Antipsychotics Flashcards
what are the 4 main classes of antidepressants
give examples
Selective serotonin reuptake inhibitors
e.g. sertraline, fluoxetine, citalopram, paroxetine
Tricyclic antidepressants
e.g. amitriptyline, clomipramine
serotonin-noradrenaline reuptake inhibitors
e.g. venlafaxine, duloxetine
monoamine oxidase inhibitors
SSRIs: mechanism of action indications pharmacokinetics ADRs
prevent re-uptake of serotonin by presynaptic membrane, so increasing serotonin in synaptic cleft
mod-severe depression (with CBT)
almost completely absorbed from gut, with long half life
metabolised by liver
safe in overdose
anorexia, nausea, diarrhoea, mania, extrapyramidal symptoms
TCAs:
mechanism of action
pharmacokinetics
ADRs
block re-uptake of serotonin and NA a presynaptic membrane
absorbed by gut, lipid soluble, long half life
metabolised by liver
wide range of action and multiple side effects: CNS (e.g. sedation), ANS (e.g. reduced glandular secretions), CVS (tachycardia, postural hypo), GI (constipation)
overdose: monitor cardiac function
SNRIs:
mechanism of action
pharmacokinetics
ADRs
prevent re-uptake of NA (high dose) as well as serotonin (low dose)
short half life: may get withdrawals
sleep disturbances, hypertension, dry mouth, hyponatremia
what are the main symptoms of schizophrenia
classify the symptoms
positive: hallucinations, behavioural change
negative: social withdrawal, unusual speech and thought
cognitive: selective attention, poor memory
affective: anxiety, depression
what is the main theory behind onset of schizophrenia
excess dopamine released by brain
what are the main dopamine pathways in the CNS
meso-limbic: emotional response and behaviour
meso-cortical: arousal and mood
nigrostriatal: control of movement
tubero-hypophyseal: pituitary and hypothalamus function
what is the main mechanism of action of schizophrenia medication
D2 antagonist
how are anti-psychotic medications (neuroleptics) used in schizophrenia treatment classified
give some examples
typical: D2 antagonists in CNS but affect variety of CNS symptoms (extra-pyramidal, tardive dyskinesia)
e. g. haloperidol, chloropromazine
atypical:
D2 antagonist but with fewer extra-pyramidal signs
e.g olanzippine, risperidone, clozapine, quetiapine
more modern and now first line
what are the main ADRs of anti-psychotics
sedation weight gain prolactin secretion extra-pyramidal signs postural hypotension cardiac toxicity
define anxiety
fear out of proportion to situation
= avoidance
what is the first line treatment for anxiety disorder
CBT
when are pharmacological agents used in anxiety disorders
adjuncts to non-pharmacological treatment in severe cases
what is the main pharmacological agent used in severe anxiety disorders
given an example
how does it work
what are the ADRs
Benzodiazepines
e.g. diazepam
act on GABA receptors
dependence, drowsiness, dizziness, psychomotor impairment, toxic in pregnancy
how is benzodiazepine overdose treated
flumazenil;
a BZD antagonist on GABA receptor
