Anti psychotics
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This document discusses anti-psychotic medications. It describes how anti-psychotics work by inhibiting dopamine to treat psychosis symptoms. The document categorizes anti-psychotics as first-generation or typical, and second-generation or atypical. Typical anti-psychotics are further divided into basal and incisive, while atypical anti-psychotics have multi-receptor targets and include multi-acting receptor targeted antagonists, dopamine-serotonin antagonists, dopamine D2-D3 antagonists, and a dopamine partial agonist. The document notes the pharmacokinetics, side effects, and therapeutic strategies for using anti-psychotics.
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Antipsychotics - Pharmacology
Antipsychotic drugs are primarily used to treat schizophrenia and other psychotic disorders by reducing hallucinations, delusions, and other positive symptoms. They are categorized into first-generation antipsychotics that are associated with movement disorders, and second-generation antipsychotics that have fewer extrapyramidal side effects but higher risks of metabolic adverse effects. While antipsychotics do not cure schizophrenia, they can help control symptoms and allow patients to function better with support. Long-term maintenance treatment is often required to prevent relapse of psychotic episodes.
Anti psychotic drugs
This document discusses antipsychotic drugs used to treat schizophrenia and their mechanisms of action and side effects. It focuses on typical antipsychotics which block dopamine D2 receptors in the mesolimbic system. These drugs are used to treat schizophrenia, drug-induced psychoses, and other disorders. Potential adverse effects include sedation, hypotension, anticholinergic effects, extrapyramidal symptoms, weight gain, and tardive dyskinesia. The document also discusses lithium, which is a mood stabilizer used to treat bipolar disorder, and its mechanisms of action and alternatives including sodium valproate, lorazepam, carbamazepine, and lamotrigine.
Mood Stabilisers (Antimanic drugs)
This document discusses mood stabilizers used to treat bipolar disorder. It describes the symptoms of mania and depression in bipolar disorder. Lithium, valproic acid, carbamazepine, lamotrigine and various antipsychotics are described as first-line mood stabilizing agents. The mechanisms of action of these drugs involve inhibition of inositol monophosphatase and other enzymes, decreasing intracellular inositol levels. Novel targets for treating bipolar disorder discussed include inhibition of glycogen synthase kinase-3, protein kinase C, modulation of brain-derived neurotrophic factor, enhanced Bcl2 expression, effects on oxidative stress, and modulation of glutamatergic transmission.
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Trazodone is a serotonin antagonist and reuptake inhibitor (SARI) antidepressant. The document discusses various classes of antidepressants including their mechanisms of action, indications, side effects and classifications such as SSRIs, SNRIs, TCAs, MAOIs and others. It provides an overview of the neurobiology of depression and genetics as well as guidelines on treatment duration.
Drug Profile: Aripiprazole
This document discusses schizophrenia and the atypical antipsychotic drug aripiprazole. It defines schizophrenia as a mental disorder where patients have difficulties determining what is real, thinking clearly, having normal emotions, and acting normally socially. It then describes the positive and negative symptoms of schizophrenia. The document outlines aripiprazole's uses in treating schizophrenia, bipolar mania, depression and agitation, as well as its mechanism of action, pharmacokinetics, side effects, drug interactions and comparisons to chlorpromazine. It concludes that aripiprazole is a second-generation antipsychotic that is better than chlorpromazine due to its partial agonist activity at dopamine D2 receptors resulting in milder extra
Tricyclic antidepressants
Tricyclic antidepressants (TCAs) share similar chemical structures and biological properties. They are highly lipophilic and tissue-bound outside the central nervous system. Their anticholinergic and noradrenergic effects can cause unpleasant or dangerous side effects. Examples of TCAs described include imipramine, desipramine, clomipramine, amitriptyline, nortriptyline, protriptyline, trimipramine, doxepin, and maprotiline. Selective serotonin reuptake inhibitors have a different structure but some TCAs are metabolized into compounds that are selective norepinephrine reuptake inhibitors. Examples given are flu
Antipsychotic drugs
Psychiatric conditions are divided into psychosis, neurosis, and affective disorders. Psychosis involves loss of contact with reality and includes schizophrenia. Neurosis involves anxiety disorders like phobias and obsessive-compulsive disorder. Affective disorders are mood disorders like depression and bipolar disorder. Psychotropic drugs treat these conditions by affecting neurotransmitters like dopamine, serotonin, and norepinephrine in the limbic system and other brain areas. Common psychotropic drugs include antipsychotics, antidepressants, and anxiolytics which have multiple mechanisms of action in the brain and body.
