This document provides an overview of neuropharmacology and various central nervous system agents that act on the brain and spinal cord. It discusses the two main branches of neuropharmacology - behavioural and molecular neuropharmacology. It then covers various drug classes that act on the central nervous system including sedatives/hypnotics like benzodiazepines, barbiturates, and cholinergic drugs. Specific drugs are discussed in terms of their mechanisms of action, indications, dosages, and side effects. The document concludes with nursing responsibilities when administering these central nervous system agents.
Benzodiazepines are a class of drugs commonly used to treat anxiety. They work by enhancing the effects of the neurotransmitter GABA at GABAA receptors in the brain. The most commonly prescribed benzodiazepines include diazepam, alprazolam, lorazepam, and clonazepam. While effective for treating anxiety, benzodiazepines can cause side effects like sedation and memory impairment. They also carry risks of tolerance, dependence, and withdrawal symptoms with long-term use. Benzodiazepines should only be used short-term to treat severe anxiety, insomnia, or muscle spasms, and are not recommended for mild or occasional
The document discusses pain and its classification, pathways, and treatment. It defines pain and describes the gate control theory of pain modulation. Pain is classified as nociceptive, neuropathic, or idiopathic. Treatment includes non-opioids like NSAIDs, opioids like morphine, and adjuvants. Morphine is a potent analgesic that acts primarily on mu opioid receptors in the CNS and PNS to reduce pain perception. Its mechanisms, effects, kinetics, uses, and adverse effects are outlined.
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.
This document discusses the classification, treatment, and mechanisms of depression. It covers:
(1) Types of depression including brief reactive, major, and manic-depressive depression.
(2) Treatment includes antidepressants like SSRIs, TCAs, MAOIs, as well as electroconvulsive therapy for severe cases.
(3) The monoamine hypothesis proposes that depression is associated with decreased neurotransmitters like serotonin, norepinephrine, and dopamine. Antidepressants increase these neurotransmitters to relieve symptoms.
Epilepsy is a disorder characterized by recurrent seizures arising from abnormal neuronal activity in the brain. There are two main types of seizures - generalized seizures involving both brain hemispheres, and partial seizures beginning in one area. Common anti-epileptic drugs work by enhancing GABA inhibition, blocking sodium channels, or inhibiting calcium channels to prevent abnormal neuronal firing. Newer anti-epileptic drugs such as gabapentin, lamotrigine, and topiramate are generally as effective with fewer side effects than older drugs like phenobarbital, phenytoin, and carbamazepine. Treatment of prolonged seizures (status epilepticus) requires rapid intravenous administration of benzodiazepines or barbit
This document provides information on anti-epileptic drugs (AEDs) including their mechanisms of action, uses, and side effects. It discusses the classification, treatment, and management of epilepsy and seizures. Some key points include:
- AEDs work by enhancing GABA inhibition, blocking sodium channels, or inhibiting calcium currents to suppress neuronal firing and seizures.
- Common AEDs include phenytoin, carbamazepine, valproic acid, lamotrigine, levetiracetam, and topiramate.
- AEDs are used to treat generalized tonic-clonic, absence, myoclonic and partial seizures. Some are also used for neuropathic
Antidepressants are used to relieve the symptoms of moderate and severe depression. They are usually taken for 4-6 months. They can be used alone or combination with other medications. The purpose of antidepressant is to increase the neurotransmitters in the synapse.
This document discusses extrapyramidal symptoms, which are movement disorders that result from disruption of the basal ganglia network in the brain. It provides an overview of the anatomy of the basal ganglia and their role in motor control. It then presents a case scenario of a 16-year-old boy who developed acute dystonia after taking an unspecified nausea medication, likely causing the extrapyramidal symptom. The document outlines different extrapyramidal symptoms like parkinsonism, acute dystonia, neuroleptic malignant syndrome, and tardive dyskinesia. It provides recommendations for treating each condition, such as using procyclidine or benztropine for acute dystonia.
Benzodiazepines are a class of drugs commonly used to treat anxiety. They work by enhancing the effects of the neurotransmitter GABA at GABAA receptors in the brain. The most commonly prescribed benzodiazepines include diazepam, alprazolam, lorazepam, and clonazepam. While effective for treating anxiety, benzodiazepines can cause side effects like sedation and memory impairment. They also carry risks of tolerance, dependence, and withdrawal symptoms with long-term use. Benzodiazepines should only be used short-term to treat severe anxiety, insomnia, or muscle spasms, and are not recommended for mild or occasional
The document discusses pain and its classification, pathways, and treatment. It defines pain and describes the gate control theory of pain modulation. Pain is classified as nociceptive, neuropathic, or idiopathic. Treatment includes non-opioids like NSAIDs, opioids like morphine, and adjuvants. Morphine is a potent analgesic that acts primarily on mu opioid receptors in the CNS and PNS to reduce pain perception. Its mechanisms, effects, kinetics, uses, and adverse effects are outlined.
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.
This document discusses the classification, treatment, and mechanisms of depression. It covers:
(1) Types of depression including brief reactive, major, and manic-depressive depression.
(2) Treatment includes antidepressants like SSRIs, TCAs, MAOIs, as well as electroconvulsive therapy for severe cases.
(3) The monoamine hypothesis proposes that depression is associated with decreased neurotransmitters like serotonin, norepinephrine, and dopamine. Antidepressants increase these neurotransmitters to relieve symptoms.
Epilepsy is a disorder characterized by recurrent seizures arising from abnormal neuronal activity in the brain. There are two main types of seizures - generalized seizures involving both brain hemispheres, and partial seizures beginning in one area. Common anti-epileptic drugs work by enhancing GABA inhibition, blocking sodium channels, or inhibiting calcium channels to prevent abnormal neuronal firing. Newer anti-epileptic drugs such as gabapentin, lamotrigine, and topiramate are generally as effective with fewer side effects than older drugs like phenobarbital, phenytoin, and carbamazepine. Treatment of prolonged seizures (status epilepticus) requires rapid intravenous administration of benzodiazepines or barbit
This document provides information on anti-epileptic drugs (AEDs) including their mechanisms of action, uses, and side effects. It discusses the classification, treatment, and management of epilepsy and seizures. Some key points include:
- AEDs work by enhancing GABA inhibition, blocking sodium channels, or inhibiting calcium currents to suppress neuronal firing and seizures.
- Common AEDs include phenytoin, carbamazepine, valproic acid, lamotrigine, levetiracetam, and topiramate.
- AEDs are used to treat generalized tonic-clonic, absence, myoclonic and partial seizures. Some are also used for neuropathic
Antidepressants are used to relieve the symptoms of moderate and severe depression. They are usually taken for 4-6 months. They can be used alone or combination with other medications. The purpose of antidepressant is to increase the neurotransmitters in the synapse.
This document discusses extrapyramidal symptoms, which are movement disorders that result from disruption of the basal ganglia network in the brain. It provides an overview of the anatomy of the basal ganglia and their role in motor control. It then presents a case scenario of a 16-year-old boy who developed acute dystonia after taking an unspecified nausea medication, likely causing the extrapyramidal symptom. The document outlines different extrapyramidal symptoms like parkinsonism, acute dystonia, neuroleptic malignant syndrome, and tardive dyskinesia. It provides recommendations for treating each condition, such as using procyclidine or benztropine for acute dystonia.
