• Save
Psychopharmacoloy
Upcoming SlideShare
Loading in...5
×
 

Psychopharmacoloy

on

  • 598 views

 

Statistics

Views

Total Views
598
Views on SlideShare
598
Embed Views
0

Actions

Likes
2
Downloads
0
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Psychopharmacoloy Psychopharmacoloy Presentation Transcript

  •  
  • PSYCHOPHARMACOLOGY CHAIRPERSON DR. NAVEEN KUMAR C ASSISTANT PROFESSOR DEPARTMENT OF PSYCHIATRY NIMHANS PRESENTED BY PRAVEEN C THULASI 1 ST MSc NURSING NIMHANS
  • INTRODUCTION The advent of psychopharmacology in the last five and a half decades has brought the treatment of psychiatric disorders in the realm of scientific medicine. Introduction of chlorpromazine in 1952 revolutionized the treatment of psychiatric disorders . View slide
  • IDEAL PSYCHOTROPIC DRUG
    • Should cure underlying pathology.
    • Should benefit all patients suffering from that
    • disorder.
    • No side effects or toxicity.
    • Rapid onset of action.
    • No dependence or withdrawal symptoms on stopping.
    • No tolerance to the drug on longer duration.
    • Should not be lethal in overdoses.
    • used in both inpatient and outpatient settings
    View slide
  • CLASSIFICATION OF PSYCHOTROPIC DRUGS
    • Antipsychotics.
    • Antidepressants.
    • Mood stabilizing agents.
    • Anti anxiety and hypnotics.
    • Anti epileptics.
    • Antiparkinsonians .
  • PHARMACOLOGICAL ACTION OF PSYCHOTROPIC DRUGS
    • Agonist action at a receptor.
    • Antagonist action at a receptor.
    • Partial agonist action at a receptor.
    • Action via second messengers.
    • Altered neurotransmitter storage.
    • Increased neurotransmitter release.
    • Inhibition of neurotransmitter reuptake.
    • Inhibition of endogenous metabolism.
  • ANTIPSYCHOTICS
    • Indications: organic psychiatric disorders, non-organic psychotic disorders, child psychiatric disorders, neurotic and other psychiatric disorders, medical disorders.
    • Classes of drugs: phenothiazine(CPZ), thioxanthines (thiothixene), butyrophenones (haloperidol),diphenylbutylpiperidines (pimozide), indolicderivatives (molindone), dibenzoxazepines(loxapine),atypical antipsychotics ( clozapine, amisulpride, risperidone, olanzapine, quetiapine, aripiprazole)
  • SIDE EFFECTS OF ANTIPSYCHOTICs
    • Autonomic side effects: dry mouth, constipation, urinary retention, impotence, orthostatic hypotension.
    • EPSE : parkinsonian syndrome, dystonia, akathesia,
    • neuroleptic malignant syndrome.
    • Other CNS effects: seizures, sedation, depression or pseudo depression.
    • Metabolic and Endocrine side effect: weight gain, diabetes, galactorrhea with or without amenorrhea
    • Allergic side effects: cholestatic jaundice, agranulocytosis.
    • Cardiac , Ocular and Dermatological side effects.
  • ANTI DEPRESSANTS
    • Indication: depression, child psychiatric disorders
    • ( ADHD, Enuresis etc.),other psychiatric disorders
    • ( OCD, PTSD, alcohol dependence etc.), medical disorders ( chronic pain, migraine, peptic ulcer disease).
    • Class of drugs: cyclic antidepressants (imipramine, amitriptylline), SSRIs (fluoxetine, sertraline), SNRIs, NSREs, NaSSA, NDRIs, SARIs, NARIs, MAOIs
  • SIDE EFFECTS OF ANTI- DEPRESSANTS
    • Autonomic side effects: dry mouth, constipation, delirium, urinary retention.
    • Sexual side effects: impotence, anorgasmia.
    • CNS effects: sedation, withdrawal syndrome, seizures.
    • Cardiac side effects: Tachycardia, Arrhythmias.
    • Allergic side effects: Agranulocytosis.
    • Metabolic and Endocrine side effects.
    • Toxicity
  • MOOD STABILIZING DRUGS
    • Indication: treatment acute mania, prophylaxis for BPAD, neurological disorders, seizures, schizo - affective disorders, paroxysmal pain syndrome.
    • Class of drugs: Lithium , Valproate, Carbamazepine .
  • SIDE EFFECTS OF MOOD STABILIZERS
    • LITHIUM: therapeutic level – 0.6-1.2 mEq/L
    • prophylaxis – 0.6-1 mEq/L
    • toxic -- >2 mEq/ L
    • Neurological (tremor, muscular weakness, neurotoxicity), renal (polyuria, polydipsia), cardiovascular (T- wave depression), endocrine (goiter, hypothyroidism, abnormal thyroid function, weight gain), G I effects (nausea, vomiting, diarrhea, metallic taste and abdominal pain), side effect during pregnancy and lactation (teratogenicity, secreted through milk)
  • SIDE EFFECTS cont.….
    • Valproate : nausea, sedation, tremor, weight gain, thrombocytopenia, menstrual disturbances, hair loss.
    • Most serious but relatively uncommon side effects include hepatic toxicity, acute hemorrhagic pancreatitis.
    • Dialysis is the management during overdose
  • SIDE EFFECTS cont.…..
    • Carbamazepine: diplopia, drowsiness, dizziness, photosensitivity, hypertension, leucopenia etc.
    • The most dangerous side effects include bone marrow suppression and cardiovascular collapse
  • ANTI ANXIETY AND HYPNOSEDATIVES
    • Indication: generalized anxiety disorder, panic disorder, insomnia, narcoanalysis, premedication in anesthesia etc.
    • Classification: barbiturates (phenobarbital, thiopentone), Non barbiturates, Non-benzodiazepine anti anxiety agents(ethanol, chloral hydrate, propranolol), benzodiazepines
    • ( midazolam, alprazolam, diazepam, clonazepam)
  • SIDE EFFECTS
    • Nausea, vomiting, weakness, epigastric pain, vertigo, impotence, sedation, dry mouth, irritability, dis inhibited behavior, dependence and withdrawal.
    • Commonly abused drugs are from this group
  • ANTI EPILEPTICS
    • Indication: seizures.
    • Drugs: phenytoin sodium, clonazepam, diazepam, lorazepam, carbamazepine, valproate sodium, lamotrigine, gabapentin.
  • SIDE EFFECTS OF ANTI EPILEPTICS
    • Phenytoin sodium:
    • Delirium, nystagmus, ataxia, incoordination, dysarthria, hand tremors
    • Skin rash, toxic epidermal necrolysis.
    • Cerebellar atrophy, peripheral neuropathy,
    • Gingival hyperplasia.
  • SIDE EFFECTS OF ANTI EPILEPTICS
    • Phenytoin sodium:
  • ANTI PARKINSONIAN
    • Indication: Parkinson's disease, prevent EPS.
    • Class of drugs: THP, Levodopa and carbidopa, selegiline, pramipexole.
  • SIDE EFFECTS OF ANTI PARKINSONIAN
    • THP: Drowsiness, head ache, vertigo, sleep disturbance, mydriasis with or without photo phobia, blurred vision, dry mouth.
    • Levodopa: hypotension, arrhythmias, nausea, hair loss, G I bleed, dis orientation and confusion. Chronic use leads to on/off oscillation, dyskinesia, freezing during movement, drug resistance.
  •