Antipsychotic Agents
The document discusses antipsychotic agents and schizophrenia. It provides details on the history and development of antipsychotic medications, including the accidental discovery of chlorpromazine. It describes psychosis and the different types. The document discusses the dopamine hypothesis of schizophrenia and the roles of dopamine, serotonin, glutamate, and other neurotransmitters. It outlines animal models of schizophrenia and current understandings of the pathophysiology.
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Antipsychotics - Pharmacology
Antipsychotic drugs are primarily used to treat schizophrenia and other psychotic disorders by reducing hallucinations, delusions, and other positive symptoms. They are categorized into first-generation antipsychotics that are associated with movement disorders, and second-generation antipsychotics that have fewer extrapyramidal side effects but higher risks of metabolic adverse effects. While antipsychotics do not cure schizophrenia, they can help control symptoms and allow patients to function better with support. Long-term maintenance treatment is often required to prevent relapse of psychotic episodes.
Anti psychotic drugs
This document discusses antipsychotic drugs used to treat schizophrenia and their mechanisms of action and side effects. It focuses on typical antipsychotics which block dopamine D2 receptors in the mesolimbic system. These drugs are used to treat schizophrenia, drug-induced psychoses, and other disorders. Potential adverse effects include sedation, hypotension, anticholinergic effects, extrapyramidal symptoms, weight gain, and tardive dyskinesia. The document also discusses lithium, which is a mood stabilizer used to treat bipolar disorder, and its mechanisms of action and alternatives including sodium valproate, lorazepam, carbamazepine, and lamotrigine.
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This document discusses schizophrenia and the atypical antipsychotic drug aripiprazole. It defines schizophrenia as a mental disorder where patients have difficulties determining what is real, thinking clearly, having normal emotions, and acting normally socially. It then describes the positive and negative symptoms of schizophrenia. The document outlines aripiprazole's uses in treating schizophrenia, bipolar mania, depression and agitation, as well as its mechanism of action, pharmacokinetics, side effects, drug interactions and comparisons to chlorpromazine. It concludes that aripiprazole is a second-generation antipsychotic that is better than chlorpromazine due to its partial agonist activity at dopamine D2 receptors resulting in milder extra
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Antipsychotic drugs
Psychiatric conditions are divided into psychosis, neurosis, and affective disorders. Psychosis involves loss of contact with reality and includes schizophrenia. Neurosis involves anxiety disorders like phobias and obsessive-compulsive disorder. Affective disorders are mood disorders like depression and bipolar disorder. Psychotropic drugs treat these conditions by affecting neurotransmitters like dopamine, serotonin, and norepinephrine in the limbic system and other brain areas. Common psychotropic drugs include antipsychotics, antidepressants, and anxiolytics which have multiple mechanisms of action in the brain and body.
Antipsychotic Agents
The document discusses antipsychotic agents and schizophrenia. It provides details on the history and development of antipsychotic medications, including the accidental discovery of chlorpromazine. It describes psychosis and the different types. The document discusses the dopamine hypothesis of schizophrenia and the roles of dopamine, serotonin, glutamate, and other neurotransmitters. It outlines animal models of schizophrenia and current understandings of the pathophysiology.
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Amphetamine is used to treat narcolepsy and attention deficit disorder with hyperactivity (ADHD).
Amphetamine may also be used for purposes other than those listed in this medication guide.
Treatment of psychosis
There are three main points covered in the document:
1. Psychosis is a thought disorder characterized by disturbances in reality, perception, cognition, and affect. It encompasses several mental disorders including schizophrenia.
2. Schizophrenia is a type of psychosis characterized by severe personality changes and thought disorders. It has an onset in late teens to early twenties and has both genetic and environmental risk factors.
3. Antipsychotic drugs treat psychosis by blocking dopamine D2 receptors in the brain. Older "typical" antipsychotics are more likely to cause extrapyramidal side effects while newer "atypical" antipsychotics have fewer neurological side effects.
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This document provides an overview of schizophrenia, including its definition, epidemiology, etiology, classification, pathophysiology, clinical presentation, diagnosis, and management. Some key points are:
- Schizophrenia is a chronic mental disorder characterized by delusions, hallucinations, disorganized speech/behavior, and impaired cognitive ability.
- It affects over 21 million people worldwide, with about 1.1% of the US population affected. Onset is typically earlier in males.
- Etiology includes genetic, viral, immune, and birth complications. Family history increases risk.
- Symptoms include positive symptoms like hallucinations and delusions, as well as negative symptoms impacting emotion and cognition.
