Anxiolytics and Antidepressants Flashcards
What is Parkinsons disease caused by?
Loss of dopamine from neurones in the mid brain.
What drug can be used to replace dopamine?
L-dopa
What do monoamine transmitter systems do?
Affect broad functional states, such as arousal and mood.
What are the symptoms of depression?
Low or depressed mood. Anhedonia.Low energy or fatigue.
What are the symptoms of mania?
Elation, talkativeness, creativity, fullness of energy and confidence.
What stages are involved in the stress process?
Stress causes hypothalamus to release CRH > CRH activates the sympathetic nervous system > pituitary gland releases ACTH > adrenal gland releases cortisol > physiological changes for a response to stress occur ‘fight or flight’
What causes depression?
High levels of cortisol. Over-activity in the amygdala and hypothalamus. Under-activity in hippocampus and prefrontal cortex. Imbalance/deficiency of noradrenaline or serotonin.
What are the different treatment types for depression?
Counselling. Psychotherapy e.g CBT. MAOIs, Tricyclic drugs, SSRI’s, third generation antidepressants, mood stabilisers. ECT.
What do monoamine oxidase inhibitors do? (MAOIs)
Non-selective blockers of the metabolism of all monamines. Used commonly for severe depression. Inhibit noradrenaline breakdown.
What is Phenelzine?
An MAOI. Treatment of depression or bipolar.
What is Tranylcypromine?
MAOI. Treatment of severe depression.
What are the side effects of MAOIs?
HTN, Inhibition of cytochrome P450 (liver enzyme). Weight gain, oedema, sexual dysfunction and sedation.
What do Tricyclic antidepressants do?
Non-selectively block the reuptake of noradrenaline and serotonin, leading to an increase in their availability at receptors.
What are the names of some tricyclic antidepressants?
Imipramine, Amitriptyline, Doxepin.
What are the side effects of tricyclic antidepressants?
Weight gain, sexual dysfunction, inhibition of cytochrome P450. Contradicted for use in patients with CV problems. Sedation. Dry mouth, blurred vision, dizziness, headache.
How do Selective Serotonin-reuptake Inhibitors work?
Increase the levels of serotonin in the brain by blocking the reabsorption of serotonin. Most widely used antidepressants.
What are the names of some SSRIs?
Fluoxetine, Paroxetine, Sertraline, Citalopram. Treat depression, OCD and panic disorders.
What are the side effects of SSRIs?
Sexual dysfunction, dependence and withdrawal. Interact with MAOIs and Warfarin. Don’t give to patients with mania or anxiety.
What are the third generation antidepressants?
They inhibit the reuptake of serotonin and noradrenaline and some dopamine.
What are the names of the third generation antidepressants?
Bupropion and Venlafaxine.
What are mood stabilisers?
Stabilise acute mania and epilepsy. Known as anticonvulsants. The lithium drugs change the biochemical, electrolyte and endocrine functions in the body.
What are the names of the mood stabilisers?
Lithium carbonate, Lithium citrate, Carbamazepine, Valproate.
What are the adverse effects of mood stabilisers?
Contradicted for patients with renal dysfunction, leukaemia, dehydration or sodium depletion. Avoid sodium bicarbonate and other antipsychotic drugs, diuretics and NSAIDs. Dizziness, headache, confusion, hair loss, oedema, cardiac dysrhythmias and nephrotoxicity.
What are the different types of anxiety disorders?
Generalised anxiety disorder, panic disorder, phobias, post-traumatic stress disorder, OCD.
What drugs are used to treat anxiety?
Anxiolytics - sedative hypnotics, benzodiazepines, second generation non-benzodiazepines.
What do anxiolytics do?
Depress the CNS - alleviate symptoms of distress.
Name the sedative hypnotics.
Thiopental, Secobarbital, Phenobarbital, Zolpidem.
What is thiopental used for?
Preparation for surgery - produces unconsciousness within less than a minute.
What are the side effects of sedative hypnotics?
Avoid other CNS depressants. Check for suicidal tendencies. Drowsiness or hangover. Dependence and tolerance.
What are benzodiazepines?
Effective anxiolytics that do not cause over sedation. Reduce anxiety symptoms and panic disorders and can be used for seizure control. They inhibit cholinergic receptors. Enhance the effect of GABA.
Name the benzodiazepines.
Diazepam, Alprazolam, Temazepam, Lorazepam.
What are the side effects of benzodiazepines?
Avoid other CNS depressants, can lead to over sedation and CNS depression. Headache, dry mouth, blurred vision, dizziness, memory loss, hypotension, GI disturbances.
What is the mainly used non-benzodiazepine anxiolytic?
Buspirone - short-term treatment of anxiety and depression. Acts on serotonin receptors rather than on GABA receptors.
Side effects of Busprione?
Avoid other CNS depressants, Never with MAOIs. Dizziness, headache, insomnia, nausea, dry mouth, blurred vision.
What are the positive symptoms of schizophrenia?
Hallucinations, delusions, bizarre thoughts.
What are the negative symptoms of schizophrenia?
Social withdrawal, flattened mood, apathy.
What are the symptoms of disorganised schizophrenia?
Disorganised, thought disorder; flattened mood, difficult to understand - speech may be incomprehensible.
What are the symptoms of paranoid schizophrenia?
Experience hallucinations and delusions, but no other symptoms.
What are the symptoms of catatonic schizophrenia?
Psychmotor disturbances e,g catatonic stupor and waxy flexibility.
What is used to treat schizophrenia?
Neuroleptics - dopamine receptor antagonists. And Antipsyhcotics.
Name the neuroleptics.
Chlorpromazine, Fluphenazine, Haloperidol, Loxapine.
What are the side effects of neuroleptics?
Parkinsonism, sedation and hypotension, impaired thermoregulation and lactation. Contradictions: CV disease, bone marrow suppression, renal, liver or thyroid dysfunction, or Parkinsons disease.
What are Atypical Antipsychotics?
Antagonists that are effective in managing psychoses and schizophrenia.
Side effects of Atypical Antipsychotics?
Avoid CNS depressants and antihypertensives. Headache, blurred vision, insomnia, nervousness, dizziness and GI distress. Weight gain
