3. Lobes of the brain (forebrain) Midbrain/ Hindbrain Protection and Blood Supply Structure and Functions of a Neuron Synaptic Transmission Neurotransmitters

4. The central nervous system consists of the brain and the spinal cord and is responsible for our basic functions, personality and behaviour.

5. Cerebrum and Cerebral cortex Left and Right Hemispheres Left hemisphere for most people is the dominant hemisphere- responsible for production of language, mathematical ability, problem solving, logic Right hemisphere thought to be responsible for creativity and spatial ability

6. Most complex organ in the body Weighs 1,300 grams Contains billions of neural networks that interact to create human behaviour

7. The major sections of the cerebral hemispheres are divided up into lobes. The lobes are named after the bones of the skull that overlie them Frontal Lobe Temporal Lobe Parietal Lobe Occipital Lobe Barlow and Durand 2005

8. Located at the front of both cerebral hemispheres Primary motor cortex Pre-motor cortex Broca’s Area- Motor Production of speech Complex Functioning Personality judgement Insight Reasoning problem solving, abstract thinking working memory

9. Located behind the temporal lobe Sensory information Temperature Pain Texture Spatial orientation Perception Recognising object by touch Links visual and sensory information together Neglect

10. Auditory information Higher order visual information Complex memory Memory of faces Comprehension of language (Wernicke’s area)

11. http://www.nidcd.nih.gov/health/voice/aphasia.asp)

12. Rearmost portion of the brain Visual processing area Corpus Callosum- Fibre bundle in the brain that connects the two hemispheres together.

13. Hypothalamus Thalamus Cerebellum Pons Medulla Oblongata Reticular formation Basal Ganglia Substantia Nigra Amygdala Hippocampus

14. Thalamus filters sensory information, controls mood states and body movement associated with emotive states Hypothalamus Central control’ for pituitary gland. Regulates autonomic, emotional, endocrine and somatic function. Has a direct involvement in stress and mood states. (http://training.seer.cancer.gov/module_anatom y/unit5_3_nerve_org1_cns.html)

15. Cerebellum regulates equilibrium, muscle tone, postural control, fine movement and coordination of voluntary muscle movement. Pons Relay station between cerebrum and cerebellum www.deryckthake.com/psychim ages/hindbrain.

16. Medulla oblongata Conscious control of skeletal muscles, balance, co-ordination regulating sound impulses in the inner ear, regulation of automatic responses such as heart rate, swallowing, vomiting, coughing and sneezing Reticular Formation- Important in arousal and maintaining consciousness, alertness attention and Reticular Activating System which controls all cyclic functions i.e. respiration, circadian rhythm.

17. Basal Ganglia Control of muscle tone, activity, posture, large muscle movements and inhibit unwanted muscle movements. Substatia Nigra Produces dopamine, is connected to the basal ganglia – EPSE’s

18. Amygdala mediates and controls major affective mood states such as friendship, love, affection, fear, rage and aggression. Hippocampus Memory, particularly the ability to turn short term memory into long term memory. Alzheimer's disease.

20. Meninges  Dura mater  Arachnoid Mater  Subarachnoid space  Pia mater CSF  2 main functions; shock absorption and mediation of blood's vessels and brain tissue in exchange of nutrients. Circle of Willis  carotid arteries and baliser arteries Blood Brain Barrier  Protect the brain from chemicals in the blood. Made up of tightly packed endothelial cells/capillaries making it difficult to penetrate. http://training.seer.cancer.gov/module_anatomy/unit5_3_n erve_org1_cns.html

24. Resting potential Positive/negative charge Voltage Gated channels Sodium/ potassium pump Action potential Threshold Depolarisation

27. Calcium ion channels stimulate the release of neurotransmitters Vesicles fuse to the cell membrane and release into the synapse Lock and key effect Reuptake of neurotransmitters into the cell or broken down by enzymes in the synaptic cleft

31. There are two kinds of neurotransmitters – INHIBITORY and EXCITATORY. stimulate the brain calm the brain

32. Neurotransmitter is a chemical Its released from the synaptic cleft Another term for neurotransmitter is a ligand Three main groups of neurotransmitters Amines Amino Acids Peptides Others