Sodium valproate is an anticonvulsant medication used to treat epilepsy and bipolar disorder. It works by blocking sodium channels and increasing GABA levels in the brain to prevent neuron hyperexcitability. Common side effects include nausea, diarrhea, weight gain and hair changes. Rare but serious side effects can include liver problems, pancreatitis, and suicidal thoughts. Sodium valproate is prescribed to reduce seizure frequency and severity in epilepsy as well as control mood swings in bipolar disorder.
Noradrenaline acts as a neurotransmitter between sympathetic postganglionic nerves and the organs they innervate. When an action potential reaches the nerve terminal, noradrenaline is released into the synaptic cleft and binds to alpha adrenoreceptors on nearby cells. This causes vasoconstriction and increases both systolic and diastolic blood pressure, raising mean arterial pressure. Noradrenaline interacts with various other drugs and medications and can cause side effects like anxiety, dizziness, and tremors. It should be used cautiously in patients with certain medical conditions.
This document discusses anti-anxiety drugs, including their classification, mechanisms of action, and side effects. It begins by defining anxiety and explaining that anti-anxiety drugs, also called anxiolytics, are used to treat pathological anxiety. The main types of anti-anxiety drugs covered are benzodiazepines, which enhance GABA inhibition; azapirones like buspirone, which do not interact with benzodiazepine receptors; beta-blockers that reduce physical symptoms of anxiety; and antidepressants such as SSRIs and SNRIs. Common side effects of anti-anxiety drugs include drowsiness, fatigue, confusion, and dry mouth.
The document discusses various classes of drugs used to treat anxiety disorders, including benzodiazepines, SSRIs, TCAs, buspirone, beta-blockers, and MAOIs. Benzodiazepines are commonly used for generalized anxiety, OCD, phobias, and panic attacks but can cause dependence, tolerance, and withdrawal symptoms. SSRIs like fluoxetine are also often used as first-line treatments for their anxiety disorders due to their safety profile. TCAs may be used for anxiety associated with depression or panic attacks. Buspirone is used for mild anxiety disorders. Beta-blockers can help reduce the somatic symptoms of anxiety. MAOIs require dietary restrictions
This document summarizes different types of anxiety disorders and their treatment with anti-anxiety drugs. It describes several classes of anti-anxiety medications including benzodiazepines, azapirones, SSRIs, beta blockers and others. It provides details on specific drugs within each class, their mechanisms of action, pharmacokinetics, advantages and side effects. The document also discusses the management of different anxiety disorders like generalized anxiety disorder, panic disorder, OCD, phobias and stress disorders with appropriate drug classes and specific medications.
Levetiracetam is an antiepileptic drug approved to treat partial onset seizures in infants and children aged 1 month and older. It is also commonly used off-label to treat neonatal seizures caused by various conditions. Levetiracetam has a favorable safety profile with minimal drug interactions and side effects reported in neonates and children. It is rapidly absorbed, has high bioavailability, and achieves steady-state concentrations quickly. The document advocates for interprofessional collaboration to improve outcomes for neonates with seizures through identifying best practices and translating research into clinical practice.
This document discusses antipsychotic drugs, including their classification, mechanisms of action, indications, side effects, and the nurse's role in monitoring patients taking these medications. It outlines that antipsychotics can reduce psychotic symptoms in conditions like schizophrenia and bipolar disorder. They work by blocking dopamine receptors in the brain. Common side effects include anticholinergic effects, hormonal effects, extrapyramidal symptoms, and tardive dyskinesia with long term use. Nurses must closely monitor patients for any side effects or complications and ensure they receive their medications accurately.
Antidepressants work through multiple mechanisms including increasing monoamines like serotonin, norepinephrine, and dopamine; increasing brain-derived neurotrophic factor (BDNF); and decreasing corticotropin-releasing hormone (CRH). The main classes of antidepressants are SSRIs, SNRIs, NDRIs, NRIs, SARIs, SPARIs, TCAs, and MAOIs. Treatment goals have shifted from response to remission and recovery, though residual symptoms often persist even with response.
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.
This document discusses antidepressant drugs, including their classification, sources, mechanisms of action, therapeutic uses, toxicity, and drug interactions. Antidepressants are primarily used to treat depression and are classified into five main categories: SSRIs, SNRIs, TCAs, MAOIs, and atypical agents. They work by increasing levels of neurotransmitters like serotonin, norepinephrine, and dopamine in the brain. While effective for conditions like depression, they can cause side effects and interact dangerously with other drugs, increasing risks like seizures or heart problems if not taken carefully.
Tardive dyskinesia (TD) is a neurological syndrome caused by long-term use of drugs to treat psychiatric disorders, presenting as repetitive, involuntary movements. Symptoms include grimacing, tongue protrusion, lip smacking. TD can be confused with Parkinson's disease which presents as tremors, rigidity, and bradykinesia. Antipsychotic medications like haloperidol, risperidone, and olanzapine can cause TD by reducing dopamine levels in the brain. Treatment involves discontinuing the causative medication, using anti-Parkinson's drugs, or vitamin E to relieve symptoms.
This document discusses various types of anti-depressant medications. It begins by explaining that depression is a medical condition requiring treatment, not a personal fault. It then covers the major classes of anti-depressants including SSRIs, SNRIs, TCAs, MAOIs and others. Each class is described in terms of its mechanism of action, indications, examples of medications, side effects and cautions. Adjunctive treatments like psychotherapy and supplements are also mentioned. The overall summary focuses on the different classes of anti-depressants, their mechanisms and side effect considerations.
This document discusses sedative/hypnotics and anxiolytics. It begins by explaining how these drugs work in the nervous system, producing sedation, hypnosis, and effects ranging from confusion to coma and death depending on dose. It then focuses on benzodiazepines and barbiturates, the two major classes of these drugs. Both act by enhancing GABAergic transmission but differ in their mechanisms and properties. Benzodiazepines are generally safer with less respiratory depression but can cause dependence, while barbiturates have greater toxicity and abuse potential. The document emphasizes using these drugs only short-term to avoid adverse effects.
by: Dr. Vishal Pawar, MD Pharmacology
All the recent updates regarding antiepileptics, composed into a single ppt presentation to make researching and learning easier
This document provides information on antianxiety drugs. It discusses that anxiety is an unpleasant emotional state associated with unease from an unknown threat. Treatment is needed when anxiety is disproportionate or excessive. It then describes various classes of antianxiety drugs including benzodiazepines, azapirones, barbiturates, beta blockers, and antidepressants. The document focuses on benzodiazepines, explaining their mechanism of action by enhancing GABA through binding sites on GABA receptors. It discusses their therapeutic uses for anxiety disorders, seizures, muscle disorders and as amnesia for medical procedures. Potential adverse effects and drug interactions are also summarized.
