{"id":369,"date":"2019-11-19T16:58:42","date_gmt":"2019-11-19T16:58:42","guid":{"rendered":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/8-3-disorders-of-the-cns-system\/"},"modified":"2021-12-07T11:26:09","modified_gmt":"2021-12-07T11:26:09","slug":"8-3-disorders-of-the-cns-system","status":"publish","type":"chapter","link":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/8-3-disorders-of-the-cns-system\/","title":{"raw":"8.3 Disorders of the CNS System","rendered":"8.3 Disorders of the CNS System"},"content":{"raw":"<div class=\"1.3-disorders-of-the-cns-system\">\n\nNow that we have reviewed basic concepts of neurotransmitters and their function, let\u2019s review common CNS disorders.\n\nAdditional supplementary videos about mental disorders are available at:\n<a class=\"arrow\" href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">Khan Academy<\/a><sup>[footnote]<a href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">Introduction to Mental Disorders<\/a> by Khan Academy is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 3.0<\/a>.[\/footnote]<\/sup>\n<h2><a id=\"_1mx1797t7cs2\" href=\"\"><\/a>Anxiety<\/h2>\nAnxiety disorders are a group of conditions marked by pathological or extreme anxiety or dread. People with anxiety experience disturbances of mood, behavior, and most systems in the body, making them unable to continue with everyday activities. Many feel anxious most of the time for no apparent reason.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n\nAnxiety is different from fear. Fear is a person's response to an event or object. The psychiatric disorder of anxiety occurs when the intensity and duration of anxiety does not match the potential for harm or threat to the affected person. Anxiety can be expressed with physical symptoms or behaviorally.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n<h3>Signs and Symptoms of Anxiety<\/h3>\n<ul>\n \t<li>Aches<\/li>\n \t<li>Pains<\/li>\n \t<li>Stomach aches<\/li>\n \t<li>Headaches<\/li>\n \t<li>Heart racing or pounding<\/li>\n \t<li>Trembling<\/li>\n \t<li>Sweating<\/li>\n \t<li>Difficulty concentrating (see Figure 8.5)<sup>[footnote]\"<a href=\"https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/\" target=\"_blank\" rel=\"noopener noreferrer\">stress-2902537_960_720.jpg<\/a>\" by <a href=\"https:\/\/pixabay.com\/users\/TheDigitalArtist-202249\/\" target=\"_blank\" rel=\"noopener noreferrer\">TheDigitalArtist<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0 1.0<\/a> [\/footnote]<\/sup><\/li>\n \t<li>Increased agitation<\/li>\n \t<li>Crying <sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote],[footnote]Mayo Clinic Staff. (2018, May 4). <em>Anxiety disorders.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/anxiety\/symptoms-causes\/syc-20350961\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/anxiety\/symptoms-causes\/syc-20350961<\/a>[\/footnote]<\/sup><\/li>\n<\/ul>\n[caption id=\"attachment_368\" align=\"aligncenter\" width=\"645\"]<img class=\"wp-image-366\" title=\"&quot;stress-2902537_960_720.jpg&quot; by TheDigitalArtist is licensed under CC0 1.0 Access for free at https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/ \" src=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537.jpg\" alt=\"Mixed media image of woman looking worried, stressed, or overwhelmed\" width=\"645\" height=\"430\"> Figure 8.5 Many patients with anxiety experience difficulty concentrating[\/caption]\n\nTreatment can include non-pharmacological interventions as well as medications. Non-pharmacological interventions to decrease anxiety include relaxation techniques such as deep breathing, exercise, psychotherapy, support groups, or cognitive behavioral therapy. Anti-anxiety medications can also be used to help both verbal and nonverbal clients feel a much-needed sense of peace. <sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote],[footnote]McCuistion, L., Vuljoin-DiMaggio, K., Winton, M, &amp; Yeager, J. (2018). <em>Pharmacology: A patient-centered nursing process approach.<\/em> pp. 227-305)[\/footnote]<\/sup>\n<p class=\"arrow\">Learn more about anxiety from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/anxiety-disorders\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<h2><a id=\"_rehswqokrj9s\" href=\"\"><\/a>Depression<\/h2>\nDepression is a frequent problem, affecting up to 5% of the population. To be diagnosed with depression, five of the following symptoms must be present during the same two-week period and represent a change from previous functioning. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms of depression cannot be due to effects of a substance or from bereavement.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>.[\/footnote]<\/sup>\n<h3>Signs and Symptoms of Depression<\/h3>\n<ul>\n \t<li>Depressed mood<\/li>\n \t<li>Diminished interest<\/li>\n \t<li>Weight loss when not dieting or weight gain<\/li>\n \t<li>Insomnia or hypersomnia<\/li>\n \t<li>Agitation<\/li>\n \t<li>Fatigue or loss of energy<\/li>\n \t<li>Feeling of worthlessness<\/li>\n \t<li>Inappropriate guilt<\/li>\n \t<li>Diminished ability to concentrate<\/li>\n \t<li>Recurrent thoughts of death, suicidal ideation, or suicide attempt<sup>[footnote]This work is a derivative of <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a> by <a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. National Library of Medicine<\/a> in the <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener noreferrer\">public domain<\/a>. \u00a0[\/footnote],[footnote]Mayo Clinic Staff. (2018, February 3). <em>Depression<\/em>. <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/symptoms-causes\/syc-20356007\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/symptoms-causes\/syc-20356007<\/a>[\/footnote]\u00a0<\/sup><\/li>\n<\/ul>\nTreatment of depression may include medication, psychotherapy, cognitive therapy, electroconvulsive therapy (ECT), and group therapy. Patients who are depressed may not report symptoms unless specifically asked, and they may be suicidal. Using assessment techniques to gather information about the history of each patient\u2019s depression, support system, specific triggering events, psychosocial assessment, and risk for harm to self or others is imperative. Each patient\u2019s response to medication is unpredictable, and often medications will need to be adjusted based on reported symptoms.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>.[\/footnote],[footnote]Varcarolis, E. M. (2017). <em>Essentials of psychiatric mental health nursing: a communication approach to evidence-based care.<\/em> pp. 255-324. Elsevier. [\/footnote]<\/sup>\n<p class=\"arrow\">Learn more about depression from the <a href=\"http:\/\/www.nimh.nih.gov\/health\/topics\/depression\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<h2><a id=\"_kgqk93qnul73\" href=\"\"><\/a>Bipolar<\/h2>\nBipolar affective disorder is marked by serious mood swings. Typically, patients experience extreme highs (called mania or hypomania) alternating with extreme lows (depression). See the \"Depression\" section for signs and symptoms of depression. People feel normal only in the periods between the highs and lows. For some people, the cycles occur so rapidly that they hardly ever feel a sense of control over their mood swings.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n<h3>Signs and Symptoms of a Manic Episode<\/h3>\n<ul>\n \t<li>Rapid speech<\/li>\n \t<li>Hyperactivity<\/li>\n \t<li>Reduced need for sleep<\/li>\n \t<li>Flight of ideas<\/li>\n \t<li>Grandiosity<\/li>\n \t<li>Poor judgement<\/li>\n \t<li>Aggression\/hostility<\/li>\n \t<li>Risky sexual behavior<\/li>\n \t<li>Neglect basic self-care<\/li>\n \t<li>Decreased impulse control <sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote],[footnote]Mayo Clinic Staff. (2018, January 31)) <em>Bipolar disorder<\/em>. <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/bipolar-disorder\/symptoms-causes\/syc-20355955\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/bipolar-disorder\/symptoms-causes\/syc-20355955<\/a>[\/footnote]<\/sup><\/li>\n<\/ul>\nTreatment for a patient diagnosed with bipolar may include medication, safety initiatives during acute mania, ECT, psychotherapy, and support groups. The severity of manic and depressive episodes varies for each patient. Assessing if a patient is a danger to others or themselves is the priority. People with bipolar may need assistance with impulse control during times when they are in a manic state.