive electrical activity from nerve cells inside the brain is a common
feature of the various diseases that make up epilepsy. The occurrence is known as a seizure.
There are two types of seizures: generalized and partial (focal). Additional subtypes of
generalized seizures include tonic-clonic, absence, myoclonic, febrile, and rapidly recurring.
Further classifications of partial seizures include simple and complex. The type of seizure the
patient had and the toxicity of the drugs that are accessible will determine the course of
treatment. The goal of drug therapy is to stabilize the overexcited neuronal membranes and/or
improve GABA's efficiency as an inhibitory neurotransmitter. Antiepileptic side effects are a
reflection of the CNS depression brought on by the medication. Antiepileptic drug users should
be recommended to wear or carry a MedicAlert notification so that emergency medical
personnel are aware of their epilepsy and antiepileptic medication use. Antiepileptic patients
frequently undergo long-term therapy, which necessitates adherence to their medication
schedule and any restrictions related to their disease and the side effects of the medication.

Chapter 24

 Parkinson's disease is an incurable, chronic neurological condition that progresses over time.
Parkinson's disease is characterized by a loss of neurons in the substantia nigra that secrete
dopamine. An imbalance between excitatory cholinergic cells and inhibitory dopaminergic cells
results from the destruction of dopamine-secreting cells. Parkinson's disease is characterized by
 tremor, modifications in posture and gait, slow and deliberate movements, and finally drooling
and speech modifications. The goal of drug treatment for Parkinson's disease is to reestablish
the equilibrium between dopamine and acetylcholine. Up until a point where a therapeutic
response is no longer elicited, the disease's signs and symptoms can be controlled.
Dopaminergic medications are used to elevate dopamine levels or to directly stimulate
dopamine receptors, whilst anticholinergic drugs are intended to block excitatory cholinergic
receptors.

Chapter 25

 The pyramidal tract in the cerebellum, which controls the coordination of deliberate muscle
movement, is one of the upper level regulators of muscle activity. A rush of impulses may reach
the spinal cord as a result of injury to a muscle or anchoring skeletal tissue. A state of
heightened contraction or a muscle spasm may result from such overstimulation. Muscle
spasticity, which results in a loss of coordinated activity, including the capacity to carry out
deliberate tasks and maintain posture, position, and motility, can be brought on by damage to
motor neurons. The effects of muscle spasm are treated by centrally acting skeletal muscle
relaxants. A direct-acting skeletal muscle relaxant called daltrolene is used to manage spasticity
and stop malignant hyperthermia. In order to lessen the severity of the abnormal head position
and neck pain brought on by cervical dystonia, rimabotulinumtoxin B is employed.
Onabotulinumtoxin A is used to treat cervical dystonia, severe primary axillary hyperhidrosis,
strabismus, and blepharospasm linked to dystonia as well as to lessen the appearance of
moderate to severe glabellar lines. Incobotulinumtoxin A is also used to treat blepharospasm in
individuals who have previously received treatment with botulinum A and to lessen the severity
of head position with cervical dystonia.

Chapter 26

 When tissue is harmed, a number of chemicals are released, resulting in pain. Small-diameter A-
delta and C fibers, which connect to interneurons in the dorsal horn of the spinal cord, carry the
pain signals to the spinal cord. Endogenous endorphins and enkephalins interact with opioid
receptors located in many different bodily tissues to alter the transmission of pain impulses.
Pain is reduced by narcotics, which are made from the opium poppy plant. They also induce
euphoria or feelings of well-being and cause constipation, respiratory depression, drowsiness,
and suppression of the cough reflex. All drugs are considered restricted substances because they
can cause physical dependence to develop. Specific drugs' potency and undesirable effects are
related to the different opioid receptor types for which they have a particular affinity. Drug
agonists interact with opioid receptor sites to promote the activation of those receptors.
Agonists and antagonists of opioid receptors interact with some opioid receptor sites to activate
them while blocking others. Compared to pure narcotic agonists, these medicines are less
addictive. Drug overdoses and undesirable side effects are treated with narcotic antagonists,
which work to counteract the effects of opioids. One side of the head experiences severe
migraine headaches that may be accompanied by an aura or warning symptom.
Chapter 27

 The use of general anesthetics causes analgesia, forgetfulness, and unconsciousness. They also
block muscular reflexes that can obstruct surgery or endanger the patient. When general
anesthetics are used, there is a generalized CNS depression that could be dangerous, especially
for individuals with underlying respiratory, cardiovascular, or CNS problems. Four predictable
stages of anesthesia lead to the loss of feeling, complete CNS depression, and death. The
interval between the start of anesthetic medication and the patient entering surgical anesthesia
is known as the induction of anesthesia. Anticholinergics, fast intravenous anesthetics, inhaled
anesthetics, NMJ blockers, and opioids are some of the medications used in balanced
anesthesia. • Patients undergoing general anesthesia should be watched for any negative side
effects; they require assurance and safety precautions until their sensibility, mobility, and
communication abilities have returned. Local anesthetics impede the transmission of pain
signals and motor impulses by blocking the depolarization of nerve membranes. In order to
deliver the medication to the appropriate location and avoid systemic absorption, which could
seriously disrupt nerve impulses and reaction, local anesthetics are used. Plasma esterases
quickly degrade ester-type local anesthetics. Amide local anesthetics are more likely to
accumulate and cause systemic toxicity since they are broken down in the liver. Patients who
are receiving general or local anesthetics require nursing care that includes safety measures to
minimize damage and skin breakdown, support and reassurance to deal with the loss of feeling
and mobility, and patient education about what to expect to decrease stress and worry.

