This document discusses various psychopharmacological agents used to treat psychiatric conditions including antipsychotics, antidepressants, mood stabilizers, and benzodiazepines. It provides details on the classification, mechanisms of action, indications, and adverse effects of typical and atypical antipsychotics, tricyclic and SSRI antidepressants, lithium and anticonvulsants used as mood stabilizers. It emphasizes the importance of monitoring serum lithium levels and describes the management of lithium toxicity as an emergency. The document aims to inform psychiatrists and other medical professionals about appropriate pharmacotherapy options for different psychiatric diagnoses.
information regarding psychopharmacology especially for nursing students and community. covers all group like anti psychotic, anti anxiety, antidepressants, mood stabilizing agents etc.
This ppt will provide a complete information on the topic Depression. It Will also provide the types of depression, pathophysiology involved, causes, drugs used in Depression and its management.
information regarding psychopharmacology especially for nursing students and community. covers all group like anti psychotic, anti anxiety, antidepressants, mood stabilizing agents etc.
This ppt will provide a complete information on the topic Depression. It Will also provide the types of depression, pathophysiology involved, causes, drugs used in Depression and its management.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Definition, Epidemiology, Etiology, Aspects of anxiety, Classification/types of anxiety, Pathophysiology of anxiety disorders, Management of anxiety disorders along with treatment algorithms
Side effects of chemotherapy are the most dreaded of all times. Fortunately, there are different ways to prevent, treat and manage the side effects today, and cancer specialists take special care to make sure that their patients don’t suffer.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Definition, Epidemiology, Etiology, Aspects of anxiety, Classification/types of anxiety, Pathophysiology of anxiety disorders, Management of anxiety disorders along with treatment algorithms
Side effects of chemotherapy are the most dreaded of all times. Fortunately, there are different ways to prevent, treat and manage the side effects today, and cancer specialists take special care to make sure that their patients don’t suffer.
Slide set for medical students discussing the physiology and pharmacology of nausea and vomiting. Provided by Professor John A Peters, University of Dundee.
Essential drug concept and rational use of medicinesPravin Prasad
Many medical students are unheard of the Essential Medicine List. This has been mentioned in very small sections in various textbooks that are in use in Nepal. The discussion on this topic is a must among medical and nursing students, as well as anyone related to field of Medicine
a beautiful ppt, illustrating the principles for prescribing, current concepts for clinical decision making, for practicing medicine and health care planning worldwide...
Development of Nutraceuticals & functional foodsEkta Belwal
“Nutraceuticals” & “Health food” shops has grown enormously, fostered by wide media coverage of their benefits. There has been a boom in their sales as patients rush to self-medicate, either in the hope that these products will be effective in treating diseases unsatisfactorily treated with pharmaceuticals, or that the adverse effects of some pharmaceuticals may be avoided.
Antipsychotics, also known as neuroleptics, are a class of medications primarily used to manage symptoms of psychosis, a mental state characterized by impaired thinking, emotions, and behaviors, often seen in conditions like schizophrenia, schizoaffective disorder, and certain mood disorders. These medications work by modulating neurotransmitters in the brain, particularly dopamine, to alleviate or reduce the severity of symptoms associated with psychosis. this ppt contains information regarding antipsychotics
A simple presentation describing medications used in Psychosis.
In this file, you can have a better idea about psychosis, Schizophrenia and their treatment nowadays.
Pharmacology lecture for medical students in English.
Major depression and mania are two extremes of affective disorders which refer to a pathological change in mood state
Major depressions characterized by symptoms like sad mood, loss of interest and pleasure, low energy, worthlessness, guilt, psychomotor retardation or agitation, change in appetite and/or sleep, melancholia, suicidal thoughts, etc
3. The mood change may have a psychotic basis with delusional thinking or occur in isolation and induce anxiety. On the other hand, pathological anxiety may lead to depression.
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
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AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
3. 1. TYPICAL ANTIPSYCHOTICS
They are D2 dopamine receptors antagonists. They
are also called neuroleptics.
They are subdivided into:
a. High Potency Antipsychotics. e.g.. Haloperidol
(Haldol,
Safinace) tab 1.5 mg and 5 mg; and
Trifluoperazine: Stelazine tab 5 mg.
b. Low Potency Antipsychotics, e.g.,
Chlorpromazine (Neurazine, Largactil) tab 25 and
100 mg.
4. 1. TYPICAL ANTIPSYCHOTICS
Mechanism
of action
• Blockage of D2 receptors in mesolimbic
mesocortical and tubuloinfudibular tracts.
• Blockage of histamine, cholinergic and
noradrenergic receptors.
