NURS215 Lecture Notes - Lecture 9: Midazolam, Status Epilepticus, Valproate
12 Jul 2018
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Review knowledge: depolarization: calcium, sodium influx & potassium efflux + synapse. Neuro-transmitters (nt) note: many varied receptors: ach, norepinephrine, dopamine, serotonin, gaba (gamma-amino butyric acid, glutamate (excitory amino acid, substance p, endogenous opioids (eg: endorphins, norepinephrine, excitory nt, high. Lethargy, sleep cycle issues, low focus: dopamine, excitory & inhibitory nt in brain. Catecholamine: balance required, centrally - precursor to norepinephrine, too much = excitation, psychosis, too little = depression, sedation. Reward-pathway : focus, motivation, positive mood, serotonin 5-ht. Present in many other organs, e. g. gi tract. Peripherally causes vasoconstriction: mediates brain stimulation ((cid:858)cal(cid:373)i(cid:374)g(cid:859)) Can be depleted if too much excitation present. Inhibitory nt in the brain (increases cl influx => decreasing excitability of cell: gaba neurotransmitter, mediates brain stimulation ((cid:858)cal(cid:373)i(cid:374)g(cid:859), high doses: sedation, fatigue; amnesia, poor concentration, confusion, glutamate (eaa, excitory nt in the brain. Nmda receptor binding: vital to cognition, memory, learning, balance required e. g. all cns drugs, caution. High frequency of cholinergic or anticholinergic (sympathomimetic) side effects.