The document discusses agomelatine, a novel antidepressant with melatonergic and serotonergic properties. It summarizes agomelatine's mechanism of action, clinical effects in treating depression and anxiety, indications, efficacy and tolerability profile compared to other antidepressants. Some key advantages are its well-tolerability, lack of sexual side effects, weight gain and discontinuation syndrome. However, liver function tests need monitoring and its efficacy may be modest for severe depression requiring combination therapy. The recommended dosing is 25mg once daily increased to 50mg if no response after two weeks.
The document provides an overview of mood stabilizers, including their definition, classification, mechanisms of action, and side effects. It defines mood stabilizers as medications that decrease vulnerability to manic or depressive episodes without exacerbating current symptoms. Common mood stabilizers are lithium, anticonvulsants like valproate and carbamazepine, and atypical antipsychotics. These medications impact neurotransmitter systems and signaling pathways in the brain to achieve their mood stabilizing effects, but can also cause side effects like tremors, weight gain, thyroid and kidney issues.
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.
This document discusses the nervous system and the roles of acetylcholine and antimuscarinic agents. It covers:
- The central and peripheral nervous systems and their roles in receiving stimuli and initiating responses.
- Acetylcholine as the predominant neurotransmitter in the parasympathetic nervous system.
- Common antimuscarinic agents like atropine that work by blocking muscarinic receptors to inhibit parasympathetic functions.
- The clinical uses of antimuscarinic agents in various systems of the body like the eye, respiratory and gastrointestinal systems.
- Important side effects of antimuscarinic overdose.
This document discusses the central nervous system, peripheral nervous system, and acetylcholine. It focuses on antimuscarinic agents like atropine, describing their mechanisms of action, uses, and side effects. Atropine is a competitive inhibitor of muscarinic receptors that blocks the effects of acetylcholine. It has various clinical uses including as a bronchodilator for asthma, to dilate the pupils, and to treat Parkinson's disease. Common side effects include dry mouth and blurred vision. The document provides details on the pharmacology of atropine and other anticholinergic drugs.
Sodium valproate is an anticonvulsant medication used to treat epilepsy and bipolar disorder. It works by blocking sodium channels and increasing GABA levels in the brain to prevent neuron hyperexcitability. Common side effects include nausea, diarrhea, weight gain and hair changes. Rare but serious side effects can include liver problems, pancreatitis, and suicidal thoughts. Sodium valproate is prescribed to reduce seizure frequency and severity in epilepsy as well as control mood swings in bipolar disorder.
Noradrenaline acts as a neurotransmitter between sympathetic postganglionic nerves and the organs they innervate. When an action potential reaches the nerve terminal, noradrenaline is released into the synaptic cleft and binds to alpha adrenoreceptors on nearby cells. This causes vasoconstriction and increases both systolic and diastolic blood pressure, raising mean arterial pressure. Noradrenaline interacts with various other drugs and medications and can cause side effects like anxiety, dizziness, and tremors. It should be used cautiously in patients with certain medical conditions.
This document discusses anti-anxiety drugs, including their classification, mechanisms of action, and side effects. It begins by defining anxiety and explaining that anti-anxiety drugs, also called anxiolytics, are used to treat pathological anxiety. The main types of anti-anxiety drugs covered are benzodiazepines, which enhance GABA inhibition; azapirones like buspirone, which do not interact with benzodiazepine receptors; beta-blockers that reduce physical symptoms of anxiety; and antidepressants such as SSRIs and SNRIs. Common side effects of anti-anxiety drugs include drowsiness, fatigue, confusion, and dry mouth.
The document discusses various classes of drugs used to treat anxiety disorders, including benzodiazepines, SSRIs, TCAs, buspirone, beta-blockers, and MAOIs. Benzodiazepines are commonly used for generalized anxiety, OCD, phobias, and panic attacks but can cause dependence, tolerance, and withdrawal symptoms. SSRIs like fluoxetine are also often used as first-line treatments for their anxiety disorders due to their safety profile. TCAs may be used for anxiety associated with depression or panic attacks. Buspirone is used for mild anxiety disorders. Beta-blockers can help reduce the somatic symptoms of anxiety. MAOIs require dietary restrictions
This document summarizes different types of anxiety disorders and their treatment with anti-anxiety drugs. It describes several classes of anti-anxiety medications including benzodiazepines, azapirones, SSRIs, beta blockers and others. It provides details on specific drugs within each class, their mechanisms of action, pharmacokinetics, advantages and side effects. The document also discusses the management of different anxiety disorders like generalized anxiety disorder, panic disorder, OCD, phobias and stress disorders with appropriate drug classes and specific medications.
Levetiracetam is an antiepileptic drug approved to treat partial onset seizures in infants and children aged 1 month and older. It is also commonly used off-label to treat neonatal seizures caused by various conditions. Levetiracetam has a favorable safety profile with minimal drug interactions and side effects reported in neonates and children. It is rapidly absorbed, has high bioavailability, and achieves steady-state concentrations quickly. The document advocates for interprofessional collaboration to improve outcomes for neonates with seizures through identifying best practices and translating research into clinical practice.
This document discusses antipsychotic drugs, including their classification, mechanisms of action, indications, side effects, and the nurse's role in monitoring patients taking these medications. It outlines that antipsychotics can reduce psychotic symptoms in conditions like schizophrenia and bipolar disorder. They work by blocking dopamine receptors in the brain. Common side effects include anticholinergic effects, hormonal effects, extrapyramidal symptoms, and tardive dyskinesia with long term use. Nurses must closely monitor patients for any side effects or complications and ensure they receive their medications accurately.
Antidepressants work through multiple mechanisms including increasing monoamines like serotonin, norepinephrine, and dopamine; increasing brain-derived neurotrophic factor (BDNF); and decreasing corticotropin-releasing hormone (CRH). The main classes of antidepressants are SSRIs, SNRIs, NDRIs, NRIs, SARIs, SPARIs, TCAs, and MAOIs. Treatment goals have shifted from response to remission and recovery, though residual symptoms often persist even with response.
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.
This document discusses antidepressant drugs, including their classification, sources, mechanisms of action, therapeutic uses, toxicity, and drug interactions. Antidepressants are primarily used to treat depression and are classified into five main categories: SSRIs, SNRIs, TCAs, MAOIs, and atypical agents. They work by increasing levels of neurotransmitters like serotonin, norepinephrine, and dopamine in the brain. While effective for conditions like depression, they can cause side effects and interact dangerously with other drugs, increasing risks like seizures or heart problems if not taken carefully.
Tardive dyskinesia (TD) is a neurological syndrome caused by long-term use of drugs to treat psychiatric disorders, presenting as repetitive, involuntary movements. Symptoms include grimacing, tongue protrusion, lip smacking. TD can be confused with Parkinson's disease which presents as tremors, rigidity, and bradykinesia. Antipsychotic medications like haloperidol, risperidone, and olanzapine can cause TD by reducing dopamine levels in the brain. Treatment involves discontinuing the causative medication, using anti-Parkinson's drugs, or vitamin E to relieve symptoms.