<sup>[footnote]Varcarolis, E. M. (2017). <em>Essentials of psychiatric mental health nursing: a communication approach to evidence-based care.<\/em> pp. 255-324. Elsevier. [\/footnote]<\/sup>\n<p class=\"arrow\">Learn more about bipolar disorder from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/bipolar-disorder\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<h2><a id=\"_sqzswoqbn6n1\" href=\"\"><\/a>Schizophrenia<\/h2>\nSchizophrenia affects people from all walks of life and usually first appears between the ages of 15 and 30. Not everyone will experience the same symptoms, but many symptoms are common such as withdrawing, hearing voices, talking to oneself, seeing things that are not there, neglecting personal hygiene, and showing low energy.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n\nSchizophrenia refers to a group of severe, disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, delusions (fixed false beliefs that cannot be changed through reasoning), hallucinations (hearing, seeing, smelling, tasting, or feeling touched by things that are not there), and flat affect (lack of observable expressions of emotions, monotone voice, expressionless face, immobile body).<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n<h3><a id=\"_l40g23sko056\" href=\"\"><\/a>Signs and Symptoms of Schizophrenia<\/h3>\nThere are three types of symptoms related to schizophrenia: positive, negative, and cognitive.\n<h4><a id=\"_4ov879eqs0oc\" href=\"\"><\/a>Positive Symptoms<\/h4>\nNote that in this context, the word <em>positive <\/em>is not the same as good. Rather, positive symptoms are psychotic and demonstrate how the individual has lost touch with reality. Positive symptoms include:\n<ul>\n \t<li>Delusions<\/li>\n \t<li>Hallucinations<\/li>\n \t<li>Disorganized thinking and behavior<\/li>\n<\/ul>\nDelusions fall into several categories. Individuals with a persecutory delusion may believe they are being tormented, followed, tricked, or spied on. Individuals with a grandiose delusion may believe they have special powers. Individuals with a reference delusion may believe that passages in books, newspapers, television shows, song lyrics, or other environmental cues are directed toward them. In delusions of thought withdrawal or thought insertion, individuals believe others are reading their mind, their thoughts are being transmitted to others, or outside forces are imposing their thoughts or impulses on them.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n\nHallucinations may include hearing, seeing, smelling, tasting, or feeling as if they have been touched by things that are not there.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n<h4><a id=\"_v4znq6hwkpxx\" href=\"\"><\/a>Negative Symptoms<\/h4>\nNegative symptoms are those characteristics that should be there but are lacking. Negative symptoms include:\n<ul>\n \t<li>Apathy (lack of interest in people, things, activities)<\/li>\n \t<li>Lack of motivation<\/li>\n \t<li>Blunted affect<\/li>\n \t<li>Poverty of speech (brief replies)<\/li>\n \t<li>Anhedonia (lack of interest in activities once enjoyed)<\/li>\n \t<li>Avoidance of relationships<\/li>\n<\/ul>\nKeep in mind that the inability to show emotion associated with a blunted affect does not reflect an inability to feel emotion. Similarly, it is helpful to understand that withdrawing from others is a coping mechanism for an individual with schizophrenia and not a rejection of those who initiate contact.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>.[\/footnote]<\/sup>\n<h4><a id=\"_drisa7gvgse\" href=\"\"><\/a>Cognitive<\/h4>\nCognitive symptoms are a change in thought pattern and include:\n<ul>\n \t<li>Poor decision making<\/li>\n \t<li>Loss of memory<\/li>\n \t<li>Distracted<\/li>\n \t<li>Difficulty focusing<\/li>\n<\/ul>\nTreatment for a patient diagnosed with schizophrenia may include medications to control positive and\/or negative signs and symptoms and nonpharmacological interventions such as limit setting, therapeutic communication, ECT, and psychotherapy. Key assessments for a patient with schizophrenia include examination for hallucinations and delusions, use of additional substances (alcohol or drugs), safety, their support system, and a medication review with a focus on compliance with their therapeutic regimen. <sup>[footnote]This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>.[\/footnote],[footnote]Varcarolis, E. M. (2017). <em>Essentials of psychiatric mental health nursing: a communication approach to evidence-based care.<\/em> pp. 255-324. Elsevier. [\/footnote],[footnote]Mayo Clinic Staff. (2020, January 7) <em>Schizophrenia.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/schizophrenia\/diagnosis-treatment\/drc-20354449\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/schizophrenia\/diagnosis-treatment\/drc-20354449<\/a>[\/footnote]<\/sup>\n<p class=\"arrow\">Learn more about schizophrenia from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/schizophrenia\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<h2><a id=\"_pfz1vlo0zacj\" href=\"\"><\/a>Attention-Deficit \/ Hyperactivity Disorder<\/h2>\nAttention-deficit\/hyperactivity disorder (ADHD) is characterized by hyperactivity, lack of impulse control, and\/or lack of attention that interferes with how a person functions. ADHD is often diagnosed during childhood, but signs and symptoms can last through adulthood.\n<h3>Signs and Symptoms of ADHD<\/h3>\n<ul>\n \t<li>Hyperactivity<\/li>\n \t<li>Inability to concentrate(see Figure 8.6)<sup>[footnote]\"<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:RightBrainDominant.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">RightBrainDominant.jpg<\/a>\" by ElisaRiva is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a>[\/footnote]<\/sup><\/li>\n \t<li>Difficulty with self-control<\/li>\n \t<li>Lack of emotional control<\/li>\n<\/ul>\nA child with ADHD may have difficulty sitting still and focusing at school or have emotional outbursts. These behaviors often impact their life. Medication, psychotherapy, behavior management, and family support all play a large part in helping an individual with ADHD. Additional resources for parents are also helpful.<sup>[footnote]Mayo Clinic Staff. (2019, June 25). <em>Attention-deficit\/hyperactivity disorder (ADHD) in children.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/adhd\/symptoms-causes\/syc-20350889\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/adhd\/symptoms-causes\/syc-20350889<\/a>[\/footnote],[footnote]McCuistion, L., Vuljoin-DiMaggio, K., Winton, M, &amp; Yeager, J. (2018). <em>Pharmacology: A patient-centered nursing process approach.<\/em> pp. 227-305. Elsevier.[\/footnote]<\/sup>\n\n[caption id=\"attachment_368\" align=\"aligncenter\" width=\"558\"]<img class=\"wp-image-367\" title=\"&quot;RightBrainDominant.jpg&quot; by ElisaRiva is licensed under CC0\" src=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-300x228.jpg\" alt=\"Illustration showing psychological division of the cerebral brain hemispheres.\" width=\"558\" height=\"424\"> Figure 8.6 Patients with ADHD may have difficulty in focusing on details[\/caption]\n<p class=\"arrow\">Learn more about ADHD from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/attention-deficit-hyperactivity-disorder-adhd\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<h2><a id=\"_b1j9ixk4rb22\" href=\"\"><\/a>Seizures<\/h2>\nThe official definition of a seizure is \"a transient occurrence of signs and\/or symptoms due to an abnormal excessive or synchronous neuronal activity in the brain.\" This means that during a seizure, large numbers of brain cells are activated abnormally at the same time. It is like an electrical storm in the brain. They may alter consciousness and produce abnormal motor activity. There are different classifications of seizures based on severity of symptoms.