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This document discusses antidepressant drugs and their mechanisms of action. It begins by describing how antidepressants work by altering neurotransmitter systems like serotonin and norepinephrine in the brain. Several classes of antidepressants are then discussed, including MAOIs, TCAs, SSRIs, SNRIs, and NDRIs. Each works differently but generally aims to increase neurotransmitter activity in the brain. The document examines specific drugs in each class, their history, mechanisms, and common side effects. Mood disorders like depression and bipolar disorder are also briefly overviewed.
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Anti psychotic drugs
This document discusses the case of a 45-year-old male patient brought to the emergency department in an agitated state. His symptoms meet the diagnostic criteria for schizophrenia. He is initially treated with haloperidol to control his agitation. After 2 weeks, his symptoms improve and he is started on an atypical antipsychotic for long-term stabilization. The document then discusses various first and second generation antipsychotics, their mechanisms of action, indications, side effects, and monitoring considerations.
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Antipsychotics
The document provides an overview of psychosis, schizophrenia, and the neurobiology and pharmacology of antipsychotic medications. It describes the positive, negative, and cognitive symptoms of schizophrenia and discusses several neurotransmitter hypotheses. It then outlines the mechanisms and side effects of first-generation and second-generation antipsychotics, including their actions on dopamine, serotonin, and other receptors. Individual antipsychotic drugs are also summarized in terms of their clinical uses and adverse effect profiles.
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This document discusses antipsychotic medications. It begins by defining psychotic disorders like schizophrenia and their symptoms. It then describes the dopamine, serotonin, and glutamate hypotheses for the causes of schizophrenia. The rest of the document summarizes different classes of antipsychotic medications, including their mechanisms of action, uses, and side effects. It covers both typical/first generation antipsychotics like chlorpromazine as well as atypical/second generation antipsychotics like clozapine, risperidone, and quetiapine.
Antipsychotic drug
This document provides an overview of schizophrenia and antipsychotic drugs. It discusses the history and classification of schizophrenia, as well as hypotheses for its mechanisms. It then describes the classification, mechanisms of action, uses, and adverse effects of various antipsychotic drugs, including first-generation antipsychotics/neuroleptics and newer second-generation atypical antipsychotics. Recent research advances discussed include studies on adjunctive treatments using drugs like raloxifene, N-acetyl cysteine, and estrogen to improve outcomes of antipsychotic treatment.
Clozapine
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Typical antipsychotics
This document provides a summary of typical antipsychotic drugs. It discusses the history of antipsychotics beginning with phenothiazines in the 1950s. It then classifies typical antipsychotics and describes their pharmacokinetics, mechanisms of action, indications, precautions, adverse reactions, and reviews several individual drugs including chlorpromazine, fluphenazine, haloperidol, and zuclopenthixol.
Antipsychotic agents
The document discusses antipsychotic drugs and their mechanisms of action. It begins by defining neuroleptics as antipsychotics that cause extrapyramidal side effects. It notes that chlorpromazine was the first neuroleptic discovered and acts by blocking dopamine receptors. Clozapine was later found to cause fewer side effects and marked a shift towards atypical antipsychotics. The document then discusses the serotonin hypothesis and dopamine hypothesis of schizophrenia and mechanisms of typical and atypical antipsychotics.
Atypical antipsychotics
This document provides information on the pharmacology of second generation antipsychotics. It discusses the history and development of antipsychotic drugs from chlorpromazine to clozapine. It describes the mechanisms of action of atypical antipsychotics including their effects on serotonin and dopamine receptors. The document classifies antipsychotics and examines the pharmacology of individual drugs like clozapine, risperidone, and olanzapine, covering their indications, mechanisms, side effects and interactions.
Pharmacotherapy of Schizophrenia
Schizophrenia is a mental disorder characterized by hallucinations and delusions. The exact cause is unknown but there are several hypotheses including a dopamine imbalance in the brain. Symptoms include changes in behavior, speech abnormalities, hallucinations, and delusions. Treatment involves antipsychotic medications which work by blocking dopamine receptors in the brain. While medications can help control symptoms, schizophrenia has no cure and often becomes a chronic condition.
Antidepressant drugs
This document discusses several classes of drugs used to treat bipolar disorder, including lithium, anticonvulsants, and various antidepressants. It provides information on the pharmacokinetics, mechanisms of action, therapeutic uses, adverse effects, drug interactions, and contraindications of these drugs. Specifically, it notes that lithium is the drug of choice for long-term treatment and prevention of relapse in bipolar disorder, while sodium valproate is often used in the acute treatment of mania. The document also discusses various antidepressants like SSRIs, TCAs, atypical antidepressants, and MAOIs that can be used but have risks of triggering mania or serotonin syndrome.