Chapter 28

 The neurotransmitter ACh is used by the neurons to communicate with the muscles at the NMJ.
NMJ blockers affect how muscles work. Depolarizing drugs and nondepolarizing agents are the
two categories of NMJ blockers. The substances that function as ACh antagonists at the NMJ and
stop muscle cells from depolarizing are categorized as nondepolarizing NMJs. The depolarizing
NMJs stimulate the muscle cell and then prevent it from repolarizing by acting as an ACh agonist
at the junction. In addition to general anesthesia, NMJ blockers are frequently used to ease
mechanical ventilation, facilitate endotracheal intubation, and prevent damage during
electroconvulsive therapy. Muscle function blocking is linked to NMJ blocker side effects such
protracted paralysis, difficulty breathing, weakness, soreness, and symptoms of immobility.
Support and reassurance are necessary for patients using NMJ blockers because paralysis
impairs communication. Airways and respiration must also be carefully maintained, skin
breakdown must be avoided, and patients must be watched for signs of function recovery.

Chapter 29

 The ANS collaborates with the endocrine system to control internal processes and sustain
homeostasis. To maintain minute-to-minute regulation of the internal environment and to
enable quick reaction to stressful conditions, the two branches of the ANS—the sympathetic
nervous system (SNS) and the parasympathetic nervous system—work antagonistically. The
 fight-or-flight response is brought on by stimulation of the SNS. By raising metabolism, directing
blood to large muscles, and enhancing cardiac and pulmonary function, it primes the body for an
instant response to stimuli. The parasympathetic system functions as a rest-and-digest response
when it is activated. In order to conserve energy, it lowers metabolism and function while
increasing nutrient digestion, absorption, and metabolism. Choline obtained from food is
converted into ACh, which is then stored in vesicles and released by the cholinergic neuron into
the synaptic cleft. Acetylcholinesterase almost immediately converts ACh to an inactive state.
Depending on how these plant alkaloids affect them, parasympathetic system receptors are
categorized as muscarinic or nicotinic.

Chapter 30

 Sympathomimetics, also known as adrenergic agonists, are medications that imitate the actions
of the SNS and are used to activate adrenergic receptors in the SNS. Sympathetic activation
frequently contributes to the side effects of these medications. When administered systemically,
isoproterenol, a non-specific beta-specific adrenergic, is used to treat shock, cardiac standstill,
and certain arrhythmias; it is particularly helpful in treating heart block in donated hearts.

Chapter 31

 Sympathomimetic medications, such as sympatholytics, lyse or impede the effects of the SNS.
These medications' therapeutic and unfavorable effects are both connected to their inhibition of
the SNS's typical reactions. It has been possible to create selective adrenergic blockers that, at
therapeutic doses, exhibit a particular affinity for either alpha- or beta-receptors or for
particular alpha1, beta1, or beta2-receptor sites. At concentrations greater than the therapeutic
range, this specificity is eliminated.

Chapter 32

 The parasympathetic nerves, some brain nerves, and the neuromuscular junction are all
stimulated by cholinergic medicines, which work at the same place as the neurotransmitter ACh.
Direct-acting cholinergic medicines react with the ACh receptor sites to induce cholinergic
activation. The systemic effects of the medication restrict the use of direct-acting cholinergic
medications. One medication is used to induce miosis and treat glaucoma, another to stimulate
GI secretions and treat Sjögren's syndrome-related dry mouth. Another medication is provided
to treat neurogenic bladder and bladder atony following surgery or childbirth.
Acetylcholinesterase inhibitors are present in all indirect-acting cholinergic medications. To stop
ACh from being degraded in the synaptic cleft, they inhibit acetylcholinesterase. ACh-producing
neurons and ACh receptor sites in the neurocortex are lost in Alzheimer's disease, a progressive
dementia. Some of these medications may have side effects that limit their usefulness, including
bradycardia, hypotension, increased GI secretions and activity, increased bladder tone, relaxed
GI and GU sphincters, bronchoconstriction, and pupil constriction. These side effects are related
to the stimulation of the parasympathetic nervous system.
Chapter 33

 Anticholinergic medications, also known as parasympatholytic medications, prevent

acetylcholine from acting at cholinergic receptor sites, which prevents the parasympathetic
nervous system's actions. The systemic cholinergic blocking actions of anticholinergic
medications, which also have the desired therapeutic effect, are responsible for many of the
systemic side effects associated with their usage. The most widely used anticholinergic
medication is atropine. It comes in oral, parenteral, and topical formulations and is approved for
a wide range of ailments. Anticholinergic drug users need to be watched out for side effects
include dry mouth, swallowing issues, constipation, urine retention, tachycardia, pupil dilatation
and photophobia, cycloplegia and blurred vision, and heat intolerance brought on by a decrease
in perspiration.

In conclusion, all of the topics discussed from the chapters 22 to 23 is a mind opening realization which
gave me the insight of having these agents in my body can help my body become the better version of
itself physiologically.