5. 1. TYPICAL ANTIPSYCHOTICS
Indications
a- Schizophrenia and other primary psychoses
such as
schizoaffective disorder, delusional disorder and
bipolar disorders.
b- Psychotic symptoms in association with major
depression
c- Psychotic disorders secondary to organic
mental disorders
d- To control behavioral symptoms in association
with
childhood conditions such as autism and
mental retardation.
e- In small doses, they are used to control
generalized anxiety
and psychosomatic disorders
7. NEUROLOGICAL SIDE-EFFECTS
it is a severe spastic contraction in a group of
muscles
• It may occur after a single dose of the drug.
• It occurs in 10% of cases.
•It occurs in the form of occulogyric crisis,
torticollis.
protrusion of the tongue and laryngeal dystonia
(most serious).
• It is treated by injection of
anticholinergic, antihistaminic drugs, or by
benzodiazepines (Valium).
8. B.
PARKINSONIAN-LIKE SIDE EFFECTS:
due to blockade of D2 receptors in the basal
ganglia
• They occur in 15% of cases
• It occurs in the form of rigidity, bradykinesia, and
tremors.
• It is treated by the addition of oral anticholinergic
drugs.
9. C.
AKASTHISIA (EMERGENCY):
• It is a subjective feeling of muscle discomfort
causing the patient to be restless. He keeps on
moving without feeling anxious.
• It occurs at any time in the course of treatment.
• It is treated by decreasing the antipsychotic drug
to the
least needed dose. Propranolol and
benzodiazepine are added to control it.
10. D.
TARDIVE DYSKINESIA (SERIOUS):
• It occurs after prolonged use of typical
antipsychotics,
most commonly with high potency drugs. It is much
less
common in atypical antipsychotics.
• It presents with abnormal involuntary movements
mainly in the face, mouth and tongue.
• Treatments: Stop drug and switch to
atypical
antipsychotics, particularly clozapine.
11. E.
NEUROLEPTIC MALIGNANT SYNDROME
(EMERGENCY):
• It occurs at any time during the course of treatment.
• It is more common with high potency antipsychotics,
particularly if high doses are introduced quickly in an
elderly or a dehydrated patient.
• It is more common in hot weather
• Characterised by increasing fever without apparent cause,
muscle rigidity, and tachycardia.
• Disturbance of conscious rapidly occurs. It progresses to
coma if not treated.
• Death may occur due to acute renal failure (due to muscle
necrosis), or acute heart failure due to exhaustion.
• CPK more than 1000 units.
• Treated by stoppage of the drug, monitor of vital signs,
monitor of renal functions, cold compresses (bath), betablockers, D2 dopamine agonists (bromocriptine) and direct
muscle relaxants (dantrolene).
12. NON-NEUROLOGICAL SIDE-EFFECTS:
a. Anticholinergic side effects as dryness of mouth,
blurring of vision, hot flushes, constipation and
urine retention. Cognitive functions dependent on
cholinergic pathways are also affected. This leads
to defective memory and concentration.
b. Cardiac as arrhythmia (anticholinergic effect).
c. Orthostatic hypotension.
d. Weight gain (antihistaminic effect).
e. Convulsions (lowering epileptic threshold).
f. Impotence and amenorrhea (due to increased
prolactin).
13. 2- ATYPICAL ANTIPSYCHOTICS:
They are more selective dopamine-serotonin
receptors antagonists.
They have the same indications as the typical
antipsychotics.
They usually cause much less of the side-effects
observed with the typical antipsychotics. Moreover,
they have the advantage of improving the negative
symptoms of schizophrenia.
Examples:
aClozapine: Leponex tab. 25 and 100 mg.
bOlanzapine: Zyprexa tab. 5 and 10 mg.
cRisperidone: Risperidal tab. 2 and 4 mg.
14. (B) ANTIDEPRESSANTS
They include:
1- Tricyclic and Tetracyclic Antidepressants.
2- Serotonin Specific Reuptake Inhibitors - SSRIs
3- Other Newer Antidepressants
15. TRICYCLIC AND TETRACYCLIC ANTIDEPRESSANTS
These
drugs exert their antidepressant
effect through the reuptake inhibition of
norepinephrine (NE) and serotonin (5-HT),
resulting in increased NE and 5-HT in the
synaptic cleft.
Tetracyclic
antidepressants include
maprotiline (Ludiomil).
16. TRICYCLIC AND TETRACYCLIC ANTIDEPRESSANTS
Examples of Tricyclic antidepressants are:
a- Imipramine: tofranil tab. 10 and 25 mg
b- Clomipramine: anafranil tab. 25 and 75 mg
c- Amitryptiline: tryptizol tab. 25 mg
The effective dose in Major Depression is 100-300
mg/day.
