Anxiolytics And Antidepressants Flashcards
Anxiolytic drug classifications
Sedative hypnotics
Benzodiazepines
Second generation non benzodiazepines
Anti psychotic drug classifications
Neuroleptics
Atypical drugs
Dopamine receptors work by…
Mediate all known pharmalogical actions of dopamine
Two major groups:
D1 like - increase cAMP
D2 like - decrease cAMP
Monoamine neurones are…
Located in the discrete nuclei writhing the brain stem and mid brain
Project widely throughout the forebrain
Affect mood and arousal
Drugs affecting this have a big effect of behaviour
Mood disorders
Major (unipolar) depression
Bipolar - depression/ mania
Fight or flight (sequence of events )
Stress causes hypothalamus to produce CRh
CRH activates SNS, tells pituitary gland to secrete ACTH
Adrenal gland secretes cortisol
This then feeds back on glucocorticoid receptors in the hypothalamus
SERT inhibitors are…
Inhibit serotonin and nor adrenaline
Non selective
Maintain high levels of monoamines in synaptic cleft
Phenelzine ( Nardil)
Tranylcypromine (parnate)
Monoamine oxidase inhibitors
Phenelzine ( Nardil) Is used to treat…
Depression and bi polar disorder
Tranylcypromine (parnate) is used to treat…
Severe depression
Side effects of MAOI’s
Hypertensive crisis
Foods high in tyramine (cheese effect)
Tryptophan drugs avoided as can cause serotonin syndrome
Weight gain
Oedema
Sedation
Sexual dysfunction
Contraindications of MAOI’s
Impaired renal or hepatic function
Hypertension
Pregnant or lactating women
Imipramine ( tofranil)
Amitriptyline (elavil)
Doxepin ( sinequan)
Tricyclic antidepressants
Imipramine (tofranil) is used to treat…
Tricyclic depression
Depression
Amitriptyline (elavil) is used to treat …
Tricyclic anti depressant
Depression
Dozepin ( sinequan) is used to treat…
Tricyclic anti depressant
Depression/anxiety
Tryicyclic anti depressants adverse effects
Weight gain
Sexual dysfunction
Inhibition of cytochrome p450
Anti cholonergic effects : dry mouth blurred vision dizziness headache and constipation
Tricyclic antidepressant contraindications
Myocardial infarction
CHD
Avoid other CnS depressant eg antihistamine
Fluoxetine ( Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (celexa)
Selective serotonin reuptake inhibitors
SSRI
Fluoxetine is used to treat …
SSRI
DEPRESSION
OCD
Paroxetine is used to treat…
SSRI
DEPRESSION
PANIC DISSORDERS
Sertraline is used to treat…
SSRI
DEPRESSION
PANIC DISSORDERS
Catalopram is used to treat…
SSRI
DEPRESSION
SSRI adverse effects
Sexual dysfunction
Dependence and withdrawal
SSRI contraindications
People with history of mania or anxiety
Bupropion ( Wellbutrin)
Venlafaxine ( Effexor)
Miscellaneous next generation antidepressants
Lithium carbonate (lithobid)
Lithium citrate (cibalith)
Carbamazepine (tegretol)
Valproate (depacon)
Mood stabilisers
Lithium carbonate is used to treat…
Mood stabiliser
Prophylaxis and acute mania
Lithium citrate is used to treat…
Mood stabiliser
Prophylaxis
Acute mania
Carbamazepine is used to treat…
Mood stabiliser
Mania
Epilepsy
Valproate is used to treat…
Mood stabiliser
Mania
Epilepsy
Adverse effects of mood stabilisers are…
Dizziness Headache Confusion Hair loss Oedema Withdrawal
Anti depressant drug classifications
MAOI
Tricyclic drugs
SSRI
Lithium
Contraindications of mood stabilisers
Renal dysfunction
Leukaemia
Dehydration
Sodium depletion
Sodium bicarbonate
Glutamate
Excitatory neurotransmitter
GABA
Inhibitory neurotransmitter
Glycine
Inhibitory neurotransmitter