Ssri.ppt 2013
SSRIs are a class of antidepressant drugs that work by inhibiting the reuptake of serotonin in the brain. They are commonly used to treat depression but also anxiety, OCD, and other disorders. While SSRIs take weeks to have an effect due to their mechanism of action beyond just increasing serotonin levels, they have fewer side effects than older antidepressants. Common side effects include nausea, sexual dysfunction, insomnia, and headaches. Drug interactions can occur and serotonin syndrome is a potential risk. SSRIs are generally preferred over older antidepressants due to their safety profile.
anti-psychotic drugs
The document discusses various types of anti-psychotic drugs, including their classification, mechanisms of action, pharmacokinetics, clinical indications, and adverse effects. It focuses on drugs that block dopamine receptors in the brain to treat schizophrenia and other psychoses by modifying dopaminergic activity. The drugs discussed include both typical and atypical antipsychotics, as well as mood stabilizers like lithium that are used to treat bipolar disorder.
Antidepressants Pharmacology
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Antipsychotics
Antipsychotic drugs, also known as neuroleptics, are used to treat psychotic disorders like schizophrenia. There are two main types - first generation "typical" antipsychotics that are associated with more extrapyramidal side effects, and second generation "atypical" antipsychotics that have fewer of these motor side effects. Antipsychotics work by blocking dopamine receptors in the brain, particularly in the mesolimbic pathway. They can have various adverse effects involving the cardiovascular, nervous, endocrine and other body systems. Proper management of these drugs requires monitoring for potential toxic reactions and drug interactions.
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Amphetamine is a stimulant and an appetite suppressant. It stimulates the central nervous system (nerves and brain) by increasing the amount of certain chemicals in the body. This increases heart rate and blood pressure and decreases appetite, among other effects.
Amphetamine is used to treat narcolepsy and attention deficit disorder with hyperactivity (ADHD).
Amphetamine may also be used for purposes other than those listed in this medication guide.
Treatment of psychosis
There are three main points covered in the document:
1. Psychosis is a thought disorder characterized by disturbances in reality, perception, cognition, and affect. It encompasses several mental disorders including schizophrenia.
2. Schizophrenia is a type of psychosis characterized by severe personality changes and thought disorders. It has an onset in late teens to early twenties and has both genetic and environmental risk factors.
3. Antipsychotic drugs treat psychosis by blocking dopamine D2 receptors in the brain. Older "typical" antipsychotics are more likely to cause extrapyramidal side effects while newer "atypical" antipsychotics have fewer neurological side effects.
Schizophrenia
This document provides an overview of schizophrenia, including its definition, epidemiology, etiology, classification, pathophysiology, clinical presentation, diagnosis, and management. Some key points are:
- Schizophrenia is a chronic mental disorder characterized by delusions, hallucinations, disorganized speech/behavior, and impaired cognitive ability.
- It affects over 21 million people worldwide, with about 1.1% of the US population affected. Onset is typically earlier in males.
- Etiology includes genetic, viral, immune, and birth complications. Family history increases risk.
- Symptoms include positive symptoms like hallucinations and delusions, as well as negative symptoms impacting emotion and cognition.
Antidepressant drugs
This document discusses antidepressant drugs and their mechanisms of action. It begins by describing how antidepressants work by altering neurotransmitter systems like serotonin and norepinephrine in the brain. Several classes of antidepressants are then discussed, including MAOIs, TCAs, SSRIs, SNRIs, and NDRIs. Each works differently but generally aims to increase neurotransmitter activity in the brain. The document examines specific drugs in each class, their history, mechanisms, and common side effects. Mood disorders like depression and bipolar disorder are also briefly overviewed.
Antidepressants
This document discusses various classes of antidepressant drugs, including their mechanisms of action, classifications, and side effects. It describes how tricyclic antidepressants and selective serotonin reuptake inhibitors work by inhibiting the reuptake of neurotransmitters like serotonin and norepinephrine. Monoamine oxidase inhibitors are also covered, noting how they work by inhibiting the enzyme MAO. The summary provides an overview of the major classes of antidepressants and their clinical applications and risks.
Anti psychotic drugs
This document discusses the case of a 45-year-old male patient brought to the emergency department in an agitated state. His symptoms meet the diagnostic criteria for schizophrenia. He is initially treated with haloperidol to control his agitation. After 2 weeks, his symptoms improve and he is started on an atypical antipsychotic for long-term stabilization. The document then discusses various first and second generation antipsychotics, their mechanisms of action, indications, side effects, and monitoring considerations.