This document discusses various types of anti-depressant medications. It begins by explaining that depression is a medical condition requiring treatment, not a personal fault. It then covers the major classes of anti-depressants including SSRIs, SNRIs, TCAs, MAOIs and others. Each class is described in terms of its mechanism of action, indications, examples of medications, side effects and cautions. Adjunctive treatments like psychotherapy and supplements are also mentioned. The overall summary focuses on the different classes of anti-depressants, their mechanisms and side effect considerations.
This document discusses sedative/hypnotics and anxiolytics. It begins by explaining how these drugs work in the nervous system, producing sedation, hypnosis, and effects ranging from confusion to coma and death depending on dose. It then focuses on benzodiazepines and barbiturates, the two major classes of these drugs. Both act by enhancing GABAergic transmission but differ in their mechanisms and properties. Benzodiazepines are generally safer with less respiratory depression but can cause dependence, while barbiturates have greater toxicity and abuse potential. The document emphasizes using these drugs only short-term to avoid adverse effects.
by: Dr. Vishal Pawar, MD Pharmacology
All the recent updates regarding antiepileptics, composed into a single ppt presentation to make researching and learning easier
This document provides information on antianxiety drugs. It discusses that anxiety is an unpleasant emotional state associated with unease from an unknown threat. Treatment is needed when anxiety is disproportionate or excessive. It then describes various classes of antianxiety drugs including benzodiazepines, azapirones, barbiturates, beta blockers, and antidepressants. The document focuses on benzodiazepines, explaining their mechanism of action by enhancing GABA through binding sites on GABA receptors. It discusses their therapeutic uses for anxiety disorders, seizures, muscle disorders and as amnesia for medical procedures. Potential adverse effects and drug interactions are also summarized.
The document discusses agomelatine, a novel antidepressant with melatonergic and serotonergic properties. It summarizes agomelatine's mechanism of action, clinical effects in treating depression and anxiety, indications, efficacy and tolerability profile compared to other antidepressants. Some key advantages are its well-tolerability, lack of sexual side effects, weight gain and discontinuation syndrome. However, liver function tests need monitoring and its efficacy may be modest for severe depression requiring combination therapy. The recommended dosing is 25mg once daily increased to 50mg if no response after two weeks.
The document provides an overview of mood stabilizers, including their definition, classification, mechanisms of action, and side effects. It defines mood stabilizers as medications that decrease vulnerability to manic or depressive episodes without exacerbating current symptoms. Common mood stabilizers are lithium, anticonvulsants like valproate and carbamazepine, and atypical antipsychotics. These medications impact neurotransmitter systems and signaling pathways in the brain to achieve their mood stabilizing effects, but can also cause side effects like tremors, weight gain, thyroid and kidney issues.
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.
This document discusses the nervous system and the roles of acetylcholine and antimuscarinic agents. It covers:
- The central and peripheral nervous systems and their roles in receiving stimuli and initiating responses.
- Acetylcholine as the predominant neurotransmitter in the parasympathetic nervous system.
- Common antimuscarinic agents like atropine that work by blocking muscarinic receptors to inhibit parasympathetic functions.
- The clinical uses of antimuscarinic agents in various systems of the body like the eye, respiratory and gastrointestinal systems.
- Important side effects of antimuscarinic overdose.
This document discusses the central nervous system, peripheral nervous system, and acetylcholine. It focuses on antimuscarinic agents like atropine, describing their mechanisms of action, uses, and side effects. Atropine is a competitive inhibitor of muscarinic receptors that blocks the effects of acetylcholine. It has various clinical uses including as a bronchodilator for asthma, to dilate the pupils, and to treat Parkinson's disease. Common side effects include dry mouth and blurred vision. The document provides details on the pharmacology of atropine and other anticholinergic drugs.
The document summarizes anticholinergic agents used in psychiatry. It discusses how they work by blocking acetylcholine receptors, their use in treating extrapyramidal side effects caused by antipsychotics, and precautions around their anticholinergic effects on various organ systems. The most commonly used anticholinergic agents for these psychiatric purposes are trihexyphenidyl, benztropine, biperiden, and procyclidine.
This document discusses various drugs used in the nervous system. It begins by outlining the topics to be covered, including analgesics, anesthetics, cholinergics, anticholinergics, antidepressants, and CNS stimulants. It then provides details on analgesics like NSAIDs, opioids, and barbiturates. It explains their mechanisms of action, examples and dosages, indications, contraindications, adverse effects, drug interactions, and nursing responsibilities. Sedatives and hypnotics are also summarized, focusing on benzodiazepines and barbiturates. Overall, the document concisely reviews many commonly used drugs for the nervous system.
The central nervous system directs bodily functions and processes sensory information. Sedative-hypnotic drugs like benzodiazepines and barbiturates depress nervous system activity by enhancing the effects of the inhibitory neurotransmitter GABA. Benzodiazepines are generally safer with less severe side effects than barbiturates. Both can cause tolerance, dependence, and dangerous respiratory depression in overdose.
Slides are prepared as per INC Syllabus Unit IX Drugs used in nervous system and it is most benefited for B sc Nursing students and faculty of the subject
This document provides an overview of drugs used in the nervous system, including analgesics, sedatives, and hypnotics. It discusses the classification, mechanism of action, examples, dosages, indications, contraindications, adverse effects, interactions, and nursing responsibilities for various drug categories. Key points covered include non-opioid analgesics like NSAIDs; opioid analgesics; benzodiazepines used as sedatives and hypnotics; and barbiturates which are now less commonly used. Nursing priorities are monitoring for side effects, ensuring safe administration, teaching patients about proper usage, and watching for drug interactions.
Anticholinergic drugs block the effects of acetylcholine at cholinergic receptors. They are divided into muscarinic and nicotinic subgroups based on receptor affinity. Muscarinic receptors include M1-M5 subtypes, while nicotinic receptors are classified as neuronal or neuromuscular. Common natural anticholinergics include atropine and scopolamine. Atropine is the prototypical muscarinic antagonist and is used to treat conditions like COPD, motion sickness, and organophosphate poisoning. Ganglion blockers like hexamethonium competitively block nicotinic receptors at autonomic ganglia.
This document discusses anticholinergic drugs, with a focus on atropine as the prototype drug. It describes how anticholinergic drugs act by blocking muscarinic acetylcholine receptors in the autonomic nervous system and central nervous system. Specifically, it summarizes atropine's pharmacological actions, including stimulating the CNS and heart rate, causing dilation of the pupils, relaxing smooth muscles, decreasing secretions from glands, and slightly raising body temperature. It also lists some common anticholinergic drugs and their uses, such as treating peptic ulcers, intestinal spasms, asthma, and as a pre-anesthetic medication.
This document provides an overview of drugs used in the nervous system, including analgesics, sedatives, and hypnotics. It discusses the classification, mechanism of action, dosages, indications, contraindications, side effects, and nursing responsibilities for various classes of drugs like NSAIDs, opioids, benzodiazepines, and barbiturates. The key classes covered are analgesics like NSAIDs for pain and fever relief, sedatives-hypnotics including benzodiazepines and barbiturates for inducing sleep or calm, and their use, effects, and monitoring by nurses.