Acetylcholine
Excitatory neurotransmitter
Dopamine
Modulatory neurotransmitter
Peptides
Modulatory neurotransmitter
Anxiolytics drug classifications are…
Sedative hypnotics
Benzodiazepines
Second generation non benzodiazepines
Thiopental (Pentothal)
Secobarbital (Seconal)
Phenobarbital ( luminal)
Zolpiderm ( ambien)
Sedative hypnotics
Thiopental is used to treat…
Sedative hypnotic
Prep for surgery
Secobarbital is given for …
Sedative hypnotic
Insomnia
Anxiety
Acute agitation
Phenobarbital is used to treat…
Sedative hypnotic
Insomnia
Anxiety
Seizures
Zolpidem is used to treat…
Sedative hypnotic
Insomnia
Sedative hypnotics adverse effects
Check for suicidal tendencies
Avoid other CNS drugs
Drowsiness
Dependence
Tolerance
Seizure on withdrawal
Contraindications of sedative hypnotics
Children under 18
Pregnancy
Nursing mothers
Diazepam (Valium)
Alprazolam (Xanax)
Tamazepan (restoril)
Lorazepam (Ativan)
Benzodiazepine
Diazepam is used to treat…
Benzodiazepine
Anxiety
Seizures
Alprazolam is used to treat…
Benzodiazepine
Anxiety
Panic DISSORDERS
Tamazepam is used to treat…
Benzodiazepine
Short term for insomnia
Lorazepam is used to treat…
Benzodiazepine
Anxiety
Status epilepticus
Pre op sedation
Amnesia
Benzodiazepine adverse effects
Headache Dry mouth Blurred vision dizziness Memory loss Hypotension
Date rape drug
Contraindications of benzodiazepines
Renal and hepatic dysfunction
Glaucoma
Pregnancy / lactation
Buspirone (buSpar)
Non benzodiazepine anxiolytic
Short term
Anxiety
Depression
Non benzodiazepine anxiolytic side effects
Anti cholonergic effects : dry mouth dizziness insomnia nausea
Avoid other CNS drugs
NEVER WITH MAOI’s
Symptoms of disorganised schizophrenia
Disorganised
Flattened mood
Difficult to understand -speech
Symptoms of paranoid schizophrenia
Hallucinations
Delusions
Symptoms of catatonic schizophrenia
Psychomotor disturbances
Catatonic stupor
Waxy flexibility
Chlorpromazine (Thorazine )
Fluphenazine (prolixin)
Haloperidol (haldol)
Loxapine (loxitane)
Typical antipsychotics/neuroleptics
Chlorpromazine is used to treat…
Typical antipsychotic /neuroleptics
Psychosis
Behaviour issues in children
Fluphenazine is used to treat…
Typical antipsychotic/ neuroleptics
Psychosis
Schizophrenia
Haloperidol is used to treat…
Typical antipsychotic /neuroleptics
Psychosis
Severe behaviour problems
Loxapine is used to treat…
Typical antipsychotic /neuroleptics
Mood disorder
Schizophrenia
Typical antipsychotic /neuroleptic side effects and contraindications
Parkinsonism
Sedation and hypotension
Tardive dyskinesia
Impaired thermoregulation and lactation
Don’t take with: CNS depressants, anticonvulsant, anti hypertensives, antacids
CI: CV disease, bone marrow depression, renal, liver, thyroid dysfunction, Parkinson’s disease
Clozapine (clozaril)
Amisulpride (solian)
Respiridone (risperdal)
Olanzepine (zyprexa)
Atypical antipsychotic
Clozapine is used to treat…
Atypical antipsychotic
Schizophrenia
Amisulpride is used to treat…
Atypical antipsychotic
Schizophrenia
Risperidone is used to treat…
Atypical antipsychotic
Schizophrenia
Olanzepine is used to treat…
Atypical antipsychotic
Schizophrenia
Side effects of atypical antipsychotic drugs
Weight gain
Headache, blurred vision, photosensitive, insomnia
Nervousness, dizziness, GI distress
Risk of neuroleptic malignancy syndrome is low
Contraindications of atypical antipsychotic drugs
CNS depressants, anti hypertensives
Glaucoma, peptic ulcer disease, impaired renal/hepatic function