<sup>[footnote]Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a>[\/footnote]<\/sup>\n<h3><a id=\"_j4nawyehl3ma\" href=\"\"><\/a>Signs and Symptoms of Seizures<\/h3>\n<h4><a id=\"_vxsx3zm0wodf\" href=\"\"><\/a>Motor Symptoms<\/h4>\n<ul>\n \t<li>Jerking (clonic)<\/li>\n \t<li>Muscles becoming limp or weak (atonic)<\/li>\n \t<li>Tense or rigid muscles (tonic)<\/li>\n \t<li>Brief muscle twitching (myoclonus)<\/li>\n \t<li>Epileptic spasms<\/li>\n<\/ul>\n<h4><a id=\"_134p9jb9ypzt\" href=\"\"><\/a>Non-motor Symptoms<\/h4>\n<ul>\n \t<li>Changes in sensation, emotions, thinking, or autonomic functions<\/li>\n \t<li>Lack of movement<\/li>\n<\/ul>\n<h3><a id=\"_44itdmpo0xdl\" href=\"\"><\/a>Classification of Seizures<\/h3>\nSeizures are classified in many ways, beginning with whether they are partial or generalized seizures.\n<h4><a id=\"_6i2iq8hlg1xo\" href=\"\"><\/a>Partial Seizures<\/h4>\nPartial seizures have focal onset on one side of the brain. They are further classified into simple, complex, or secondarily generalized:\n<ul>\n \t<li>Simple partial seizures are most common. They may also affect sensory and autonomic systems.<\/li>\n \t<li>Complex partial seizures include impairment of consciousness, with or without motor activity or other signs.<\/li>\n \t<li>Simple or complex partial seizures may become secondarily generalized, producing a tonic-clonic seizure.<\/li>\n<\/ul>\n<h4><a id=\"_3bzwa0io53jg\" href=\"\"><\/a>Generalized Seizures<\/h4>\nGeneralized seizures have bilateral onset on both sides of the brain and are typified by petit mal seizures, which can be recognized by clinical characteristics as well as interictal EEG abnormalities. <sup>[footnote]This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA 4.0<\/a>.[\/footnote],[footnote]This work is a derivative of <a href=\"https:\/\/www.oercommons.org\/authoring\/54330-pharmacology-notes-nursing-implications-for-clinic\/view\" target=\"_blank\" rel=\"noopener noreferrer\">Pharmacology Notes: Nursing Implications for Clinical Practice<\/a> by <a href=\"https:\/\/www.oercommons.org\/profile\/213497\" target=\"_blank\" rel=\"noopener noreferrer\">Gloria Velarde<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>.[\/footnote],[footnote]Mayo Clinic Staff. (2019, June 18). <em>Seizures.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/seizure\/symptoms-causes\/syc-20365711\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/seizure\/symptoms-causes\/syc-20365711<\/a>[\/footnote],[footnote]Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a>[\/footnote]<\/sup>\n<h4><a id=\"_mtjf2zjihnlo\" href=\"\"><\/a>Status Epilepticus<\/h4>\n<strong>[pb_glossary id=\"1878\"]Status epilepticus[\/pb_glossary]<\/strong> is a state of repeated or continuous seizures. It is often defined operationally as a single seizure lasting more than 20 minutes or repeated seizures without recovery of consciousness. Prolonged status epilepticus leads to irreversible brain injury and has a very high rate of mortality. The goal of therapy should be to achieve control of a seizure within 60 minutes or less. Pharmacological treatment of seizures is very successful in the majority of cases, but it requires accurate diagnosis and classification of seizures. Medication management of seizures may include CNS depressants, benzodiazepines or barbiturates, or anticonvulsants such as phenytoin.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>.[\/footnote]<\/sup>\n<h2><a id=\"_qrybvf2hnd8z\" href=\"\"><\/a>Parkinson\u2019s Disease<\/h2>\nParkinson\u2019s disease is a progressive disease of the nervous system that impairs one\u2019s ability to move. The typical onset for Parkinson\u2019s disease is middle to later stages of life. This disease worsens over time and has no cure. The cause of this disease is unknown, but it is known that it is characterized by a loss of dopaminergic neurons.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/openlibrary.ecampusontario.ca\/catalogue\/item\/?id=7cb679be-692a-49a5-838f-c4deeecfee2a\" target=\"_blank\" rel=\"noopener noreferrer\">Neuroscience: Canadian 1st Edition<\/a> by Dr. William Ju and is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0.<\/a>[\/footnote],[footnote]Mayo Clinic Staff. (2018, June 30). <em>Parkinson\u2019s disease.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/parkinsons-disease\/symptoms-causes\/syc-20376055\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/parkinsons-disease\/symptoms-causes\/syc-20376055<\/a>[\/footnote]<\/sup>\n<h3>Signs and Symptoms of Parkinson\u2019s Disease<\/h3>\n<ul>\n \t<li><strong>[pb_glossary id=\"2399\"]Tremor[\/pb_glossary]<\/strong> at rest<\/li>\n \t<li><strong>[pb_glossary id=\"1879\"]Bradykinesia[\/pb_glossary]<\/strong><\/li>\n \t<li>Muscle <strong>[pb_glossary id=\"2404\"]rigidity[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"2392\"]Postural instability[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"1880\"]Gait disturbance[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"1881\"]Dystonia[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"1882\"]Ophthalmoplegia[\/pb_glossary]<\/strong><\/li>\n \t<li>Active mood disorders<\/li>\n<\/ul>\nSee Figure 8.7\u00a0for a typical posture associated with Parksinon\u2019s disease.<sup>[footnote]\"<a href=\"https:\/\/en.wikipedia.org\/wiki\/File:Paralysis_agitans_(1907,_after_St._Leger).png\" target=\"_blank\" rel=\"noopener noreferrer\">Paralysis agitans (1907, after St. Leger).png<\/a>\" by <a href=\"https:\/\/en.wikipedia.org\/wiki\/William_Richard_Gowers\" target=\"_blank\" rel=\"noopener noreferrer\">William Richard Gowers<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a>[\/footnote]<\/sup> Treatment for a patient with Parkinson\u2019s disease often includes medication to increase dopamine in the brain to slow the progression of the disease.\n\n[caption id=\"\" align=\"aligncenter\" width=\"462\"]<img title=\"&quot;Paralysis agitans (1907, after St. Leger).png&quot; by William Richard Gowers is licensed under CC0 \" src=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/image7-11.png\" alt=\"Illustration of man with stooped posture, shown from front and profile views\" width=\"462\" height=\"487\"> Figure 8.7. The typical stooping posture associated with Parksonson\u2019s disease.[\/caption]\n\n&nbsp;\n<div class=\"textbox\">\n\n<strong>Potential new treatment of proteins in Alzheimers and Parkinson\u2019s disease<\/strong>\n\nThe underlying cause of some neurodegenerative diseases, such as Alzheimer\u2019s and Parkinson\u2019s, appears to be related to proteins\u2014specifically, to proteins behaving badly. One of the strongest theories of what causes Alzheimer\u2019s disease is based on the accumulation of beta-amyloid plaques, dense conglomerations of a protein that is not functioning correctly. Parkinson\u2019s disease is linked to an increase in a protein known as alpha-synuclein that is toxic to the cells of the substantia nigra nucleus in the midbrain.\n\nFor proteins to function correctly, they are dependent on their three-dimensional shape. The linear sequence of amino acids folds into a three-dimensional shape that is based on the interactions between and among those amino acids. When the folding is disturbed and proteins take on a different shape, they stop functioning correctly. But the disease is not necessarily the result of functional loss of these proteins; rather, these altered proteins start to accumulate and may become toxic. For example, in Alzheimer\u2019s the hallmark of the disease is the accumulation of these amyloid plaques in the cerebral cortex. The term coined to describe this sort of disease is \u201cproteopathy\u201d and it includes other diseases. Creutzfeld-Jacob disease, the human variant of the disease known as mad cow disease, also involves the accumulation of amyloid plaques, similar to Alzheimer\u2019s. Diseases of other organ systems can fall into this group as well, such as cystic fibrosis or type 2 diabetes. Recognizing the relationship between these diseases has suggested new therapeutic possibilities. Interfering with the accumulation of the proteins, and possibly as early as their original production within the cell, may unlock new ways to alleviate these devastating diseases.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/openstax.org\/details\/books\/anatomy-and-physiology\" target=\"_blank\" rel=\"noopener noreferrer\">Anatomy and Physiology<\/a> by <a href=\"https:\/\/openstax.