Cholinergic antagonists and blockers-Dr.Jibachha Sah,M.V.Sc,LecturerDr. Jibachha Sah
Dr. Jibachha Sah,M.V.Sc( Veterinary pharmacology, TU,Nepal),posted lecturer notes on AUTONOMIC AND SYSTEMIC PHARMACOLOGY for B.V.Sc & A.H. 6 th semester veterinary students of College of veterinary science,Nepal Polytechnique Institute, Bharatpur, Bhojard, Chitwan, Nepal.I hope this lecture notes may be beneficial for other Nepalese veterinary students. Please send your comment and suggestion .Email:jibachhashah@gmail.com,moble,00977-9845024121
Sedatives and hypnotics drugs ppt by kashikant yadavKashikant Yadav
Sedatives and hypnotics are central nervous system depressants that are used to induce sleep or reduce anxiety. Barbiturates were previously commonly used but have largely been replaced by benzodiazepines due to lower risks of dependence and overdose. Both classes of drugs work by enhancing the effects of the inhibitory neurotransmitter GABA. Sedatives primarily reduce anxiety and excitement while hypnotics are used to induce sleep. Common side effects include drowsiness, dizziness, and impaired coordination. Tolerance can develop with repeated use of both barbiturates and benzodiazepines.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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The document discusses drugs that act on the autonomic nervous system, including:
- Adrenergic drugs that stimulate the sympathetic nervous system by mimicking norepinephrine and epinephrine. This includes both catecholamines and non-catecholamines.
- Adrenergic blockers that block the actions of norepinephrine and epinephrine at adrenergic receptor sites. This includes both alpha-blockers and beta-blockers.
- Cholinergic drugs that stimulate the parasympathetic nervous system by mimicking acetylcholine, and anticholinergic drugs that block acetylcholine's actions. Cholinergic drugs can be direct-acting or indirect-
This document provides an overview of general principles of psychopharmacology. It discusses key topics including:
- Psychopharmacology is the study of how drugs affect the nervous system and behavior. Drugs can produce changes in physiological processes and behavior.
- Drugs act through various sites in the body including receptors, ion channels, enzymes, and carrier proteins. Their effects depend on how the drug structure interacts with these sites.
- Drugs are classified based on their structure, mechanism of action, history, uniqueness, and major clinical applications like antidepressants, antipsychotics, and anxiolytics.
- Pharmacodynamics examines what the body does to the drug through processes like receptors, dose
This document provides an overview of sedatives and hypnotics. It discusses the stages of normal sleep and classifies sedatives and hypnotics. Benzodiazepines and barbiturates are the main classes described. Benzodiazepines have short, intermediate, and long-acting types while barbiturates have ultra-short, short, and long-acting types. The document covers the pharmacokinetics, therapeutic uses, adverse effects, and mechanisms of action of these drug classes and compares their advantages. Treatment for barbiturate poisoning is also summarized.
This document provides an overview of anticholinergic drugs, including:
- Their classification into natural alkaloids, semisynthetic derivatives, and synthetic compounds.
- Their mechanisms of action as muscarinic receptor antagonists and effects on various organ systems like the CNS, eyes, cardiovascular, respiratory, gastrointestinal, and urinary systems.
- Examples of individual drugs from each class and their therapeutic uses for conditions like Parkinson's disease, peptic ulcers, overactive bladder, respiratory diseases, and more.
- Information on pharmacokinetics, pharmacology, interactions, contraindications, and belladonna poisoning from anticholinergic overdose.
Central Nervous System Stimulants presentationDixitGoyal10
CNS stimulants increase mental and physical activity by blocking neurotransmitter reuptake or promoting release. They are classified based on their site of action in the brain or spinal cord and mechanism of action. While they have therapeutic uses for conditions like ADHD and narcolepsy, CNS stimulants can also cause adverse effects like euphoria, insomnia, convulsions, and addiction if misused.
1) The document discusses various cholinergic agonists including natural alkaloids like muscarine, pilocarpine, and arecholine as well as synthetic alkaloids like oxotramorine and nicotine.
2) It also discusses various types of anticholinesterases that can be reversible like physostigmine or irreversible like organophosphorus compounds.
3) The effects of acetylcholine are discussed in various organ systems mediated through muscarinic and nicotinic receptors.
Rheumatic heart disease is a condition that affects the heart valves and is caused by rheumatic fever, which is an inflammatory response to a streptococcal throat infection. The inflammation caused by rheumatic fever can damage heart valves and cause them to narrow or leak, resulting in long term valve problems or heart failure. Symptoms of rheumatic heart disease include heart murmurs and arrhythmias. Diagnosis involves confirming a history of rheumatic fever through diagnostic criteria and using echocardiograms or heart catheterization to evaluate the valves. Treatment depends on severity and may include medications, balloon valvuloplasty, or valve replacement surgery.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness and well-being.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
1) Ischemic stroke, which accounts for about 87% of stroke cases, occurs when blood flow to the brain is interrupted, depriving brain cells of oxygen.
2) The main types of ischemic stroke are thrombotic, caused by blood clots; embolic, caused by clots traveling from other parts of the body to the brain; and artery to artery embolism.
3) Common risk factors for ischemic stroke include atherosclerosis, atrial fibrillation, heart attack, and hypercoagulable disorders.
Fungal infections can be difficult to treat and antifungal drugs play an important role. There are several classes of antifungal drugs that work by disrupting the fungal cell membrane or interfering with ergosterol production. Polyene antifungals bind to ergosterol in the cell membrane and form pores that allow cellular contents to leak out, while azole antifungals inhibit ergosterol synthesis.
The document is a presentation by Mr. Pradeep Singh N B. It does not provide any other details about the content or topic of the presentation. The summary cannot extract any essential information from the document as it only states the presenter's name and does not include any presentation content or context.
The document appears to be a presentation by Mr. Pradeepsingh N B who is the Head of Department of Medical Surgical Nursing. The presentation likely covers topics related to medical surgical nursing given the presenter's role. No other contextual or content details are provided in the brief document.
The document appears to be a presentation by Mr. Pradeepsingh N B who is the Head of Medical Surgical Nursing. No other details are provided in the 3 line document.
The document appears to be a presentation by Mr. Pradeepsingh N B who is the Head of Department of Medical Surgical Nursing. The presentation likely covers topics related to medical surgical nursing given the presenter's role. Further details about the specific content or topics covered in the presentation are not provided in the brief document.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Guillain-Barre syndrome is a rare autoimmune disorder that attacks the peripheral nervous system. It causes muscle weakness and paralysis. Common symptoms include numbness and tingling in the legs and arms that spreads upwards. While there is no cure, treatments like plasma exchange and immunoglobulin therapy can speed recovery, with most patients regaining the ability to walk independently within months. Risk factors include certain viral or bacterial infections, though the cause is not fully understood.
Glioma is a type of tumor that occurs in the brain and spinal cord. It begins in glial cells that surround and support nerve cells. Risk factors include being between ages 45-65, exposure to radiation, and family history. Types include astrocytomas, ependymomas, and oligodendrogliomas. Treatment depends on tumor type, size, grade and location, and may involve surgery to remove the tumor, radiation therapy, chemotherapy, targeted drug therapy, and rehabilitation.
