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Tuberoinfundibular Pathway PMHNP Exam

*Tuberoinfundibular Pathway in the PMHNP Exam* The *tuberoinfundibular pathway* is a *dopaminergic pathway* that plays a key role in **prolactin regulation**. It is frequently tested on the **PMHNP-BC exam**, particularly in relation to **hyperprolactinemia, the effects of antipsychotics, and endocrine complications**. --- *1. Overview of the Tuberoinfundibular Pathway* *Origin:* *Hypothalamus (Arcuate Nucleus)* *Destination:* *Anterior Pituitary Gland* *Function:* *Regulates prolactin secretion by inhibiting its release* *Neurotransmitter:* *Dopamine (DA) inhibits prolactin release* --- *2. Role of the Tuberoinfundibular Pathway in Endocrine Function* *Dopamine acts as an inhibitory factor on the pituitary gland* to **suppress prolactin secretion**. **Dopamine blockade (via antipsychotics) leads to increased prolactin**, causing **hyperprolactinemia**. --- *3. The Tuberoinfundibular Pathway & Antipsychotics* **First-Generation Antipsychotics (FGAs) & Some Second-Generation Antipsychotics (SGAs) block D2 receptors**, which **increases prolactin secretion**. *Hyperprolactinemia Symptoms:* *Women:* Amenorrhea, galactorrhea, infertility, decreased libido. *Men:* Gynecomastia, erectile dysfunction, decreased libido, osteoporosis. *Antipsychotics most associated with hyperprolactinemia:* *High risk:* *Risperidone, Paliperidone, Haloperidol, Fluphenazine* *Low risk:* *Aripiprazole, Quetiapine, Clozapine* (Aripiprazole is a **partial D2 agonist**, which stabilizes prolactin levels.) --- *4. Comparison of Dopaminergic Pathways (PMHNP Exam)* | *Pathway* | *Function* | *Effect of D2 Blockade* | |------------|------------|----------------------| | *Mesolimbic* | *Reward, motivation, positive symptoms of schizophrenia* | *Reduces positive symptoms* | | *Mesocortical* | *Cognition, emotion, negative symptoms of schizophrenia* | *Can worsen negative symptoms & cognitive deficits* | | *Nigrostriatal* | *Movement control (basal ganglia)* | *EPS (extrapyramidal symptoms), tardive dyskinesia* | | *Tuberoinfundibular* | *Regulates prolactin release* | *Hyperprolactinemia (gynecomastia, amenorrhea, sexual dysfunction)* | --- *5. PMHNP Exam Key Takeaways* *Tuberoinfundibular Pathway = Dopamine inhibits prolactin release.* *D2 blockade (by antipsychotics) → Increased prolactin → Hyperprolactinemia.* *High prolactin can cause amenorrhea, galactorrhea, gynecomastia, and infertility.* *Risperidone & Paliperidone have the highest risk of hyperprolactinemia.* *Aripiprazole is preferred for patients needing antipsychotics but at risk of hyperprolactinemia.* #PMHNP #mentalhealth #psychiatricnursing PMHNP,PMHNP EXAM,PMHNP Study,PMHNP EXAM PREP,PMHNP EXAM STUDY GUIDE