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenStax<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. Access for free at <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction<\/a>[\/footnote]<\/sup>\n\n<\/div>\n<\/div>","rendered":"<div class=\"1.3-disorders-of-the-cns-system\">\n<p>Now that we have reviewed basic concepts of neurotransmitters and their function, let\u2019s review common CNS disorders.<\/p>\n<p>Additional supplementary videos about mental disorders are available at:<br \/>\n<a class=\"arrow\" href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">Khan Academy<\/a><sup><a class=\"footnote\" title=\"Introduction to Mental Disorders by Khan Academy is licensed under CC BY-NC-SA 3.0.\" id=\"return-footnote-369-1\" href=\"#footnote-369-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/sup><\/p>\n<h2><a id=\"_1mx1797t7cs2\" href=\"\"><\/a>Anxiety<\/h2>\n<p>Anxiety disorders are a group of conditions marked by pathological or extreme anxiety or dread. People with anxiety experience disturbances of mood, behavior, and most systems in the body, making them unable to continue with everyday activities. Many feel anxious most of the time for no apparent reason.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-2\" href=\"#footnote-369-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/sup><\/p>\n<p>Anxiety is different from fear. Fear is a person&#8217;s response to an event or object. The psychiatric disorder of anxiety occurs when the intensity and duration of anxiety does not match the potential for harm or threat to the affected person. Anxiety can be expressed with physical symptoms or behaviorally.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-3\" href=\"#footnote-369-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/sup><\/p>\n<h3>Signs and Symptoms of Anxiety<\/h3>\n<ul>\n<li>Aches<\/li>\n<li>Pains<\/li>\n<li>Stomach aches<\/li>\n<li>Headaches<\/li>\n<li>Heart racing or pounding<\/li>\n<li>Trembling<\/li>\n<li>Sweating<\/li>\n<li>Difficulty concentrating (see Figure 8.5)<sup><a class=\"footnote\" title=\"&quot;stress-2902537_960_720.jpg&quot; by TheDigitalArtist is licensed under CC0 1.0\" id=\"return-footnote-369-4\" href=\"#footnote-369-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/sup><\/li>\n<li>Increased agitation<\/li>\n<li>Crying <sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-5\" href=\"#footnote-369-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a>,<a class=\"footnote\" title=\"Mayo Clinic Staff. (2018, May 4). Anxiety disorders. https:\/\/www.mayoclinic.org\/diseases-conditions\/anxiety\/symptoms-causes\/syc-20350961\" id=\"return-footnote-369-6\" href=\"#footnote-369-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a><\/sup><\/li>\n<\/ul>\n<figure id=\"attachment_368\" aria-describedby=\"caption-attachment-368\" style=\"width: 645px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-366\" title=\"&quot;stress-2902537_960_720.jpg&quot; by TheDigitalArtist is licensed under CC0 1.0 Access for free at https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/\" src=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537.jpg\" alt=\"Mixed media image of woman looking worried, stressed, or overwhelmed\" width=\"645\" height=\"430\" srcset=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537.jpg 960w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-300x200.jpg 300w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-768x512.jpg 768w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-65x43.jpg 65w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-225x150.jpg 225w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-350x233.jpg 350w\" sizes=\"auto, (max-width: 645px) 100vw, 645px\" \/><figcaption id=\"caption-attachment-368\" class=\"wp-caption-text\">Figure 8.5 Many patients with anxiety experience difficulty concentrating<\/figcaption><\/figure>\n<p>Treatment can include non-pharmacological interventions as well as medications. Non-pharmacological interventions to decrease anxiety include relaxation techniques such as deep breathing, exercise, psychotherapy, support groups, or cognitive behavioral therapy. Anti-anxiety medications can also be used to help both verbal and nonverbal clients feel a much-needed sense of peace. <sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-7\" href=\"#footnote-369-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a>,<a class=\"footnote\" title=\"McCuistion, L., Vuljoin-DiMaggio, K., Winton, M, &amp; Yeager, J. (2018). Pharmacology: A patient-centered nursing process approach. pp. 227-305)\" id=\"return-footnote-369-8\" href=\"#footnote-369-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><\/sup><\/p>\n<p class=\"arrow\">Learn more about anxiety from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/anxiety-disorders\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<h2><a id=\"_rehswqokrj9s\" href=\"\"><\/a>Depression<\/h2>\n<p>Depression is a frequent problem, affecting up to 5% of the population. To be diagnosed with depression, five of the following symptoms must be present during the same two-week period and represent a change from previous functioning. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms of depression cannot be due to effects of a substance or from bereavement.<sup><a class=\"footnote\" title=\"This work is a derivative of Principles of Pharmacology by LibreTexts licensed under CC BY-NC-SA 4.0.\" id=\"return-footnote-369-9\" href=\"#footnote-369-9\" aria-label=\"Footnote 9\"><sup class=\"footnote\">[9]<\/sup><\/a><\/sup><\/p>\n<h3>Signs and Symptoms of Depression<\/h3>\n<ul>\n<li>Depressed mood<\/li>\n<li>Diminished interest<\/li>\n<li>Weight loss when not dieting or weight gain<\/li>\n<li>Insomnia or hypersomnia<\/li>\n<li>Agitation<\/li>\n<li>Fatigue or loss of energy<\/li>\n<li>Feeling of worthlessness<\/li>\n<li>Inappropriate guilt<\/li>\n<li>Diminished ability to concentrate<\/li>\n<li>Recurrent thoughts of death, suicidal ideation, or suicide attempt<sup><a class=\"footnote\" title=\"This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. \u00a0\" id=\"return-footnote-369-10\" href=\"#footnote-369-10\" aria-label=\"Footnote 10\"><sup class=\"footnote\">[10]<\/sup><\/a>,<a class=\"footnote\" title=\"Mayo Clinic Staff. (2018, February 3). Depression. https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/symptoms-causes\/syc-20356007\" id=\"return-footnote-369-11\" href=\"#footnote-369-11\" aria-label=\"Footnote 11\"><sup class=\"footnote\">[11]<\/sup><\/a>\u00a0<\/sup><\/li>\n<\/ul>\n<p>Treatment of depression may include medication, psychotherapy, cognitive therapy, electroconvulsive therapy (ECT), and group therapy. Patients who are depressed may not report symptoms unless specifically asked, and they may be suicidal. Using assessment techniques to gather information about the history of each patient\u2019s depression, support system, specific triggering events, psychosocial assessment, and risk for harm to self or others is imperative. Each patient\u2019s response to medication is unpredictable, and often medications will need to be adjusted based on reported symptoms.<sup><a class=\"footnote\" title=\"This work is a derivative of Principles of Pharmacology by LibreTexts licensed under CC BY-NC-SA 4.0.\" id=\"return-footnote-369-12\" href=\"#footnote-369-12\" aria-label=\"Footnote 12\"><sup class=\"footnote\">[12]<\/sup><\/a>,<a class=\"footnote\" title=\"Varcarolis, E. M. (2017). Essentials of psychiatric mental health nursing: a communication approach to evidence-based care. pp. 255-324. Elsevier.\" id=\"return-footnote-369-13\" href=\"#footnote-369-13\" aria-label=\"Footnote 13\"><sup class=\"footnote\">[13]<\/sup><\/a><\/sup><\/p>\n<p class=\"arrow\">Learn more about depression from the <a href=\"http:\/\/www.nimh.nih.gov\/health\/topics\/depression\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<h2><a id=\"_kgqk93qnul73\" href=\"\"><\/a>Bipolar<\/h2>\n<p>Bipolar affective disorder is marked by serious mood swings. Typically, patients experience extreme highs (called mania or hypomania) alternating with extreme lows (depression). See the &#8220;Depression&#8221; section for signs and symptoms of depression. People feel normal only in the periods between the highs and lows. For some people, the cycles occur so rapidly that they hardly ever feel a sense of control over their mood swings.