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This document discusses depression, mania, and various antidepressant medications. It covers the symptoms of depression and mania. It then discusses various classes of antidepressants including SSRIs, SNRIs, TCAs, MAOIs, and atypical antidepressants. For each class, it describes the mechanisms of action, therapeutic uses, adverse effects, and examples of medications within the class.
Antipsychotics
The document provides an overview of psychosis, schizophrenia, and the neurobiology and pharmacology of antipsychotic medications. It describes the positive, negative, and cognitive symptoms of schizophrenia and discusses several neurotransmitter hypotheses. It then outlines the mechanisms and side effects of first-generation and second-generation antipsychotics, including their actions on dopamine, serotonin, and other receptors. Individual antipsychotic drugs are also summarized in terms of their clinical uses and adverse effect profiles.
Pharmacotherapy of antipsychotics
This document discusses antipsychotic medications. It begins by defining psychotic disorders like schizophrenia and their symptoms. It then describes the dopamine, serotonin, and glutamate hypotheses for the causes of schizophrenia. The rest of the document summarizes different classes of antipsychotic medications, including their mechanisms of action, uses, and side effects. It covers both typical/first generation antipsychotics like chlorpromazine as well as atypical/second generation antipsychotics like clozapine, risperidone, and quetiapine.
Antipsychotic drug
This document provides an overview of schizophrenia and antipsychotic drugs. It discusses the history and classification of schizophrenia, as well as hypotheses for its mechanisms. It then describes the classification, mechanisms of action, uses, and adverse effects of various antipsychotic drugs, including first-generation antipsychotics/neuroleptics and newer second-generation atypical antipsychotics. Recent research advances discussed include studies on adjunctive treatments using drugs like raloxifene, N-acetyl cysteine, and estrogen to improve outcomes of antipsychotic treatment.
Clozapine
Clozapine is an atypical antipsychotic that was the first to be developed. It was introduced in Europe in 1971 but withdrawn in 1975 due to fatal agranulocytosis in some patients. In 1989, studies showed it was more effective than other antipsychotics for schizophrenia, and the FDA approved its use for treatment-resistant schizophrenia with mandatory blood monitoring. Clozapine has a black box warning for agranulocytosis and requires monitoring of white blood cell and absolute neutrophil counts before each prescription. It is initiated at a low dose and gradually titrated up to achieve therapeutic effects while minimizing side effects.
Depression
Depression is a syndrome characterized by low mood and loss of interest. Antidepressants work by increasing levels of neurotransmitters like serotonin and norepinephrine. There are several classes of antidepressants including SSRIs, SNRIs, TCAs, and MAOIs. They have various mechanisms of action and side effects that depend on their pharmacological properties. Other CNS stimulants like caffeine, amphetamines, and modafinil work by increasing neurotransmitters to improve alertness, but can also cause side effects like anxiety, insomnia, and dependence.
Typical antipsychotics
This document provides a summary of typical antipsychotic drugs. It discusses the history of antipsychotics beginning with phenothiazines in the 1950s. It then classifies typical antipsychotics and describes their pharmacokinetics, mechanisms of action, indications, precautions, adverse reactions, and reviews several individual drugs including chlorpromazine, fluphenazine, haloperidol, and zuclopenthixol.
Antipsychotic agents
The document discusses antipsychotic drugs and their mechanisms of action. It begins by defining neuroleptics as antipsychotics that cause extrapyramidal side effects. It notes that chlorpromazine was the first neuroleptic discovered and acts by blocking dopamine receptors. Clozapine was later found to cause fewer side effects and marked a shift towards atypical antipsychotics. The document then discusses the serotonin hypothesis and dopamine hypothesis of schizophrenia and mechanisms of typical and atypical antipsychotics.
Atypical antipsychotics
This document provides information on the pharmacology of second generation antipsychotics. It discusses the history and development of antipsychotic drugs from chlorpromazine to clozapine. It describes the mechanisms of action of atypical antipsychotics including their effects on serotonin and dopamine receptors. The document classifies antipsychotics and examines the pharmacology of individual drugs like clozapine, risperidone, and olanzapine, covering their indications, mechanisms, side effects and interactions.
Pharmacotherapy of Schizophrenia
Schizophrenia is a mental disorder characterized by hallucinations and delusions. The exact cause is unknown but there are several hypotheses including a dopamine imbalance in the brain. Symptoms include changes in behavior, speech abnormalities, hallucinations, and delusions. Treatment involves antipsychotic medications which work by blocking dopamine receptors in the brain. While medications can help control symptoms, schizophrenia has no cure and often becomes a chronic condition.
