anxiolytics and antidepressants Flashcards
describe the limbic system?
ascending arousal system which modulates activity through the brain; moods and emotions are controlled in this system
parts of the limbic system?
hypothalamus, amygdala, hippo-campus, nucleus accumbens, cingulate cortex, pre-frontal cortex
role of the hypothalamus within the limbic system?
maintains homoeostasis and motivational drives
role of amygdala within the limbic system?
recognises and responds to emotions
role of hippocampus within the limbic system?
long term storage of experiences and memory
role of nucleus accumbens within the limbic system?
involved in reward and pleasure
role of cingulate cortex?
registers pleasant and painful stimuli, is involved in aggression
role of prefrontal cortex within the limbic system?
deals with decision making and expression of mood
where are neurotransmitters stored?
in vesicles within the terminal of the pre-synaptic neurone
what are monoamine transmitters?
transmitters derived from amino acids; e.g. serotonin, noradrenaline, dopamine
examples of serotonin releasers and their action?
fenfluramine, MDMA, ecstacy; act on the serotonin transporter, and inhibit the transport of serotonin into the cell, and facilitate its outward transport.
action of SERT inhibitors?
maintain higher levels of monoamines in the synaptic cleft
describe depression;
a mood disorder with a triad of symptoms; low or depressed mood (dysphoria), anhedonia, low energy of fatigue
describe bipolar disorder?
a manic-depressive illness; symptoms include elation, talkativeness, creativity, energy and confidence
which patients have high cortisol levels?
depressed patients; they have overactivity in the hypothalamus and amygdala
describe the mechanisms of the fight or flight response:
1) amygdala perceives stress/ fearful events. 2) hypothalamus releases CRH which activates the SNS (responsible for releasing adrenaline). 3) pituitary gland produces ACTH. 4) adrenal gland secretes cortisol. 5) physiological changes in response to stress. 6) cortisol feedback to glucocorticoid receptors
drug treatments for depression?
MAOI’s, tricyclic antidepressants, SSRI’s, miscellaneous antidepressants, mood stabilisers
examples of MAOI’s and their action?
ipronidazid, phenelzine, tranylcypromine - treat depression and bipolar; they non-selective blockers of the metabolism of monoamines
action of tricyclic antidepressants ?
non-selectively block the re-uptake of noradrenaline and serotonin - used for depression and anxiety
examples of tricyclic antideressants?
imipramine, amitriptyline, doxepin
what are the most prescribed antidepressants?
SSRI’S; example, fluoxetine, paroxetine, sertraline, citaloram
adverse effects of SSRIs?
sexual dysfunction, weight loss, dependence or withdrawal
examples of mood stabilisers and their actions?
lithium carbonate, lithium citrate, carbamazepine, valporate - treat prophylaxis, mania and epilepsy
most important inhibitory neurotransmitter in the brain?
GABA
examples of anxiolytics?
sedative hypnotics, benzodiazepines, non–benzodiazepines
side effects of sedative hypnotics?
drowsiness, hangover
examples of sedative hypnotics?
thiopental, secobarbital, phenobarbital, zolpidem
examples of benzodiazepines and their function?
diazepam; anxiety and seizures. alprazolam; anxiety and panic. temazepam; insomnia. lorazepam; anxiety, sedation, amnesia
side effects of benzodiazepines?
anticholinergic effects; headache, dry mouth, blurred vision, dizziness, memory loss, hypotension, GI disturbances
what is schizophrenia?
when patients are unable to separate real from unreal experiences - behaviour is often bizzare and inappropriate
categories of schizophrenia?
disorganised, paranoid, catatonic
“positive” symptoms of schizophrenia (symptoms that add something)
hallucinations, delusions, bizarre thoughts
“negative” symptoms of schizophrenia? (symptoms that take away something)
social withdrawal, flattened mood, apathy
categories of drugs that treat schizophrenia?
anti psychotics / neuroleptics, and atypical antipsychotics
examples of antipsychotics / neuroleptics?
chloropromazine, fluphenazine, haoeidol, loxapine
examples of atypical antipsychotics and their actions?
clozapine, amisulpride, isperidone, olanzepine - all manage schizophrenia, effective in treating both positive and negative symptoms
which antipsychotic is used for treatment of schizophrenia and behavioural problems in children?
chlorpromazine
adverse effects of MAOI’s?
inhibit noradrenaline breakdown in peripheral sympathetic system; increase BP. inhibit liver enzyme cytochrome P450. weight gain, oedema, sexual dysfunction, sedation
contraindictations of MAOI;s?
do not use for; impaired renal or hepatic function, hypertension, pregnant or lactating women.
examples of SSRI’s?
fluoexetine, paroxetine, sertraline, citalopram
side effects of neuroleptics / antipsychotics
tremor, akinesia, muscle ridgitiy- parkinsonism, tardive dyskensia, sedation, hypotension, thermoregulation, lactation
side effects of atypical antipsychotics?
headache, blurred vision, photosensitivity, insomnia, nervousness, dizziness, GI distress, glaucoma, peptic ulcer disease, urinary retention, dsyrhythmias, hepatic dysfunction, weight gain