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-14\" href=\"#footnote-369-14\" aria-label=\"Footnote 14\"><sup class=\"footnote\">[14]<\/sup><\/a><\/sup><\/p>\n<h3>Signs and Symptoms of a Manic Episode<\/h3>\n<ul>\n<li>Rapid speech<\/li>\n<li>Hyperactivity<\/li>\n<li>Reduced need for sleep<\/li>\n<li>Flight of ideas<\/li>\n<li>Grandiosity<\/li>\n<li>Poor judgement<\/li>\n<li>Aggression\/hostility<\/li>\n<li>Risky sexual behavior<\/li>\n<li>Neglect basic self-care<\/li>\n<li>Decreased impulse control <sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-15\" href=\"#footnote-369-15\" aria-label=\"Footnote 15\"><sup class=\"footnote\">[15]<\/sup><\/a>,<a class=\"footnote\" title=\"Mayo Clinic Staff. (2018, January 31)) Bipolar disorder. https:\/\/www.mayoclinic.org\/diseases-conditions\/bipolar-disorder\/symptoms-causes\/syc-20355955\" id=\"return-footnote-369-16\" href=\"#footnote-369-16\" aria-label=\"Footnote 16\"><sup class=\"footnote\">[16]<\/sup><\/a><\/sup><\/li>\n<\/ul>\n<p>Treatment for a patient diagnosed with bipolar may include medication, safety initiatives during acute mania, ECT, psychotherapy, and support groups. The severity of manic and depressive episodes varies for each patient. Assessing if a patient is a danger to others or themselves is the priority. People with bipolar may need assistance with impulse control during times when they are in a manic state.<sup><a class=\"footnote\" title=\"Varcarolis, E. M. (2017). Essentials of psychiatric mental health nursing: a communication approach to evidence-based care. pp. 255-324. Elsevier.\" id=\"return-footnote-369-17\" href=\"#footnote-369-17\" aria-label=\"Footnote 17\"><sup class=\"footnote\">[17]<\/sup><\/a><\/sup><\/p>\n<p class=\"arrow\">Learn more about bipolar disorder from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/bipolar-disorder\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<h2><a id=\"_sqzswoqbn6n1\" href=\"\"><\/a>Schizophrenia<\/h2>\n<p>Schizophrenia affects people from all walks of life and usually first appears between the ages of 15 and 30. Not everyone will experience the same symptoms, but many symptoms are common such as withdrawing, hearing voices, talking to oneself, seeing things that are not there, neglecting personal hygiene, and showing low energy.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-18\" href=\"#footnote-369-18\" aria-label=\"Footnote 18\"><sup class=\"footnote\">[18]<\/sup><\/a><\/sup><\/p>\n<p>Schizophrenia refers to a group of severe, disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, delusions (fixed false beliefs that cannot be changed through reasoning), hallucinations (hearing, seeing, smelling, tasting, or feeling touched by things that are not there), and flat affect (lack of observable expressions of emotions, monotone voice, expressionless face, immobile body).<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-19\" href=\"#footnote-369-19\" aria-label=\"Footnote 19\"><sup class=\"footnote\">[19]<\/sup><\/a><\/sup><\/p>\n<h3><a id=\"_l40g23sko056\" href=\"\"><\/a>Signs and Symptoms of Schizophrenia<\/h3>\n<p>There are three types of symptoms related to schizophrenia: positive, negative, and cognitive.<\/p>\n<h4><a id=\"_4ov879eqs0oc\" href=\"\"><\/a>Positive Symptoms<\/h4>\n<p>Note that in this context, the word <em>positive <\/em>is not the same as good. Rather, positive symptoms are psychotic and demonstrate how the individual has lost touch with reality. Positive symptoms include:<\/p>\n<ul>\n<li>Delusions<\/li>\n<li>Hallucinations<\/li>\n<li>Disorganized thinking and behavior<\/li>\n<\/ul>\n<p>Delusions fall into several categories. Individuals with a persecutory delusion may believe they are being tormented, followed, tricked, or spied on. Individuals with a grandiose delusion may believe they have special powers. Individuals with a reference delusion may believe that passages in books, newspapers, television shows, song lyrics, or other environmental cues are directed toward them. In delusions of thought withdrawal or thought insertion, individuals believe others are reading their mind, their thoughts are being transmitted to others, or outside forces are imposing their thoughts or impulses on them.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-20\" href=\"#footnote-369-20\" aria-label=\"Footnote 20\"><sup class=\"footnote\">[20]<\/sup><\/a><\/sup><\/p>\n<p>Hallucinations may include hearing, seeing, smelling, tasting, or feeling as if they have been touched by things that are not there.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-21\" href=\"#footnote-369-21\" aria-label=\"Footnote 21\"><sup class=\"footnote\">[21]<\/sup><\/a><\/sup><\/p>\n<h4><a id=\"_v4znq6hwkpxx\" href=\"\"><\/a>Negative Symptoms<\/h4>\n<p>Negative symptoms are those characteristics that should be there but are lacking. Negative symptoms include:<\/p>\n<ul>\n<li>Apathy (lack of interest in people, things, activities)<\/li>\n<li>Lack of motivation<\/li>\n<li>Blunted affect<\/li>\n<li>Poverty of speech (brief replies)<\/li>\n<li>Anhedonia (lack of interest in activities once enjoyed)<\/li>\n<li>Avoidance of relationships<\/li>\n<\/ul>\n<p>Keep in mind that the inability to show emotion associated with a blunted affect does not reflect an inability to feel emotion. Similarly, it is helpful to understand that withdrawing from others is a coping mechanism for an individual with schizophrenia and not a rejection of those who initiate contact.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals with Intellectual Disability &amp; Mental illness by Sheri Melrose is licensed under CC BY 4.0.\" id=\"return-footnote-369-22\" href=\"#footnote-369-22\" aria-label=\"Footnote 22\"><sup class=\"footnote\">[22]<\/sup><\/a><\/sup><\/p>\n<h4><a id=\"_drisa7gvgse\" href=\"\"><\/a>Cognitive<\/h4>\n<p>Cognitive symptoms are a change in thought pattern and include:<\/p>\n<ul>\n<li>Poor decision making<\/li>\n<li>Loss of memory<\/li>\n<li>Distracted<\/li>\n<li>Difficulty focusing<\/li>\n<\/ul>\n<p>Treatment for a patient diagnosed with schizophrenia may include medications to control positive and\/or negative signs and symptoms and nonpharmacological interventions such as limit setting, therapeutic communication, ECT, and psychotherapy. Key assessments for a patient with schizophrenia include examination for hallucinations and delusions, use of additional substances (alcohol or drugs), safety, their support system, and a medication review with a focus on compliance with their therapeutic regimen. <sup><a class=\"footnote\" title=\"This work is a derivative of Principles of Pharmacology by LibreTexts licensed under CC BY-NC-SA 4.0.\" id=\"return-footnote-369-23\" href=\"#footnote-369-23\" aria-label=\"Footnote 23\"><sup class=\"footnote\">[23]<\/sup><\/a>,<a class=\"footnote\" title=\"Varcarolis, E. M. (2017). Essentials of psychiatric mental health nursing: a communication approach to evidence-based care. pp. 255-324. Elsevier.\" id=\"return-footnote-369-24\" href=\"#footnote-369-24\" aria-label=\"Footnote 24\"><sup class=\"footnote\">[24]<\/sup><\/a>,<a class=\"footnote\" title=\"Mayo Clinic Staff. (2020, January 7) Schizophrenia. https:\/\/www.mayoclinic.org\/diseases-conditions\/schizophrenia\/diagnosis-treatment\/drc-20354449\" id=\"return-footnote-369-25\" href=\"#footnote-369-25\" aria-label=\"Footnote 25\"><sup class=\"footnote\">[25]<\/sup><\/a><\/sup><\/p>\n<p class=\"arrow\">Learn more about schizophrenia from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/schizophrenia\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<h2><a id=\"_pfz1vlo0zacj\" href=\"\"><\/a>Attention-Deficit \/ Hyperactivity Disorder<\/h2>\n<p>Attention-deficit\/hyperactivity disorder (ADHD) is characterized by hyperactivity, lack of impulse control, and\/or lack of attention that interferes with how a person functions. ADHD is often diagnosed during childhood, but signs and symptoms can last through adulthood.<\/p>\n<h3>Signs and Symptoms of ADHD<\/h3>\n<ul>\n<li>Hyperactivity<\/li>\n<li>Inability to concentrate(see Figure 8.6)<sup><a class=\"footnote\" title=\"&quot;RightBrainDominant.jpg&quot; by ElisaRiva is licensed under CC0\" id=\"return-footnote-369-26\" href=\"#footnote-369-26\" aria-label=\"Footnote 26\"><sup class=\"footnote\">[26]<\/sup><\/a><\/sup><\/li>\n<li>Difficulty with self-control<\/li>\n<li>Lack of emotional control<\/li>\n<\/ul>\n<p>A child with ADHD may have difficulty sitting still and focusing at school or have emotional outbursts. These behaviors often impact their life. Medication, psychotherapy, behavior management, and family support all play a large part in helping an individual with ADHD. Additional resources for parents are also helpful.