Antidepressant drugs
This document discusses several classes of drugs used to treat bipolar disorder, including lithium, anticonvulsants, and various antidepressants. It provides information on the pharmacokinetics, mechanisms of action, therapeutic uses, adverse effects, drug interactions, and contraindications of these drugs. Specifically, it notes that lithium is the drug of choice for long-term treatment and prevention of relapse in bipolar disorder, while sodium valproate is often used in the acute treatment of mania. The document also discusses various antidepressants like SSRIs, TCAs, atypical antidepressants, and MAOIs that can be used but have risks of triggering mania or serotonin syndrome.
Ssri.ppt 2013
SSRIs are a class of antidepressant drugs that work by inhibiting the reuptake of serotonin in the brain. They are commonly used to treat depression but also anxiety, OCD, and other disorders. While SSRIs take weeks to have an effect due to their mechanism of action beyond just increasing serotonin levels, they have fewer side effects than older antidepressants. Common side effects include nausea, sexual dysfunction, insomnia, and headaches. Drug interactions can occur and serotonin syndrome is a potential risk. SSRIs are generally preferred over older antidepressants due to their safety profile.
anti-psychotic drugs
The document discusses various types of anti-psychotic drugs, including their classification, mechanisms of action, pharmacokinetics, clinical indications, and adverse effects. It focuses on drugs that block dopamine receptors in the brain to treat schizophrenia and other psychoses by modifying dopaminergic activity. The drugs discussed include both typical and atypical antipsychotics, as well as mood stabilizers like lithium that are used to treat bipolar disorder.
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Antipsychotic drugs, also known as neuroleptics, are used to treat psychotic disorders like schizophrenia. There are two main types - first generation "typical" antipsychotics that are associated with more extrapyramidal side effects, and second generation "atypical" antipsychotics that have fewer of these motor side effects. Antipsychotics work by blocking dopamine receptors in the brain, particularly in the mesolimbic pathway. They can have various adverse effects involving the cardiovascular, nervous, endocrine and other body systems. Proper management of these drugs requires monitoring for potential toxic reactions and drug interactions.
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Anti psychotics
Antipsychotic drugs like phenothiazines and butyrophenones were initially used to treat psychotic disorders by blocking dopamine receptors, but often caused serious side effects. Newer atypical antipsychotics have been developed that are more selective in their receptor targeting, reducing side effects. Current research focuses on individualizing treatment and developing drugs that target other neurotransmitter systems beyond just dopamine to better treat symptoms with fewer side effects.
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Anti psychotics
This document discusses various anti-psychotic and mood stabilizing medications, including their indications, mechanisms of action, side effects, and drug interactions. It provides examples of common anti-psychotic medications like haloperidol, olanzapine, quetiapine, and risperidone. It also discusses lithium, valproic acid, and carbamazepine as common mood stabilizing agents. The document ends with a case study describing a patient found wandering in a park in army fatigues who is brought to the emergency room and is on multiple medications.
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Barbiturates
Barbiturates such as thiopental and methohexital act as central nervous system depressants by enhancing the effects of the neurotransmitter GABA at GABA-A receptors. Thiopental is commonly used for induction of general anesthesia due to its rapid onset and short duration of action. It has a narrow therapeutic index, so proper dosing is important to achieve hypnosis without causing respiratory depression or cardiovascular complications. While barbiturates can provide neuroprotective effects at high doses, their use remains controversial except for certain clinical scenarios like incomplete brain ischemia. Potential adverse effects include hypotension, apnea, allergy, and tissue damage if injected intra-arterially rather than intravenously.
Antipsychotics
This document discusses antipsychotic and mood stabilizing drugs. It begins by classifying antipsychotics such as phenothiazines, butyrophenones, and atypical antipsychotics. It then describes the mechanism of action, uses, and adverse effects of typical antipsychotics like chlorpromazine and haloperidol. Atypical antipsychotics like clozapine and risperidone are also discussed. The document also covers mood stabilizers lithium and sodium valproate, focusing on lithium's mechanism and use in treating mania and bipolar disorder. Management of schizophrenia, mania, and bipolar disorder is described.
Antipsychotic drugs
Anti-psychotic drugs work by blocking dopamine D2 receptors in the brain and are used to treat schizophrenia and other psychotic disorders. They are categorized as either typical or atypical, with atypical drugs blocking additional serotonin receptors and being less likely to cause motor side effects. Common types include risperidone, olanzapine, quetiapine, and clozapine. While effective in reducing psychotic symptoms, anti-psychotics may cause movement disorders or other side effects depending on their receptor affinities. Long-term treatment can help prevent recurrence of psychotic episodes.