33. Amines Dopamine Noradrenaline Adrenaline Serotonin Amino Acids Glutamate and GABA Aspartate and glycine Peptides Cholecystrokinin Neuropetide Y Vasoactive intestinal Peptide Substance P & Substance K Somatosatin Others Acetylcholine Histamine

34. Small molecule neurotransmitters TypeNeurotransmitterPostsynaptic effect Other Acetylcholine Excitatory Amino acidsGamma aminobutyric acid (GABA) Inhibitory GlycineInhibitory Glutamate Excitatory AspartateExcitatory Biogenic amines Dopamine Excitatory NoradrenalineExcitatory SerotoninExcitatory

37. Almost a million nerve cells in the brain contain dopamine. Role in complex movement cognition motor control emotional responses such as euphoria or pleasure. Newer antipsychotic medication focus on particular dopaminergic pathways in the brain. Lessening EPSE’s.

38. The dopamine hypothesis of psychosis – overactivity of dopamine neurons in the mesolimbic pathway of the brain may mediate the positive symptoms of psychosis Mesolimbic pathway responsible for pleasure, effects of drugs and alcohol and hallucinations and delusions

39. Five subtypes – D2 most important in terms of psychosis Blockade of mesolimbic receptors leads to reduced psychotic symptoms Blockade of the mesocortical pathway leads to increased negative symptoms

40. Dopamine and acetylcholine have a reciprocal relationship- Blockade of dopamine receptors increases the activity of acetylcholine Over activity of acetylcholine causes EPSE Blockade of dopamine causes movement disorders in the nigostriatal pathway Long term blockade causes “upregulation” and leads to Tardive Dyskinesia

41. Tuberoinfundibular pathway hyperprolactinemia (lactation, infertility, sexual dysfunction) Nigrostriatal pathway extrapyramidal side effects (EPS) and tardive dyskinesia Mesocortical pathway enhanced negative and cognitive psychotic symptoms Mesolimbic pathway dramatic therapeutic action on positive psychotic symptoms

42. www.lundbeck.com.au

44. Believed to be one of the great influences on behaviour. Complex neurotransmitter. Surprisingly only 2% of serotonin is found in CNS. Roles include Vasoconstriction, gastrointestinal regulation. Low serotonin associated with aggression, suicide, impulsive eating, anxiety and low mood. Regulates general activity of the CNS, particularly sleep. Delusions, hallucinations and some of the negative symptoms of schizophrenia. www.rodensor.com/images/site_gra phics/Dopamineseratonin

45. www.lundbeck.com.au

48. Glutamate is found in all cells of the body control the opening of ion channels that allow calcium to pass into nerve cells producing impulses Blocking of glutamate receptors produces psychotic symptoms ( eg. By PCP) schizophrenic like symptoms Over exposure of neurons to glutamate cause cell death seen in stroke and Huntington’s disease (PN).

49. Inhibitory and its pathways are only found within the CNS. control excitatory neurotransmitters in the brain and controlling spinal and cerebral reflexes. anxiety disorders decreased GABA can lead to seizure activity Benzodiazepines and barbiturates sedative medication act on GABA Benzo.org.au

52. Found in the posterior hypothalamus. Believed to be involved in the regulation of the sleeping and waking states. Histaminergic cells fire rapidly during waking and slowly during periods of relaxation and tiredness. Cease transmission during REM and non-REM sleep

54. Cholinergic pathways thought to be involved in cognition (esp. memory) and our sleep/wake cycle parasympathetic nervous system regulating bodily functions such as heart rate, digestion, secretion of saliva and bladder function Alzheimer’s disease and myathesia gravis (weakness of skeletal muscles) Anti-cholinergic effects

55. www.lundbeck.com.au

56. Norepinephrine (NE) Found mainly in 3 areas of the brain; the locus coeruleous, the pons reticular formation. Main role; attention, alertness, arousal sleep/wake cycle regulating mood Deprexchart.gif Scienceblogs.com

57. www.lundbeck.com.au

60. The variability in response to modern multi-target drugs suggests a complex trait in which several genes may play a part in the bodies response to drugs. Reported associations between polymorphic receptors for metabolic enzymes and treatment response confirm this hypothesis These results can be taken as evidence of the genomic influence in drug response