The document is a submission from Mr. Pradeepsingh B, who is an Assistant Professor and Head of Department of Medical Surgical Nursing. Mr. Pradeepsingh B holds these roles and is submitting something in that professional capacity.
The document is a submission from Mr. Pradeepsingh B, who is an Assistant Professor and Head of Department of Medical Surgical Nursing. Mr. Pradeepsingh B holds these roles and is submitting something in those capacities.
Nausea and vomiting are common medical conditions that can have many underlying causes. The document appears to be a presentation on nausea and vomiting given by Mr. Pradeepsingh B, an assistant professor and head of the medical surgical nursing department. The presentation likely provides an overview of the causes, symptoms, and treatments associated with nausea and vomiting.
The document discusses shock, including its classification, stages, pathophysiology, clinical manifestations, diagnostic studies, and collaborative care approach. Shock is defined as a syndrome characterized by decreased tissue perfusion and cellular metabolism. There are several types of shock classified by their underlying mechanisms, such as cardiogenic shock resulting from cardiac dysfunction, hypovolemic shock from fluid loss, and septic shock caused by systemic infection and inflammation. Shock progresses through initial, compensatory, progressive, and refractory stages as the body attempts to compensate for low perfusion and eventually loses the ability to do so without intervention.
The document is a submission from Mr. Pradeepsingh B, who is an Assistant Professor and Head of Department of Medical Surgical Nursing. Mr. Pradeepsingh B holds these roles and is submitting something in that capacity.
The document is a submission from Mr. Pradeepsingh B, who is an Assistant Professor and Head of Department of Medical Surgical Nursing. Mr. Pradeepsingh B holds these roles and is submitting something in that professional capacity.
The document is a submission from Mr. Pradeepsingh B, who is an Assistant Professor and Head of Department of Medical Surgical Nursing. It appears to be some type of proposal or report submitted by Mr. Pradeepsingh B in his role as Assistant Professor and HOD of Medical Surgical Nursing.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Test bank clinical nursing skills a concept based approach 4e pearson educati...rightmanforbloodline
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
When it comes to creating marketing strategies that target older adults, it is crucial to have insight into their media habits and preferences. Understanding how older adults consume and use media is key to creating acquisition and retention strategies. We recently conducted our seventh annual survey to gain insight into the media preferences of older adults in 2024. Here are the survey responses and marketing implications that stood out to us.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
2. INTRODUCTION
Neuropharmacalogy is the study of how drugs affect cellular function in the
body, the nervous system and neural mechanism through which they influence
behavior.
Neuropharmacology is a region of science that encompasses many aspects of
nervous system from single neuron manipulation to entire areas of brain,spinal
cord, and peripheral nerves.
There are two main branches of neuropharmacology:
BEHAVIOURAL
MOLECULAR
3. BEHAVIOURAL
NEUROPHARMACOLGY
It focuses on the study of how drugs affect human
behavior, including the study of how drug dependence and
addiction affect the human behavior.
4. MOLECULAR NEUROPHARMOLOGY
It involves the study of neurons and their
neurochemical interactions, with the overall goal of
developing drugs that have beneficial effects on
neurological function.
6. Central nervous system agents are medicines that affect the CNS.
The CNS is responsible for processing and controlling most of our bodily functions and consist
of nerves in brain & spinal cord.
The drugs that work on CNS include:
Analgesics and anti pyretics
Anesthetics
Hypnotics and sedatives
Cholinergic drugs
Anticholinergic drugs
Muscle relaxants
Antipsychotic drugs
9. SEDATIVE
S
It is a drug that produces calming or quietening effect and
reduces excitement, it may induce drowsiness.
Drugs that calm the patient and reduce anxiety without
inducing normal sleep.
10. HYPNOTICS
It is a drug that induces sleep, resembling natural sleep.
Drugs that initiate and maintain normal sleep.
13. PHARMACOLOGICAL
ACTION
Sedation and hypnosis
Reduction in anxiety
Anaesthesia
Muscle relaxation
Anticonvulsion effect
Amnesia
Other actions such as decrease in nocturnal gastric secretion and
prevents stress ulcers.
16. PHARMACOKINETICS
Benzodiazepines are completely absorbed on oral administration.
Intramuscular absorption is slow, hence oral route is preferred.
They are extremely bound to plasma protein metabolized in the liver
& excreted through kidney.
18. CLASSIFICATION
BARBITURATES
ULTRA SHORT ACTING
(< 15-20min)
-Theopentone
- Melhohexitone
SHORT ACTING
(< 3hours)
-Hexobarbitone
- Pentobarbitone
- Secobarbitone
LONG ACTING
(6-12hours)
- Mephobarbitone
- Phenobarbitone
19. DOSE / ROUTE / FREQUENCY
1. Mephobarbitol : 32mg – 100mg TID/QID oral
2. Pentobarbitol : For trouble sleeping – 100mg OD (night) oral
For sedation before surgery - 100mg before surgery oral
3. Phenobarbitol : Troubled sleeping – 100mg-320mg OD (night) oral
Sedation before surgery – 3.5mg/kg body weight
4. Secobarbitol : 200mg-300mg before surgery, oral
100mg for troubled sleep
20. PHARMACOLOGICAL ACTION
1. CNS: Produce dose dependent effect.
- Hypnotics dose shortens the time taken to fall asleep and increases
duration.
- Sedative dose given at day time can produce drowsiness, reduction in
anxiety and excitability.
- No analgesic effect but can cause hyperalgesia
- Anticonvulsant property.
21. 2. Other systems
- Respiratory: Depressed in higher dose.
- CVS: Slight decrease in BP and heart rate.
- Skeletal muscle: Hypnotic dose has a little effect but anaesthesia
dose reduces muscle contraction by action on neuromuscular
junction.
- Smooth muscle: Tone and motility of bowel is decreased by hypnotic
dose.
- Kidney: Tend to reduce urine flow.
22. PHARMACOKINETICS
Barbiturates are well absorbed from the GI tract and widely
distributed in the body.
The rate of entry into CNS depends on the lipid solubility.
Redistribution from CNS to skeletal muscle.
Metabolized in the liver by oxidation, dealkylation and conjugation.
Metabolites are excreted in urine.
23. INDICATIONS
Except for phenobarbitone in epilepsy and thiopentone in
anesthesia no other barbiturates are used now.
Used in psychosomatic disorders.
Hypnotics and anxiolytics.
25. MISCELLANEOUS
1. PARALDEHYDE
- It is a colorless, transparent, pungent, inflammable liquid.
- It is an irritant and can dissolve plastic syringe.
- It also has anticonvulsant properties.
ROUTE
- Rectal
- Intra muscular
- Oral
USES
- As a convulsant in status epilepticus particularly in children
- Hypnotic rarely used.
26. 2. MELATONIN
- The hormone secreted by the pineal gland is known to regulate sleep.
- Melatonin acts on the melatonin receptors.
- It doesnot depress the CNS, it improves the quality of sleep and helps in
withdrawing benzodiazepines after long term use.
3. RAMELTEON
- It is an agonist at the melatonin receptors is a novel hypnotic drug.
- It doesnot modify the sleep.
- The duration of action is prolonged.