Mood stabilizers
This document discusses mood stabilizers, which are medications used to treat mood disorders like bipolar disorder. It describes bipolar disorder and its symptoms. The main types of mood stabilizers are lithium, anticonvulsants like valproate and carbamazepine, and antipsychotics. Lithium was one of the first mood stabilizers and works by interfering with cell signaling pathways. Anticonvulsants also have mood stabilizing effects through mechanisms like enhancing GABA. Antipsychotics are used to treat mania and can have side effects like extrapyramidal symptoms. The goals of treatment are to reduce symptoms, prevent relapse, and improve functioning while reducing risks.
Lithium
Lithium is approved for treating bipolar disorder and is dosed based on achieving a target serum level. Common side effects include thyroid dysfunction, diabetes insipidus, tremor, weight gain and cognitive impairment. Dosing must be adjusted for renal impairment and in elderly patients due to reduced clearance. Lithium has a half-life of 14-24 hours and is primarily excreted unchanged in the urine. Monitoring of serum levels and side effects is important during long-term lithium treatment.
Barbiturates
Barbiturates are a class of drugs that act as central nervous system depressants and were one of the first intravenous anesthetic agents used clinically, with thiopental and methohexital being two examples that are ultra short-acting and can be used for anesthetic induction. Barbiturates work by enhancing the effects of the inhibitory neurotransmitter GABA in the brain and have a variety of clinical uses but also potential adverse effects like respiratory depression if overdosed.
Barbiturates
Barbiturates are derivatives of barbituric acid that act as central nervous system depressants. They have multiple mechanisms of action in the brain involving GABA receptors and ion channels. Barbiturates are classified based on their duration of action and include long, intermediate, short, and ultrashort-acting varieties. While once widely used as sedatives, hypnotics, and for anesthesia, barbiturates have significant disadvantages like low therapeutic index, drug interactions, abuse potential, and severe withdrawal syndrome. Newer agents like benzodiazepines, buspirone, zolpidem, and zaleplon have replaced barbiturates for most indications due to safer profiles
Histamine and antihistaminics
John, a 24-year old male, suffers from seasonal allergic rhinitis every winter causing a runny nose, itchy eyes, and sneezing. He takes an over-the-counter antihistamine, diphenhydramine, to relieve his symptoms but it causes drowsiness and dry mouth. His doctor prescribes loratadine which effectively treats his allergies without side effects. Histamine is released during allergic reactions, binding to H1 receptors and causing symptoms. First-generation antihistamines like diphenhydramine relieve symptoms by blocking H1 receptors but cross the blood-brain barrier, while second-generation drugs like loratadine do not cross
Antihistamines
Introduction
Biosynthesis
Metabolism
Receptors
SAR
Drugs
Mechanism of action
Uses of antihistamines
Conclusion
References
Antihistamine
Histamine is a chemical released during allergic reactions that causes symptoms like sneezing, itching, and runny nose. It works by binding to H1 receptors, especially in the nose, lungs, and skin. Antihistamines block this binding and relieve allergy symptoms. First-generation antihistamines like diphenhydramine can cause drowsiness by crossing the blood-brain barrier, while second-generation drugs like loratadine and fexofenadine mainly work in the periphery and have fewer side effects. Antihistamines are used to treat allergic conditions, nausea, motion sickness, and other issues involving the H1 receptor.
Barbiturates
Sedatives and hypnotics work by calming agitation, inducing sleep, and reducing anxiety. Barbiturates are central nervous system depressants that produce their effects by potentiating the inhibitory neurotransmitter GABA. Their mechanism of action, uses, synthesis, and structure-activity relationships are described. While formerly widely used, barbiturates have largely been replaced by benzodiazepines due to risks of addiction and tolerance. Other sedative-hypnotics discussed include paraldehyde, chloral hydrate, alcohols, ethchlorvynol, and glutarimide derivatives.
Antipsychotic drugs
Antipsychotic drugs are primarily used to treat schizophrenia and other psychotic disorders by decreasing hallucinations, delusions, and permitting patients to function better. First-generation ("typical") antipsychotics like chlorpromazine work mainly by blocking dopamine receptors in the brain. Second-generation ("atypical") antipsychotics have fewer motor side effects and also block serotonin receptors. Clozapine was the first atypical drug and is effective for treatment-resistant cases but requires blood monitoring due to risk of agranulocytosis. Risperidone and olanzapine are also widely used atypical antipsychotics.
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Schizophrenia A chronic mental disorder involving a breakdown in the relation between thought, emotion, and behaviour, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.
