Psychiatric Disorders<br />
Definition of Depression<br />Feelings of depression may be described as feeling sad, blue, unhappy, miserable, or down in...
 Drug used in treament          depression<br />Tricyclic Antidepression(TCAs)<br />
Monoamine Oxidase Inhibitors<br />MAOIs  block the enzyme responsible for the breakdown of certain neurotransmitters such ...
CON<br />Switching aptient from anther anti depressant to MAOIs (wait 2week) except for fluoxetine 5-<br />6week)<br />Whe...
SELECTIVE SEROTONIN REUPTAKE INHIBITORS<br />
(Characteristics of( SSRIs<br />
Note<br />Because these have potent serotonergic activity,combination  with drug effecting serotonin can lead to serotonin...
Treament <br />-discontinuing the offending agent                         <br />
Adverese Effects<br />GIT Complaints,insomnia,restlessness,headache,and sexual dysfunction(Bupropion&Nefazodone appear to ...
Venlafaxine<br />Deual action (balanced NE&5-HT)<br />At lower dose the effect on serotonin predominates,As dose increased...
-TrazodoneSSRIS &Blocks 5-HT2A ,it dose not cause anticholinegic or cardiotoxic effects,cuase sedating effect<br />Nefazod...
Mirtazapine<br />Increase in NE&5-HT In the synapse<br />Side effect<br />Sedation,weight gain.constipation<br />Duloxetin...
Augmention Therapy<br />Augmention regimens include the following<br />-Lithium adding lithium help in the treament resisa...
BIPOLAR DISORER<br />Amanic episode is characterized by at least 1 week of abnormal elevated mood,(irritability,decrease n...
ANTIPSYCHOTIC DRUGS<br />Schizophrenia<br />Positive symptoms:<br />Thought disorders<br />Delusions<br />- Hallucinations...
Two Class For Treatment of  schizophrenia<br /><ul><li>1-Frist generation anti psychotic (FGAS)also called typical anti ps...
-This class of agents older anti psychotic agents as chlorpromazine was first agents
2-Second generation anti psychotic (SGAS) also called Atypical anti psychotic </li></li></ul><li>
Anti psychotic agent for treatment of  schizophrenia by chemical class<br />
CONT<br />
by potencyFGAS for treatment of SchizophreniaE.G))<br />
Second generation –anti pscyhotic<br /><ul><li>These agents were developed to reduce EPS
Risk of dyskinsia is reduce
-Ability to block 5-TH2</li></li></ul><li>Metabolic adverse effects of SGAS<br />
ANXIETY DISORDERS <br /><ul><li>1-Generalized anxiety characterized by 6month or more worry
2-Panic disorder sudden fear
3-Obsessive-compulsive disorder
4-Posttraumatic disorder (Sertaline first-line agent)
5-Social anxitey
6-Specific phobias(not treated with medication) </li></li></ul><li>OPTION FOR ANXIETY DISORDER <br /><ul><li>1-Benzodiazepine
2-Antidepressant
3-Buspiron
4-Miscellaneous agents
A)B-blcker
B)Monoamine oxide inhibitor
C)antihistamine( e.g.) hydroxyzine
D)Barbiturtes
E)Antipsychotics</li></li></ul><li>Half-liFes&potency of the most commonly prescribed Benzodiazepines.<br />
INSOMNIA<br />Insomnia is defined as inabilty to initiate or maintin sleep<br />TYPE OF INSOMNIA<br />Transient,duration 2...
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Anti pschyctitic drugs