61. 5-HTs, 5-HTT, H2 - Clozapine response prediction Arranz et al. (2000) 5-HT6 - Clozapine response Yu et al. (1999) 5-HTT - Response to SSRIs Smeraldi et al. (1998) Kim et al. (2000) APOE, PS1 and PS2 - Alzheimer’s disease treatment response Cacabelos et al. (2000)

62. CYP1A2 - Movement disorders Basile et al. (2000) CYP2D6 - Tardive dyskinesia Kapitany et al. (1998) & Extra-pyramidal side-effects Scordo et al. (2000) CYP2C19 - Mephenytoin blood levels Ferguson et al. (1998) D2 Short-term neuroleptic response Malhotra et al. (1999) Schafer et al. (2001) D3 - Clozapine response Scharfetter et al. (1998) D3 - Tardive dyskinesia Steen et al. (1997) Kapitany et al. (1998) Segman et al. (2000) Ozdemir et al. (2001) D4 - Clozapine response Shaikh et al. (1993) 5-HT2A - Clozapine response Arranz et al. (1995, 1998b) 5-HT2C - Clozapine response Sodhi et al. (1995) Tardive dyskinesia Segman et al. (2000)

65. The study of the movement of a drug through the body Absorption Distribution Metabolism Elimination

66. Absorption The rate at which a drug gets out of the G.I tract and into the blood stream Distribution Process of drug molecules leaving the blood stream to reach tissues and organs

67. General body capillaries allow drug molecules to pass freely into the surrounding tissue.

68. Brain capillaries have a dense walled structure & are surrounded by glial cells (lipid). This prevents many drug molecules from entering the surrounding tissue. Glial cells Capillary wall

69. Metabolism: Detoxification or breakdown. Enzymes (Cytochrome P450) in liver cells transform drug from fat soluble to water soluble. Elimination: removal of drug from body. Most via kidney’s, lungs & G.I. Tract (small amounts) nature.com

71. Drug receptor interaction: drug concentrated at the site of action. Effect (body responses): Therapeutic effects, intoxication & side effects. The effect will vary depending on age, gender & health of person, plus the route, frequency of use, duration of use and the environment in which the drug is consumed.

72. Blockade of receptors Receptor sensitivity changes Reuptake inhibition Interference with storage vesicles Pre-curser chain interference Synaptic enzyme inhibition Second messenger cascade

73. Receptor Neurotransmitter Synapse Presynaptic storage vesicles Re-uptake pump Dendrite Axon

79. Acetylcholine Serotonin Dopamine Noradrenaline Glutamate GABA

80. Acetylcholine Dopamine Noradrenaline Serotonin Dopamine Noradrenaline Serotonin = Stimulates the ANS – Fright & Flight Fine muscle movement, decision making, stimulates the hypothalamus to release hormones Learning & Memory sleep regulation, hunger, mood states, pain perception, aggression and sexual behaviour

81. Noradrenaline & Serotonin Acetylcholine

82. Glutamate, Noradrenaline Dopamine

83. Acetylcholine Dopamine

84. Acetylcholine

85. Dopamine Norepinephrine Serotonin Dopamine Norepinephrine Serotonin

86. Boyd (2002). Psychiatric Nursing, contemporary practice.Lippincott, USA Rosenweig, Breedlove and Leiman (2002) Biological Psychology: an introduction to cognitive, behavioural and clinical neuroscience 3rd Edition.Sineur Associates, Inc USA. Stuart and Laraia (2005) Prinicples and Practice of Psychiatric Nursing. Mosby, USA. Barlow and Durand (2005). Abnormal Psychology, and intergrated approach.Thompson/Wadsworth, Australia. Leonard BE (1997). Fundamentals in Psychopharmacology. 2nd ed. Chichester: Wiley & Sons. Purves DE, Augustine GJ, Fitzpatrick D, et al. (eds). Neuroscience. Sunderland, MA: Sinauer Associates, Inc; 1997. Lundbeck Institute, www.brainexplorer.comwww.brainexplorer.com Blakemore & Frith (2005). The Learning Brain. Blackwell Publishing Begley (2005). The blood brain Barrier. Gauchers News May 2005c Staddon S, Arranz MJ, Mancama D, Mata I, Kerwin RW (2002) Clinical applications of pharmacogenetics in psychiatry, Psychopharmacology 162: 18–23