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Anti psychotics
- 1. Anti-Psychotics Mgr. Malek Azar CHARLES UNIVERSITY IN PRAGUE FACULTY OF PHARMACY
- 2. Psychosis • A mental disorder characterized by loss of contact with reality caused by excess of dopamine in the limbic system in the brain. • Types of psychosis: Schizophrenia, Bipolar disorder, others. Psychosis Symptoms Positive Negative Hallucination Cognitive, Emotional Impairment Delusions Isolation Agitation Apathy
- 3. Anti-Psychotics • They are medications used in psychosis by inhibiting dopamine (D). • They are divided into two main parts: 1st Generation 2nd Generation • They may be used in: Aggressive patients, vomiting, bipolar disorder, refractory pain, depression and anxiety.
- 4. Pharmacokinetics • Mainly orally • Good absorption • High lipophilicity • Extensively metabolized in the liver by CYP450 • Once daily (long half life)
- 5. Side Effects Mainly they inhibit dopamine receptors so they cause Extra-pyramidal side effects: • Dystonia: sustained muscle contraction • Akathisia: restlessness, constant movement • Parkinsonism • Dyskinesia: involuntary muscle movement
- 6. Other Side Effects Many of them inhibit many receptors • Alpha: hypotension, sexual dysfunction • Muscarinic: dry mouth, blurred vision, constipation, urinary retention,… • Histaminic: sedation, weight gain • QT prolongation.
- 7. 1st GENERATION ANTI-PSYCHOTICS • These are divided into two parts: Basal Incisive
- 8. Incisive Anti-Psychotics • High affinity to D2 receptors • Low affinity to other types of receptors. • They affect positive symptoms of schizophrenia mainly. • They bring extrapyramidal symptoms (EPS).
- 9. Incisive Anti-Psychotics Pheno-thiazines / Thio-xanthenes Butyro-phenones Perphenazine Haloperidol Fluphenazine Melperone Flupenthixol
- 10. Basal Anti-Psychotics • Lower affinity to D2 receptors • Higher affinity to other receptor types. • They affect positive and negative symptoms of schizophrenia. • They have sedative, anticholinergic, antihistaminic and cardiovascular side effect, but extrapyramidal symptoms are less frequent.
- 11. Basal Anti-Psychotics Pheno-thiazines Thio-xanthenes Chlor-promazine Chlor-prothixene Levome-promazine Zuclo-penthixol
- 12. 2nd GENERATION ANTI-PSYCHOTICS (ATYPICAL ANTI-PSYCHOTICS) • In general, they are serotonin-dopamine antagonists (antagonists of D2 and serotonin receptors 5HT-2A) • They affect in general many other types of receptors. • They are much more efficient in treatment of negative symptoms of schizophrenia in comparison with conventional antipsychotics. • Have lower side effects (lower EPS)
- 13. 2nd GENERATION ANTI-PSYCHOTICS • They are metabolized by CYP450 in liver. • They potentiate the sedation effects of analgesics, alcohol and antihistamines.
- 14. Atypical anti-psychotics Multi Acting Receptor Targeted Antagonists Dopamine- Serotonin Antagonists D2-D3 Antagonists Dopamine Partial Agonist
- 15. Multi Acting Receptor Targeted Antagonists (MARTA) • They block many types of receptors: D2, M, A, H1, 5HT2 • They have low risk of causing Extrapyramidal SE and hyperprolactenemia • They have other side effects (due to their multi antagonism): sedation, weight gain and hypotension. • Risk of induction of Diabetes Mellitus 2. • Clozapine – Olanzapine – Quetiapine – Zotepine.
- 16. Dopamine-Serotonin Antagonists • They block D2-D3 and 5HT2 receptors and some others (H-A). • They cause less sedation and hypotension but more risk of hyperprolactinemia and extrapyramidal SE. • Similar effects to MARTA compounds. • Risperidone – Paliperidone – Sertindole – Ziprasidone
- 17. Dopamine D2-D3 Antagonists • They block selectively D2-D3 receptors • In low dose, they block the presynaptic receptors affect negative symp. • In high dose, they block the postsynaptic ones affect positive symp. • High risk of Extrapyramidal and hyperprolactinemia SE. • Sulpiride – Amisulpiride
- 18. Dopamine Partial Agonist • It has D2 , 5HT1A partial agonism and 5HT2A antagonism. • It has a very low incidence of side effects. • Aripiprazole
- 19. Therapeutic Strategy • Atypical anti-psychotics are the drugs of choice. • Onset of beneficial effects may take 2-3 weeks and till the optimal effects, it requires 4-6 weeks of therapy. • Discontinuation may lead to relapse.