<sup><a class=\"footnote\" title=\"Mayo Clinic Staff. (2019, June 25). Attention-deficit\/hyperactivity disorder (ADHD) in children. https:\/\/www.mayoclinic.org\/diseases-conditions\/adhd\/symptoms-causes\/syc-20350889\" id=\"return-footnote-369-27\" href=\"#footnote-369-27\" aria-label=\"Footnote 27\"><sup class=\"footnote\">[27]<\/sup><\/a>,<a class=\"footnote\" title=\"McCuistion, L., Vuljoin-DiMaggio, K., Winton, M, &amp; Yeager, J. (2018). Pharmacology: A patient-centered nursing process approach. pp. 227-305. Elsevier.\" id=\"return-footnote-369-28\" href=\"#footnote-369-28\" aria-label=\"Footnote 28\"><sup class=\"footnote\">[28]<\/sup><\/a><\/sup><\/p>\n<figure id=\"attachment_368\" aria-describedby=\"caption-attachment-368\" style=\"width: 558px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-367\" title=\"&quot;RightBrainDominant.jpg&quot; by ElisaRiva is licensed under CC0\" src=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-300x228.jpg\" alt=\"Illustration showing psychological division of the cerebral brain hemispheres.\" width=\"558\" height=\"424\" srcset=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-300x228.jpg 300w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-1024x780.jpg 1024w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-768x585.jpg 768w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-1536x1170.jpg 1536w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-65x49.jpg 65w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-225x171.jpg 225w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant-350x267.jpg 350w, https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/RightBrainDominant.jpg 1920w\" sizes=\"auto, (max-width: 558px) 100vw, 558px\" \/><figcaption id=\"caption-attachment-368\" class=\"wp-caption-text\">Figure 8.6 Patients with ADHD may have difficulty in focusing on details<\/figcaption><\/figure>\n<p class=\"arrow\">Learn more about ADHD from the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/attention-deficit-hyperactivity-disorder-adhd\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<h2><a id=\"_b1j9ixk4rb22\" href=\"\"><\/a>Seizures<\/h2>\n<p>The official definition of a seizure is &#8220;a transient occurrence of signs and\/or symptoms due to an abnormal excessive or synchronous neuronal activity in the brain.&#8221; This means that during a seizure, large numbers of brain cells are activated abnormally at the same time. It is like an electrical storm in the brain. They may alter consciousness and produce abnormal motor activity. There are different classifications of seizures based on severity of symptoms.<sup><a class=\"footnote\" title=\"Epilepsy Foundation. (2016, December 22). 2017 Revised classification of seizures. https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" id=\"return-footnote-369-29\" href=\"#footnote-369-29\" aria-label=\"Footnote 29\"><sup class=\"footnote\">[29]<\/sup><\/a><\/sup><\/p>\n<h3><a id=\"_j4nawyehl3ma\" href=\"\"><\/a>Signs and Symptoms of Seizures<\/h3>\n<h4><a id=\"_vxsx3zm0wodf\" href=\"\"><\/a>Motor Symptoms<\/h4>\n<ul>\n<li>Jerking (clonic)<\/li>\n<li>Muscles becoming limp or weak (atonic)<\/li>\n<li>Tense or rigid muscles (tonic)<\/li>\n<li>Brief muscle twitching (myoclonus)<\/li>\n<li>Epileptic spasms<\/li>\n<\/ul>\n<h4><a id=\"_134p9jb9ypzt\" href=\"\"><\/a>Non-motor Symptoms<\/h4>\n<ul>\n<li>Changes in sensation, emotions, thinking, or autonomic functions<\/li>\n<li>Lack of movement<\/li>\n<\/ul>\n<h3><a id=\"_44itdmpo0xdl\" href=\"\"><\/a>Classification of Seizures<\/h3>\n<p>Seizures are classified in many ways, beginning with whether they are partial or generalized seizures.<\/p>\n<h4><a id=\"_6i2iq8hlg1xo\" href=\"\"><\/a>Partial Seizures<\/h4>\n<p>Partial seizures have focal onset on one side of the brain. They are further classified into simple, complex, or secondarily generalized:<\/p>\n<ul>\n<li>Simple partial seizures are most common. They may also affect sensory and autonomic systems.<\/li>\n<li>Complex partial seizures include impairment of consciousness, with or without motor activity or other signs.<\/li>\n<li>Simple or complex partial seizures may become secondarily generalized, producing a tonic-clonic seizure.<\/li>\n<\/ul>\n<h4><a id=\"_3bzwa0io53jg\" href=\"\"><\/a>Generalized Seizures<\/h4>\n<p>Generalized seizures have bilateral onset on both sides of the brain and are typified by petit mal seizures, which can be recognized by clinical characteristics as well as interictal EEG abnormalities. <sup><a class=\"footnote\" title=\"This work is a derivative of Principles of Pharmacology by LibreTexts licensed under CC BY-NC-SA 4.0.\" id=\"return-footnote-369-30\" href=\"#footnote-369-30\" aria-label=\"Footnote 30\"><sup class=\"footnote\">[30]<\/sup><\/a>,<a class=\"footnote\" title=\"This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0.\" id=\"return-footnote-369-31\" href=\"#footnote-369-31\" aria-label=\"Footnote 31\"><sup class=\"footnote\">[31]<\/sup><\/a>,<a class=\"footnote\" title=\"Mayo Clinic Staff. (2019, June 18). Seizures. https:\/\/www.mayoclinic.org\/diseases-conditions\/seizure\/symptoms-causes\/syc-20365711\" id=\"return-footnote-369-32\" href=\"#footnote-369-32\" aria-label=\"Footnote 32\"><sup class=\"footnote\">[32]<\/sup><\/a>,<a class=\"footnote\" title=\"Epilepsy Foundation. (2016, December 22). 2017 Revised classification of seizures. https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" id=\"return-footnote-369-33\" href=\"#footnote-369-33\" aria-label=\"Footnote 33\"><sup class=\"footnote\">[33]<\/sup><\/a><\/sup><\/p>\n<h4><a id=\"_mtjf2zjihnlo\" href=\"\"><\/a>Status Epilepticus<\/h4>\n<p><strong>Status epilepticus<\/strong> is a state of repeated or continuous seizures. It is often defined operationally as a single seizure lasting more than 20 minutes or repeated seizures without recovery of consciousness. Prolonged status epilepticus leads to irreversible brain injury and has a very high rate of mortality. The goal of therapy should be to achieve control of a seizure within 60 minutes or less. Pharmacological treatment of seizures is very successful in the majority of cases, but it requires accurate diagnosis and classification of seizures. Medication management of seizures may include CNS depressants, benzodiazepines or barbiturates, or anticonvulsants such as phenytoin.<sup><a class=\"footnote\" title=\"This work is a derivative of Principles of Pharmacology by LibreTexts licensed under CC BY-NC-SA 4.0.\" id=\"return-footnote-369-34\" href=\"#footnote-369-34\" aria-label=\"Footnote 34\"><sup class=\"footnote\">[34]<\/sup><\/a><\/sup><\/p>\n<h2><a id=\"_qrybvf2hnd8z\" href=\"\"><\/a>Parkinson\u2019s Disease<\/h2>\n<p>Parkinson\u2019s disease is a progressive disease of the nervous system that impairs one\u2019s ability to move. The typical onset for Parkinson\u2019s disease is middle to later stages of life. This disease worsens over time and has no cure. The cause of this disease is unknown, but it is known that it is characterized by a loss of dopaminergic neurons.<sup><a class=\"footnote\" title=\"This work is a derivative of Neuroscience: Canadian 1st Edition by Dr. William Ju and is licensed under CC BY 4.0.\" id=\"return-footnote-369-35\" href=\"#footnote-369-35\" aria-label=\"Footnote 35\"><sup class=\"footnote\">[35]<\/sup><\/a>,<a class=\"footnote\" title=\"Mayo Clinic Staff. (2018, June 30). Parkinson\u2019s disease. https:\/\/www.mayoclinic.org\/diseases-conditions\/parkinsons-disease\/symptoms-causes\/syc-20376055\" id=\"return-footnote-369-36\" href=\"#footnote-369-36\" aria-label=\"Footnote 36\"><sup class=\"footnote\">[36]<\/sup><\/a><\/sup><\/p>\n<h3>Signs and Symptoms of Parkinson\u2019s Disease<\/h3>\n<ul>\n<li><strong>Tremor<\/strong> at rest<\/li>\n<li><strong>Bradykinesia<\/strong><\/li>\n<li>Muscle <strong>rigidity<\/strong><\/li>\n<li><strong>Postural instability<\/strong><\/li>\n<li><strong>Gait disturbance<\/strong><\/li>\n<li><strong>Dystonia<\/strong><\/li>\n<li><strong>Ophthalmoplegia<\/strong><\/li>\n<li>Active mood disorders<\/li>\n<\/ul>\n<p>See Figure 8.7\u00a0for a typical posture associated with Parksinon\u2019s disease.