For other indications, a lower dose may be used.
17. INDICATIONS OF TCA
1- Depressive disorders
2- In addition to antipsychotics in schizoaffective
disorder depressive type.
3- Anxiety disorders as obsessive compulsive
disorder
(clomipramine), panic disorder, and different types
of phobias
4- Sleep disorders in children as nightmares
(amitryptiline)
5- Nocturnal enuresis (imipramine)
6- Some sexual disorders as premature
ejaculation (clomipramine)
18. ADVERSE EFFECTS:
Common side-effects include the following:
1-Anticholinergic side effects
2- Central Alpha-1 adrenergic effects
3-Anti-histaminic effects
4- Sexual side effects
5- Seizures: especially in epileptic patients.
6- Cardiac Side-effects
7- Exacerbation of manic episode in bipolar
patients.
8- Exacerbation of psychotic episode in
predisposed patients.
19. SEROTONIN SPECIFIC REUPTAKE INHIBITORS
(SSRIS):
Their side effects are much less than tricyclic and
tetracyclic antidepressants.
This group includes the following members:
1- Fluoxetine: Prozac capsules 20 mg
2- Fluvoxamine: Faverin tab 50 and 100 mg
3- Citalopram: Cipram tab. 20 mg
4- Sertraline: Lustral tab. 50 mg
5- Paroxetine: Seroxat tab. 20 mg
20. INDICATIONS OF SSRI
1- Depressive disorders
2- In addition to antipsychotics in schizoaffective
disorder depressive type.
3- Anxiety disorders: SSRIs are the treatment of
choice in obsessive compulsive disorder, panic
disorder, and different types of phobias
4- Some sexual disorders as premature ejaculation
5- Eating disorders, particularly bulimia nervosa
21. ADVERSE EFFECTS OF SSRI:
1- GIT: anorexia, nausea, and vomiting, in the initial
phase of treatment
2- Headache, anxiety, disturbed sleep continuity
and irritability, in the initial phase of treatment
3- Sexual: delayed ejaculation, anorgasmia and
impotence
4- Seizures. in susceptible patients, particularly with
fluoxetine
23. (C) MOOD STABILIZERS
These are a group of pharmacological agents that are
used mainly to control and prevent bipolar disorders.
Their anti-manic mechanism of action is not clear.
However, their usefulness is proved by controlled clinical
studies.
They include:
1- Lithium salts: Lithium carbonate (Prianel) tab. 400mg
2- Some Conventional Antiepileptics:
a. Sodium valproate: Depakine tab. 200 and 500 mg
b. Carbamazepine: Tegretol tab. 200 and 400 mg
3- Some Novel Antiepileptics:
a. Lamotrigine: Lamictal tab. 25 mg and 100 mg
b. Topiramate: Topamax tab. 25 mg and 100 mg
c. Gabapentine: Neurontine caps. 400 mg
24. LITHIUM SALTS:
Lithium is a monovalent ion. It is not metabolized by
the liver, and is excreted by the kidneys.
Indications
1- Bipolar Disorders
2- Schizoaffective Disorder - bipolar type.
3- Major depression (for resistant cases).
4- Resistant schizophrenia.
5- Aggressive behavior in mental retardation and
dementia.
25. ADVERSE EFFECTS OF LITHIUM
1- GIT: nausea, vomiting, and diarrhea (in the initial
phase of treatment)
2- Tremors
3- Polyuria (diabetes insipidus): It occurs due to
inhibition of ADH that leads to decreased reabsorption of fluids. It is treated by fluids and K.
retaining diuretics.
4- Thyroid effect: decrease of thyroid hormone,
goiter in 5% of cases
5- Cardiac effect: manifestations of hypokalemia in
ECG
6- Epilepsy in susceptible patients
7- Teratogenicity in pregnant patients
26. LITHIUM TOXICITY (EMERGENCY)
Early signs include nausea, diarrhea, polyuria,
ataxia, and tremors.
Signs of severe toxicity are renal failure, ataxia,
convulsions, delirium, and coma.
Death can occur due to dehydration, cardiac sideeffects and neurotoxicity.
27. LITHIUM TOXICITY (EMERGENCY)
It is treated by:
a- Stoppage of the drug.
b- Monitoring and support of vital signs.
c- Neurological and mental status examination.
d- ECG, renal functions, electrolytes and serum
lithium level
assessment.
e- Hydration and restoration of electrolyte balance.
f- Heamodialysis if lithium level is more than 4 mEq
/ litter.
28. SERUM LEVEL MONITORING
• Assessment of the serum level of lithium must be
done regularly.