- Adverse effects are dizziness and fatigue.
27. NURSES
RESPONSIBILITIES
Nursing considerations for benzodiazepines involve:
- Careful monitoring of the patient’s condition
- Education of the medication regimen
Benzodiazepines are a schedule IV drug, so the patient should be
assessed for drug abuse potential and dependence.
These drugs are a pregnancy risk.
Since benzodiazepines change intraocular pressure, patients with narrow
angle glaucoma should not receive these drugs.
Liver and kidney function should also be monitored.
Respiratory depression may result if patient is taking other CNS
depressants.
28. Common side effects include drowsiness and dizziness.
If a patient receives an overdose of benzodiazepines should be
administered to reverse the CNS depression.
All forms of nicotin should be avoided because they decrease the
effectiveness of benzodiazepines.
Rebound seizures may develop if the drug is abruptly stopped.
The drug should be taken with food to prevent GI disturbance.
Do not mix these drugs with others because they tend to precipitate and
irritate the
Patient teaching should include avoiding alcohol, drugs, herbal
medications without prescription.
30. INTRODUCTION
Cholinergic drugs are drugs that inhibit, enhance or mimic the
action of neurotransmitter acetylcholine, the primary transmitter
of nerve impulses within the parasympathetic nervous system.
Parasympathetic nervous system is a part of autonomic nervous
system that controls smooth muscles, dilates blood vessels,
increases bodily secretions and slows the heart rate.
32. DIRECT ACTING
CHOLINERGICS
These agents mimic the effect of acetylcholine by binding directly to
the cholinoreceptors.
They are synthetic esters of choline such as carbachol and
bethanechol or naturally occurring alkaloids such as pilocarpine.
All these drugs have longer duration than acetylcholine.
33. 1. ACETYLCHOLINE
It is a neurotransmitter of parasympathetic nervous system and cholinergic nerves.
ACTION
• Decreases heart rate and cardiac output.
• Decreases blood pressure due to vasodilation
OTHER ACTIONS
- GIT: Increases salivary secretion and increases intestinal motility & secretion.
- Respiration: Stimulates bronchiolar secretions.
- Genitourinary tract: Increases detrusor muscle tone.
- Eye: Miosis (marked constriction of pupil)
35. 2. BETHANECHOL
Structurally related to ACH, has a strong muscarinic activity.
It directly stimulates muscarinic receptors of GIT causing increase
intestinal motility & tone.
USES
• Bladder stimulation in postpartum & post operative non
obstructive urine retention.
37. 3. PILOCARPINE
Mainly used in ophthalmology, it exhibit muscarinic activity, it produces rapid miosis
& contraction of the ciliary muscle.
USES
• It is a drug of choice in the emergency lowering of intra-ocular pressure in case of
glaucoma.
SIDE EFFECTS
- It can enter the brain and cause CNS disturbance.
- It stimulates profuse sweating.
- Salivation
38. INDIRECT ACTING
CHOLINERGIC DRUGS
These are drugs that exert cholinergic actions by prolonging the life
time of acetylcholine via the inhibition of acetyl-cholinesterase
enzyme.
This results in accumulation of ACH in synaptic space and provokes
response at all cholinoceptors in the body as well as neuromuscular
junction and the brain.
These drugs are termed reversible and irreversible.
41. It is reversible inhibitor of acetylcholinesterase and potentiate
cholinergic activity throughout body.
It stimulates muscarinic & nicotinic receptors of autonomic nervous
system, its duration of action is 2-4 hours, it can enter & stimulate
CNS.
44. Synthetic compound reversibly inhibits acetylcholinesterase, it
doesnot enter the CNS.
It has greater effect on skeletal muscle that can increase contractibility
then paralysis.
USES
• Stimulates atonic bladder & intestines
• Antidote for neuromuscular blocking agents
• Symptomatic treatment in myasthenia gravis
46. These are synthetic organophosphorus compounds that bind
acetylcholinesterase covalently and inhibit it irreversibly, so there will be
increase in ACH at all sites of its release.
These drugs are extremely toxic & used in military as nerve agents.
Some agents like parathion and Malathion are used in insecticides.
47. These drug causes permanent inactivation of acetylcholinesterase, the restoration of
enzyme activity requires synthesis of new enzymes.
It causes generalized cholinergic stimulation, paralysis of motor function leading to
breathing difficulties, convulsions.
The inhibited acetylcholinesterase can be reactivated by pralidoxime which is a synthetic
compound that can regenerate new enzyme.
CLINICAL USES
• Ointment used topically for the treatment of glaucoma, its effect may last for one week
after a single administration.
• Echothiophate has also the same uses of Isoflurophate.
48. Acute intoxication which must be recognized & treated properly.
The dominant initial signs are:
- Miosis
- Salivation
- Sweating
- Brochial constriction
- Vomiting
- Diarrhoea
Cognitive disturbances, convulsions & coma usually follow rapidly.
49. TREATMENT
1. Maintainance of vital signs, Respiration may be impaired.
2. Atropine parenterally in large doses given as often as required to
control signs of muscarinic excess.
3. Therapy often also includes treatment with pralidoxime &
administration of benzodiazepines for seizures.
50. Administer oral drug on empty stomach to decrease nausea and vomiting
If drug is given intra venously, administer slowly to avoid severe cholinergic effects.
Maintain atropine as standby to use it as an antidote for excessive doses of cholinergic
drugs.
Discontinue drud if excessive salivation, diarrhea, emesis or frequent urination becomes
a problem to decrease the risk of adverse reactions.
Provide safety precautions of the patients reports poor visual activity in dim light to
prevent injury.
Provide comfort measures.
Provide patient education about drug effects and warning signs.
51.
52. Anticholinergics are drugs that block the action of acetylcholine.
USES
Urinary incontinence Overactive bladder Chronic Obstructive
Pulmonary Disorder
Parkinson’s disease
56. Assess the consciousness level of the patient before administering the
drug.
Monitor for the signs of anticholinergic crisis.
Provide comfort measures for dryness of mucous membranes.
Minimise exposure to heat or cold or strenuous exercise.
Monitor input and output chart.
57. Monitor patient for abdominal distension and auscultate for bowel
sounds.
Prevent adverse drug reactions.
Provide patient and family education.
Emphasize the importance of adequate fluid and salt intake.
58. MUSCLE RELAXANTS
These are the drugs that relax muscles.
These are used to reduce discomfort in acute, painful musculoskeletal disorders
such as muscle spasms.
CLASSIFICATION
MUSCLE RELAXANTS
Centrally acting muscle relaxants
Direct acting muscle relaxants
59. These drugs act on central nervous system to interfere with the
reflexes that cause muscle spasms.
These drugs include :
- Baclofen
- Caridoprodol
63. Monitor patients response to drug.
Provide thorough teaching to the patient about drug, its effects and its side effects.
Explain the patient to avoid alcohol or other depressants while taking medications.
Evaluate the patient for therapeutic response.
Explain the patient that drowsiness usually diminishes with continued therapy.
Instruct the patient to change position slowly which helps to prevent dizziness.
Discontinue the drug if any signs of hypersensitivity are seen.