<sup><a class=\"footnote\" title=\"&quot;Paralysis agitans (1907, after St. Leger).png&quot; by William Richard Gowers is licensed under CC0\" id=\"return-footnote-369-37\" href=\"#footnote-369-37\" aria-label=\"Footnote 37\"><sup class=\"footnote\">[37]<\/sup><\/a><\/sup> Treatment for a patient with Parkinson\u2019s disease often includes medication to increase dopamine in the brain to slow the progression of the disease.<\/p>\n<figure style=\"width: 462px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" title=\"&quot;Paralysis agitans (1907, after St. Leger).png&quot; by William Richard Gowers is licensed under CC0\" src=\"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-content\/uploads\/sites\/5\/2021\/12\/image7-11.png\" alt=\"Illustration of man with stooped posture, shown from front and profile views\" width=\"462\" height=\"487\" \/><figcaption class=\"wp-caption-text\">Figure 8.7. The typical stooping posture associated with Parksonson\u2019s disease.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<div class=\"textbox\">\n<p><strong>Potential new treatment of proteins in Alzheimers and Parkinson\u2019s disease<\/strong><\/p>\n<p>The underlying cause of some neurodegenerative diseases, such as Alzheimer\u2019s and Parkinson\u2019s, appears to be related to proteins\u2014specifically, to proteins behaving badly. One of the strongest theories of what causes Alzheimer\u2019s disease is based on the accumulation of beta-amyloid plaques, dense conglomerations of a protein that is not functioning correctly. Parkinson\u2019s disease is linked to an increase in a protein known as alpha-synuclein that is toxic to the cells of the substantia nigra nucleus in the midbrain.<\/p>\n<p>For proteins to function correctly, they are dependent on their three-dimensional shape. The linear sequence of amino acids folds into a three-dimensional shape that is based on the interactions between and among those amino acids. When the folding is disturbed and proteins take on a different shape, they stop functioning correctly. But the disease is not necessarily the result of functional loss of these proteins; rather, these altered proteins start to accumulate and may become toxic. For example, in Alzheimer\u2019s the hallmark of the disease is the accumulation of these amyloid plaques in the cerebral cortex. The term coined to describe this sort of disease is \u201cproteopathy\u201d and it includes other diseases. Creutzfeld-Jacob disease, the human variant of the disease known as mad cow disease, also involves the accumulation of amyloid plaques, similar to Alzheimer\u2019s. Diseases of other organ systems can fall into this group as well, such as cystic fibrosis or type 2 diabetes. Recognizing the relationship between these diseases has suggested new therapeutic possibilities. Interfering with the accumulation of the proteins, and possibly as early as their original production within the cell, may unlock new ways to alleviate these devastating diseases.<sup><a class=\"footnote\" title=\"This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction\" id=\"return-footnote-369-38\" href=\"#footnote-369-38\" aria-label=\"Footnote 38\"><sup class=\"footnote\">[38]<\/sup><\/a><\/sup><\/p>\n<\/div>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-369-1\"><a href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">Introduction to Mental Disorders<\/a> by Khan Academy is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 3.0<\/a>. <a href=\"#return-footnote-369-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-369-2\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-369-3\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-369-4\">\"<a href=\"https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/\" target=\"_blank\" rel=\"noopener noreferrer\">stress-2902537_960_720.jpg<\/a>\" by <a href=\"https:\/\/pixabay.com\/users\/TheDigitalArtist-202249\/\" target=\"_blank\" rel=\"noopener noreferrer\">TheDigitalArtist<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0 1.0<\/a>  <a href=\"#return-footnote-369-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-369-5\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-369-6\">Mayo Clinic Staff. (2018, May 4). <em>Anxiety disorders.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/anxiety\/symptoms-causes\/syc-20350961\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/anxiety\/symptoms-causes\/syc-20350961<\/a> <a href=\"#return-footnote-369-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-369-7\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-369-8\">McCuistion, L., Vuljoin-DiMaggio, K., Winton, M, &amp; Yeager, J. (2018). <em>Pharmacology: A patient-centered nursing process approach.<\/em> pp. 227-305) <a href=\"#return-footnote-369-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><li id=\"footnote-369-9\">This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>. <a href=\"#return-footnote-369-9\" class=\"return-footnote\" aria-label=\"Return to footnote 9\">&crarr;<\/a><\/li><li id=\"footnote-369-10\">This work is a derivative of <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a> by <a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. National Library of Medicine<\/a> in the <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener noreferrer\">public domain<\/a>. \u00a0 <a href=\"#return-footnote-369-10\" class=\"return-footnote\" aria-label=\"Return to footnote 10\">&crarr;<\/a><\/li><li id=\"footnote-369-11\">Mayo Clinic Staff. (2018, February 3). <em>Depression<\/em>. <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/symptoms-causes\/syc-20356007\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/symptoms-causes\/syc-20356007<\/a> <a href=\"#return-footnote-369-11\" class=\"return-footnote\" aria-label=\"Return to footnote 11\">&crarr;<\/a><\/li><li id=\"footnote-369-12\">This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>. <a href=\"#return-footnote-369-12\" class=\"return-footnote\" aria-label=\"Return to footnote 12\">&crarr;<\/a><\/li><li id=\"footnote-369-13\">Varcarolis, E. M. (2017). <em>Essentials of psychiatric mental health nursing: a communication approach to evidence-based care.<\/em> pp. 255-324. Elsevier.  <a href=\"#return-footnote-369-13\" class=\"return-footnote\" aria-label=\"Return to footnote 13\">&crarr;<\/a><\/li><li id=\"footnote-369-14\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-14\" class=\"return-footnote\" aria-label=\"Return to footnote 14\">&crarr;<\/a><\/li><li id=\"footnote-369-15\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-15\" class=\"return-footnote\" aria-label=\"Return to footnote 15\">&crarr;<\/a><\/li><li id=\"footnote-369-16\">Mayo Clinic Staff. (2018, January 31)) <em>Bipolar disorder<\/em>. <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/bipolar-disorder\/symptoms-causes\/syc-20355955\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/bipolar-disorder\/symptoms-causes\/syc-20355955<\/a> <a href=\"#return-footnote-369-16\" class=\"return-footnote\" aria-label=\"Return to footnote 16\">&crarr;<\/a><\/li><li id=\"footnote-369-17\">Varcarolis, E. M. (2017). <em>Essentials of psychiatric mental health nursing: a communication approach to evidence-based care.<\/em> pp. 255-324. Elsevier.  <a href=\"#return-footnote-369-17\" class=\"return-footnote\" aria-label=\"Return to footnote 17\">&crarr;<\/a><\/li><li id=\"footnote-369-18\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-18\" class=\"return-footnote\" aria-label=\"Return to footnote 18\">&crarr;<\/a><\/li><li id=\"footnote-369-19\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-19\" class=\"return-footnote\" aria-label=\"Return to footnote 19\">&crarr;<\/a><\/li><li id=\"footnote-369-20\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-20\" class=\"return-footnote\" aria-label=\"Return to footnote 20\">&crarr;<\/a><\/li><li id=\"footnote-369-21\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-21\" class=\"return-footnote\" aria-label=\"Return to footnote 21\">&crarr;<\/a><\/li><li id=\"footnote-369-22\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals with Intellectual Disability &amp; Mental illness<\/a> by Sheri Melrose is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. <a href=\"#return-footnote-369-22\" class=\"return-footnote\" aria-label=\"Return to footnote 22\">&crarr;<\/a><\/li><li id=\"footnote-369-23\">This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>. <a href=\"#return-footnote-369-23\" class=\"return-footnote\" aria-label=\"Return to footnote 23\">&crarr;<\/a><\/li><li id=\"footnote-369-24\">Varcarolis, E. M. (2017). <em>Essentials of psychiatric mental health nursing: a communication approach to evidence-based care.