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Anti pschyctitic drugs

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Anti pschyctitic drugs

  1. 1. Psychiatric Disorders<br />
  2. 2. Definition of Depression<br />Feelings of depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. <br />
  3. 3. Drug used in treament depression<br />Tricyclic Antidepression(TCAs)<br />
  4. 4. Monoamine Oxidase Inhibitors<br />MAOIs block the enzyme responsible for the breakdown of certain neurotransmitters such as NE.<br />They are effective for atypical depression (sleeping too much ,increased appetite,weight gain )<br />They should not be combined with other anti depressants.<br />
  5. 5. CON<br />Switching aptient from anther anti depressant to MAOIs (wait 2week) except for fluoxetine 5-<br />6week)<br />When swiching form MAOIs to anther anti depressant ,2week washout period ,EMSAM,it,is available in pach with (6mg/24h,9mg/24h,12mg/24h).<br />
  6. 6. SELECTIVE SEROTONIN REUPTAKE INHIBITORS<br />
  7. 7. (Characteristics of( SSRIs<br />
  8. 8. Note<br />Because these have potent serotonergic activity,combination with drug effecting serotonin can lead to serotonin syndrom (combination with MAOIs,dextromethorphan ,meperidine ,and other sympathomimetic) these can cause restlessness,tremor,diarrhea...etc<br />
  9. 9. Treament <br />-discontinuing the offending agent <br />
  10. 10. Adverese Effects<br />GIT Complaints,insomnia,restlessness,headache,and sexual dysfunction(Bupropion&Nefazodone appear to be less likely to cause sexual dysfunction <br />
  11. 11. Venlafaxine<br />Deual action (balanced NE&5-HT)<br />At lower dose the effect on serotonin predominates,As dose increased the effect on Nebecomev more<br />Side effect<br />AS SSRIS +mild HT<br />
  12. 12. -TrazodoneSSRIS &Blocks 5-HT2A ,it dose not cause anticholinegic or cardiotoxic effects,cuase sedating effect<br />Nefazodone 5-TH2A antgonist ,block 5-HT&NE,liver toxicity as side effect<br />Bupropion the parent drug block dopamine reuptake ,whereas the metabolite block NE reuptake (This class called noradrenalin-dopamine reuptake inhibitors.<br />
  13. 13. Mirtazapine<br />Increase in NE&5-HT In the synapse<br />Side effect<br />Sedation,weight gain.constipation<br />Duloxetine<br />Mixed NE/Serotonin reuptake blocker <br />Side effect liver toxicity,increase of B.P<br />
  14. 14. Augmention Therapy<br />Augmention regimens include the following<br />-Lithium adding lithium help in the treament resisant depression <br />-Thyroid also adding help in the resistant depression T3 is effective more than T4Buspiron<br /> - Seconed generation antipsyotic<br />
  15. 15. BIPOLAR DISORER<br />Amanic episode is characterized by at least 1 week of abnormal elevated mood,(irritability,decrease need for sleep,pleasure activities,poor attention)<br />A-bipolar 1(presence of manic episodes +major depressive<br />B-bipolar11(presence of major depression +hypomanic episodes<br />
  16. 16. ANTIPSYCHOTIC DRUGS<br />Schizophrenia<br />Positive symptoms:<br />Thought disorders<br />Delusions<br />- Hallucinations<br />- Paranoia<br />Negative symptoms:<br />- Amotivation<br />Social withdrawal<br />Flat affect<br />Poor speech<br />
  17. 17. Two Class For Treatment of schizophrenia<br /><ul><li>1-Frist generation anti psychotic (FGAS)also called typical anti psychotic
  18. 18. -This class of agents older anti psychotic agents as chlorpromazine was first agents
  19. 19. 2-Second generation anti psychotic (SGAS) also called Atypical anti psychotic </li></li></ul><li>
  20. 20. Anti psychotic agent for treatment of schizophrenia by chemical class<br />
  21. 21. CONT<br />
  22. 22. by potencyFGAS for treatment of SchizophreniaE.G))<br />
  23. 23. Second generation –anti pscyhotic<br /><ul><li>These agents were developed to reduce EPS
  24. 24. Risk of dyskinsia is reduce
  25. 25. -Ability to block 5-TH2</li></li></ul><li>Metabolic adverse effects of SGAS<br />
  26. 26. ANXIETY DISORDERS <br /><ul><li>1-Generalized anxiety characterized by 6month or more worry
  27. 27. 2-Panic disorder sudden fear
  28. 28. 3-Obsessive-compulsive disorder
  29. 29. 4-Posttraumatic disorder (Sertaline first-line agent)
  30. 30. 5-Social anxitey
  31. 31. 6-Specific phobias(not treated with medication) </li></li></ul><li>OPTION FOR ANXIETY DISORDER <br /><ul><li>1-Benzodiazepine
  32. 32. 2-Antidepressant
  33. 33. 3-Buspiron
  34. 34. 4-Miscellaneous agents
  35. 35. A)B-blcker
  36. 36. B)Monoamine oxide inhibitor
  37. 37. C)antihistamine( e.g.) hydroxyzine
  38. 38. D)Barbiturtes
  39. 39. E)Antipsychotics</li></li></ul><li>Half-liFes&potency of the most commonly prescribed Benzodiazepines.<br />
  40. 40. INSOMNIA<br />Insomnia is defined as inabilty to initiate or maintin sleep<br />TYPE OF INSOMNIA<br />Transient,duration 2-3 days ,actue environmental stress .<br />Short term less 3weeks ,continued personal stress. <br />Chronic more 3weeks,psychiatric illenss,medical cause sleep disorder <br />
  41. 41.
  42. 42. AGENT TO TREAT INSOMNIA<br /><ul><li>1-Barbiturate (no longer indicated )
  43. 43. 2-Non barbiturates e.g.(chloral hydrate)limited indication
  44. 44. 3-Benzodiazepine
  45. 45. 4-Non-benzodiazepine </li></li></ul><li>
  46. 46. BENZODIAZEPINE<br />
  47. 47. SIDE EFFECT<br />1-Tolerance&physical dependence may occur after long periods<br />2-Residual daytime sedation<br />3- Rebound insomnia this can occur when the drug is discontinued.<br />
  48. 48. NON-BENZODIAZEPINE<br />1-Zolpidem(Ambien),has sedative&hypnotic effect ,lack of anticovulsant action,lack of muscle relaxant , lower risk of tolerance &withdrwal<br />Half life 1.5-4h ,avoide inrenal &hepatic ptns<br />2-over-the counter medication as antihistamine<br />3-non-benzodiazepine tcas<br />
  49. 49. ALCOHOL -ABUSE<br />-Treament of actue alcohol withdrawal<br />Benzodiazepine can eliminate many of mamifestation of withrawal <br />Loading dose diazepam ,is given in adose of 10-20 mgevery 1-2 hour until the symptoms of withrawal are alleviated.<br />
  50. 50.
  51. 51. Benzodiazepine in treament of actue alcohol<br />
  52. 52. Nutritional considrtins<br />Thiamine 100mg im to prevent Wernick-Korsakoff syndrome<br />Magnesium, Electrolytes,Vitamins <br />-Fluid iv 5%dectrose soltuion with 0.5normal saline<br />-Hallucinations manage by benzodiazepine,and also seizures<br />
  53. 53. -B-blocker help with vital signs &blood pressure<br />ALph –Agonists (e.g clonidine)this agents will help withdrawal symptoms.<br />
  54. 54. Chronic therapy<br />Disulfiram thes drug blocks acetaldehyde dehydrogenase <br />-Naltrexone,it reduce alcohol craving<br />-Acamprosate it ,s new drug also ,reduce craving of alcohol.<br />
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