Screen patient for cardiac depression, pregnancy, lactation or epilepsy.
64. Antipsychotic drugs are used to manage psychosis including
delusions, paranoia and hallucinations.
They are also known as neuroleptics or major tranquilizers.
68. Treatment of acute and chronic psychosis.
Selected agents are used as antiemetics.
Treatments of hiccoughs.
Vocal utterances in Tourette’s disorder.
71. Risk for other directed violence related to panic anxiety & mistrust of others.
Risk for injury related to medication side effects of sedation, extra pyramidal symptoms,
tardive dyskinesia.
Client is instructed not to abruptly stand to prevent fall due to orthostatic hypotension.
Check vitals before and after medication.
Increased intake of fluid& high fibre diet is recommended to avoid dry mouth and
constipation.
Educate client to wear full sleeves and eye gears while going out to avoid
photosensitivity.
72. ANTI DEPRESSANTS
Anti depressants are used in the treatment of major depression
with psychotic symptoms, alcoholism, schizophrenia or mental
retardation.
These drugs elevate mood and alleviate other symptoms
associated with moderate to severe depression.
77. NURSE’S RESPONSIBILITIES
Risk for suicide related to depressive mood.
Risk for injury related to side effects of sedation, photosensitivity,
arrhythmias, etc.
Socially isolated related to depressive mood.
Constipation related to side effects of the medication.
78. ANTICONVULSANTS
Treatment of convulsions varies with the type of seizures.
Anticonvulsants inhibit neuromuscular transmission, they may be
used for :
I. Long term management of chronic epilepsy (recurrent seizures)
II. Short term management of acute seizures
III. Emergency treatment of status epilepticus (continuous seizures)
81. MECHANISM OF ACTION
Anticonvulsants suppress the excessive rapid firing of neurons
during seizures.
Anticonvulsants also prevent the spread of seizure within the
brain.
84. SIDE EFFECTS OF ANTICONVULSANTS
Nausea
Muscle
and joint
pain
Respiratory
depression
Megaloblastic
anemia
Numbness Alopecia
85. NURSE’S RESPONSIBILITIES
Excessive use of alcohol should be reduced for the efficacy of the drug.
Give oral drugs with meal to minimize gastric irritation.
Prolonged use may led to drug tolerance.
Advice periodic ophthalmologic examinations, because drug can produce
ocular damage.
Note that confusion, agitation and behavioral disturbances occurs
commonly in elderly people.
Use cautiously in patients having hepatic and cardiac diseases and in
elderly and pregnant women.
86. MOOD STABILIZERS
Mood stabilizers are the drugs used to treat mood disorders,
generally characterized by rapid unstable mood shifts alternating
between mania & depression.
Mood stabilizers are more effective in mania than the depressive
phase of illness.
87. CLASSIFICATION
Lithium
• Best known mood
stabilizers
Anticonvulsants
• Carbamazepine
• Sodium valproate
Antipsychotics
• Risperdone
• Topiramate
88.
89. INDICATIONS
Bipolar disorder
Manic depressive psychosis
Recurrent mania
Cyclic depression
Acute hypomania
DRUGS INCLUDE :
o Lithium carbonate (Li2CO3)
o Lithium Chloride (LiCl)
90. CONTRAINDICATIONS OF MOOD STABILIZERS
Pregnancy
Cardivascular
disorders
Kidney
disorders
Severe
dehydration
Obesity Diabetes
92. NURSE’S RESPONSIBILITIES
Assess the client’s mood & behavior before & during the course of
Lithium therapy & monitor mood change.
Prepare the patient for respected side effects in non-anxious
manner.
Monitor serum lithium levels weekly two three times for first 2
months & afterwards once weekly.
Monitor input & output and promote fluid intake of 2-3 L/day to
prevent retention.
Assess the weight & check for edema in legs, ankles & wrists,
monitor for weight plan.
93. ANTI EMETIC DRUGS
Antiemetic drugs are medicines that ease nausea & vomiting.
The feeling of nausea results froma complex process in the body and this is why various
drugs have been designed to ease nausea in different situations.
SOME OF THE ANTI EMETICS ARE :
o Sodium citrate
o Orthophosphoric acid
o Bismuth subsalicylate
o Prochlorperazine
o Dexamethasone
o Ondansetron
94.
95. INDICATIONS OF ANTI EMETICS
Motion sickness Stomach flu Pregnancy
Effects of surgery Chemotherapy
96. Sleepiness Dry mouth Constipation
Indigestion Tinnitus
SIDE EFFECTS OF ANTI EMETICS
97. NURSE’S RESPONSIBILITIES
Monitor for dehydration.
Advise patient to have bland foods and avoid spicy foods.
Advise patient to move less and sit upright.
Assess the type of emesis from the patient.
Assess the consciousness level of patient before administering the
drug.
Teach patient to change positions slowly.
Assess patients neurological status, level of orientation and
reflexes.
98. ANTIPARKINSONIAM DRUGS
INTRODUCTION
Parkinsonism is a chronic, progressive motor disorder characterized
by rigidity, tremors, hypokinesis.
If these symptoms worsen, there maybe breathing difficulty and
inability to walk.
99. DRUG DOSE
2 – 3 g/day, BD, Oral.
- Symptoms of hypokinesia, rigidity and tremors resolve on
administration of Levodopa.
100. Dizziness Nausea Dark coloured urine
Unusual dreams Loss of apetite Abdominal cramps
SIDE EFFECTS OF LEVODOPA
101. DRUG DOSE
- 75 – 100 mg, TID, Oral.
ACTION
- Treat Parkinson’s symptoms such as :
• Shakiness
• Stiffness
• Difficulty in moving
102. SIDE EFFECTS OF CARBIDOPA
Dizziness
Loss of
apetite
Constipation Dry mouth Confusion
103. NURSE’S RESPONSIBILITIES
Assess for parkinsoniam and extra pyramidal symptoms.
Caution patient to make position change slowly.
Administer drug with low protein foods.
Assess for suicidal tendencies.
Assess for consciousness level of patient before administering drug.
Patient should be taught not to discontinue antiparkinson drugs
suddenly.
104. CNS STIMULANTS
INTRODUCTION
CNS stimulants are medicines that stimulate the brain, speeding up
both mental and physical processes.
They increase energy , improve attention and alertness and elevate
blood pressure, heart rate & respiration rate.
105. 1. AMPHETAMINES
DRUG DOSE
- 5 – 10 mg/day, Oral
- They promote release of catecholamines from presynaptic nerve terminals &
prevent their reuptake into nerve endings.
INDICATIONS
- Obesity
- Neurolepsy brain dysfunction syndrome in children.
107. SIDE EFFECTS OF AMPHETAMINES
Dizziness Headache Tachycardia Hypertension Diarrhea
108. NURSE’S RESPONSIBILITIES
Carefully screen potential uses for a history of drug abuse.
Administer last dose atleast 6 hours before bedtime.
Inform diabetic patient that insulin/dietary requirement maybe diluted by
amphetamines.
Caution patient that ability to drive or operate heavy machinery maybe impaired
by the drug.
Use amphetamines for weight control only after other weight reduction
programme have failed.