<\/em> pp. 255-324. Elsevier.  <a href=\"#return-footnote-369-24\" class=\"return-footnote\" aria-label=\"Return to footnote 24\">&crarr;<\/a><\/li><li id=\"footnote-369-25\">Mayo Clinic Staff. (2020, January 7) <em>Schizophrenia.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/schizophrenia\/diagnosis-treatment\/drc-20354449\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/schizophrenia\/diagnosis-treatment\/drc-20354449<\/a> <a href=\"#return-footnote-369-25\" class=\"return-footnote\" aria-label=\"Return to footnote 25\">&crarr;<\/a><\/li><li id=\"footnote-369-26\">\"<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:RightBrainDominant.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">RightBrainDominant.jpg<\/a>\" by ElisaRiva is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a> <a href=\"#return-footnote-369-26\" class=\"return-footnote\" aria-label=\"Return to footnote 26\">&crarr;<\/a><\/li><li id=\"footnote-369-27\">Mayo Clinic Staff. (2019, June 25). <em>Attention-deficit\/hyperactivity disorder (ADHD) in children.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/adhd\/symptoms-causes\/syc-20350889\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/adhd\/symptoms-causes\/syc-20350889<\/a> <a href=\"#return-footnote-369-27\" class=\"return-footnote\" aria-label=\"Return to footnote 27\">&crarr;<\/a><\/li><li id=\"footnote-369-28\">McCuistion, L., Vuljoin-DiMaggio, K., Winton, M, &amp; Yeager, J. (2018). <em>Pharmacology: A patient-centered nursing process approach.<\/em> pp. 227-305. Elsevier. <a href=\"#return-footnote-369-28\" class=\"return-footnote\" aria-label=\"Return to footnote 28\">&crarr;<\/a><\/li><li id=\"footnote-369-29\">Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a> <a href=\"#return-footnote-369-29\" class=\"return-footnote\" aria-label=\"Return to footnote 29\">&crarr;<\/a><\/li><li id=\"footnote-369-30\">This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA 4.0<\/a>. <a href=\"#return-footnote-369-30\" class=\"return-footnote\" aria-label=\"Return to footnote 30\">&crarr;<\/a><\/li><li id=\"footnote-369-31\">This work is a derivative of <a href=\"https:\/\/www.oercommons.org\/authoring\/54330-pharmacology-notes-nursing-implications-for-clinic\/view\" target=\"_blank\" rel=\"noopener noreferrer\">Pharmacology Notes: Nursing Implications for Clinical Practice<\/a> by <a href=\"https:\/\/www.oercommons.org\/profile\/213497\" target=\"_blank\" rel=\"noopener noreferrer\">Gloria Velarde<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>. <a href=\"#return-footnote-369-31\" class=\"return-footnote\" aria-label=\"Return to footnote 31\">&crarr;<\/a><\/li><li id=\"footnote-369-32\">Mayo Clinic Staff. (2019, June 18). <em>Seizures.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/seizure\/symptoms-causes\/syc-20365711\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/seizure\/symptoms-causes\/syc-20365711<\/a> <a href=\"#return-footnote-369-32\" class=\"return-footnote\" aria-label=\"Return to footnote 32\">&crarr;<\/a><\/li><li id=\"footnote-369-33\">Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a> <a href=\"#return-footnote-369-33\" class=\"return-footnote\" aria-label=\"Return to footnote 33\">&crarr;<\/a><\/li><li id=\"footnote-369-34\">This work is a derivative of <a href=\"https:\/\/med.libretexts.org\/Bookshelves\/Pharmacology_and_Medicine\/Book%3A_Principles_of_Pharmacology_(OCW)\" target=\"_blank\" rel=\"noopener noreferrer\">Principles of Pharmacology<\/a> by <a href=\"https:\/\/libretexts.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">LibreTexts<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>. <a href=\"#return-footnote-369-34\" class=\"return-footnote\" aria-label=\"Return to footnote 34\">&crarr;<\/a><\/li><li id=\"footnote-369-35\">This work is a derivative of <a href=\"https:\/\/openlibrary.ecampusontario.ca\/catalogue\/item\/?id=7cb679be-692a-49a5-838f-c4deeecfee2a\" target=\"_blank\" rel=\"noopener noreferrer\">Neuroscience: Canadian 1st Edition<\/a> by Dr. William Ju and is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0.<\/a> <a href=\"#return-footnote-369-35\" class=\"return-footnote\" aria-label=\"Return to footnote 35\">&crarr;<\/a><\/li><li id=\"footnote-369-36\">Mayo Clinic Staff. (2018, June 30). <em>Parkinson\u2019s disease.<\/em> <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/parkinsons-disease\/symptoms-causes\/syc-20376055\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.mayoclinic.org\/diseases-conditions\/parkinsons-disease\/symptoms-causes\/syc-20376055<\/a> <a href=\"#return-footnote-369-36\" class=\"return-footnote\" aria-label=\"Return to footnote 36\">&crarr;<\/a><\/li><li id=\"footnote-369-37\">\"<a href=\"https:\/\/en.wikipedia.org\/wiki\/File:Paralysis_agitans_(1907,_after_St._Leger).png\" target=\"_blank\" rel=\"noopener noreferrer\">Paralysis agitans (1907, after St. Leger).png<\/a>\" by <a href=\"https:\/\/en.wikipedia.org\/wiki\/William_Richard_Gowers\" target=\"_blank\" rel=\"noopener noreferrer\">William Richard Gowers<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a> <a href=\"#return-footnote-369-37\" class=\"return-footnote\" aria-label=\"Return to footnote 37\">&crarr;<\/a><\/li><li id=\"footnote-369-38\">This work is a derivative of <a href=\"https:\/\/openstax.org\/details\/books\/anatomy-and-physiology\" target=\"_blank\" rel=\"noopener noreferrer\">Anatomy and Physiology<\/a> by <a href=\"https:\/\/openstax.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenStax<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. Access for free at <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction<\/a> <a href=\"#return-footnote-369-38\" class=\"return-footnote\" aria-label=\"Return to footnote 38\">&crarr;<\/a><\/li><\/ol><\/div><div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_369_1878\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_1878\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_369_2399\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_2399\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_369_1879\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_1879\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_369_2404\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_2404\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_369_2392\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_2392\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_369_1880\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_1880\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_369_1881\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_1881\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_369_1882\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_369_1882\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":2,"menu_order":3,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[49],"contributor":[],"license":[53],"class_list":["post-369","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by"],"part":356,"_links":{"self":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/369","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/users\/2"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/369\/revisions"}],"predecessor-version":[{"id":370,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/369\/revisions\/370"}],"part":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/356"}],"metadata":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/369\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=369"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=369"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=369"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=369"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}