The first sample can be taken after 5 days of
treatment, then every month after stabilization of
the level.
• The blood sample is collected 8-12 hours after the
last dose.
29. SODIUM VALPROATE
Indications
In bipolar disorders, sodium valproate is similar to
lithium. However. it is preferred in the mixed and
rapid cycling bipolar episodes.
Adverse effects
1- GIT: nausea, and vomiting
2- Sedation and tremors
3- Hepatotoxicity especially if used in children (<2
years).
4- Hair loss and weight gain.
5- Neural tube defect if used during pregnancy.
30. CARBAMAZEPINE
Indications
They are similar to lithium and sodium valproate. In
addition, it is useful for the treatment of alcohol and
benzodiazepine withdrawal.
Adverse effects
1- GIT: nausea, and vomiting.
2- Sedation, memory disturbance.
3- Elevate liver enzymes.
4- Hypersensitivity reactions, skin rash.
5- Agranulocytosis.
6- Neural tube defect can occur if used in pregnancy.
7- Carbamazepine is an inducer of liver enzymes, so it
can decrease the blood level of many drugs such as
haloperidol, tricyclic antidepressants and anticoagulants.
32. MECHANISM OF ACTION OF BDZ
They are agonists of benzodiazepine receptors.
These receptors bind to GABA receptors,
increasing the affinity of these receptors to GABA.
There are two types of benzodiazepine receptors:
• BZ 1 which is responsible for sleep.
• BZ 2 which is responsible for cognition and motor
activity.
33. MECHANISM OF ACTION OF BDZ
Generally speaking, benzodiazepines have the
following clinical effects:
a. Anxiolytic effect: reducing anxiety
b. Sedation: sleep inducing effect, induction of
anesthesia
c. Direct muscle relaxant effect
d. Antiepileptic effects
Individual members of benzodiazepines vary
according to their ability to exert one or more of the
above-mentioned effects.
34. INDICATIONS OF BDZ
1- Anxiety disorders such as generalized anxiety
disorder, panic disorder, and phobias
2- Insomnia
3- Akathisia
4- Agitation.
5- Depression especially alprazolam.
6- Bipolar disorders especially clonazepam.
7- Alcohol withdrawal
35. ADVERSE EFFECTS OF BDZ
1- Drowsiness.
2- Memory impairment.
3- Respiratory depression.
4- Withdrawal symptoms (especially in short half life
drugs as alprazolam): Symptoms include: anxiety,
insomnia, irritability, depression and seizures can occur.
5- Paradoxical increase in agitation.
6- Tolerance, dependence and addiction.
7- Overdose: Benzodiazepines are safe as they have a
high lethality index.
Death occurs if they are combined with another CNS
depressant drug such as alcohol.
Symptoms include respiratory depression, coma and
death.
36. ELECTRO-CONVULSIVE THERAPY (ECT)
Mode of Action
It is done through the passage of an electric current
capable of inducing a generalized seizure activity in
the brain.
The mechanism of action is not clear, but ECT is
one of the most efficient methods of treatment in
psychiatry.
It has the least complications when applied
properly.
37.
38. ELECTRO-CONVULSIVE THERAPY (ECT)
Technique
• Thorough physical examination.
• Patient is fasting and artificial dentures are
removed. A mouth gag is applied to protect teeth
and tongue.
39.
40. ELECTRO-CONVULSIVE THERAPY (ECT)
• Premedication and anesthesia:
- Atropine (0.5 mg I.M.) to protect the heart from
parasympathetic overtone and reduce bronchial
secretions.
- Short acting anesthesia (e.g., thiopental I.V.), a
sleeping dose is needed.
- Muscle relaxant (e.g., succinylcholine) in full dose
to minimize or prevent convulsions.
41.
42. ELECTRO-CONVULSIVE THERAPY (ECT)
• Application of electrodes:
1- Bilateral (more effective): bifrontotemporal
application of the electrodes.
2- Unilateral applied to non-dominant hemisphere
(less cognitive side-effects).
43.
44.
45. INDICATIONS OF ECT
1- Major Depression.
2- Bipolar Mood Disorder.
3- Acute psychotic disorders:
- Undifferentiated and brief psychotic disorders.
- Acute delusional disorders.
4- Schizoaffective disorders.
5- Schizophrenia:
- With catatonic symptoms.
- With mood (depressive symptoms).
- With acute exacerbation of symptoms.
48. COMPLICATIONS OF ECT
1- Transient short-term memory loss and confusion.
2- Rare complication:
- Fractures or dislocations (if muscle relaxant is not
adequately used).
- Myocardial infarction or arrhythmias.
- Miscarriage, if patient has threatened abortion.