CNS inhibitors - hypnotics, sedatives, anxiolytics and antipsychotics Flashcards
What are psychotropic drugs?
Drugs of various origins that have the ability to restore disturbed mental functions - attention, learning and memory, perception, mood and emotions, thinking
What are the two main categories of psychotropic drugs?
Depriving
Excitating
What action do depriving psychotropic drugs have?
Inhibitory, depressing action
Give 4 types of depriving drugs
Sedatives
Tranquilisers
Neuroleptics
Normotimics
What action do excitating psychotropic drugs have?
Activating, stimulating type of action
Give four examples of excitating drugs
Antidepressants
Nootropics
Psychostimulants
Adaptogens
Are sedative drugs selective or non-selective?
The are non-selective increasing inhibition processes and decreasing excitation processes in all brain structures
What is the action of sedative drugs?
Elimination of emotional instability and excessive reactions to external irritants
Give side effects of sedative drugs
They cause sleepiness and reduce working ability
What are contraindications for sedatives?
Contraindicated for drivers and operators
Give synonyms for tranquilizative drugs
Anxiolytic
Ataractic
Antiphobic
What is the action of tranquilizative drugs?
Elimination of negative emotions such as internal tension, anxiety, fear etc
What are the indications for tranquilizers?
They are needed to restore working ability and emotional comfort after stress and elimination of hypochondria.
Insomnia
Give a side effect of tranquilizers
Psychic dependence
Give a synonym for neuroleptic drugs
Antipsychotics
What are the actions of neuroleptics?
Elimination of delirium, hallucinations and restoring of the critical attitude to them
Give some indications of neuroleptics
Schizophrenia
Mania
Alcohol delirium
What is the origin of bromides?
Artificial
How do bromides function as sedatives
Enhance and concentrate processes of inhibition in the brain cortex
How do agents obtained from plants function as sedatives?
Decrease the processes of stimulation in the CNS
What is anxiety in a medical context?
Anxiety is an unpleasant state of tension, apprehension or uneasiness - a fear that seems to arise from an unknown source
What are the most common mental disturbances?
Disorders involving anxiety
Describe the symptoms of severe anxiety
Similar to the symptoms of fear such as sweating, palpitations, tachycardia and trembling. This is due to sympathetic activation.
What effect can tranquilizers have on the body?
Relaxation of muscles
Give four classes of tranquilizers based on mechanism of action
Agonists of benzodiazepine receptors
Antagonists of benzodiazepine receptors
Agonists of serotonin receptors
Blockers of the central M - cholinoreceptors
What is the main inhibitory neurotransmitter in the central nervous system
GABA
What is the GABA-A receptor composed of?
2 alpha subunits, 2 beta subunits and one gamma subunit
How is the GABA receptor activateed?
Two GABA molecules bind to the alpha subunits of the receptor
What happens once the receptor is activated?
Negatively charged ions are allowed into the cytoplasm, which results in hyperpolarisation and the inhibition of neurotransmission
What is the general action of barbiturates?
Central nervous system depressant
What are the indications for the use of barbiturates?
Anxiety
Insomnia
Name some side effects of barbiturates
Dependence
Overdose
Foetal dependence
Name some contraindications for barbituates?
Elderly patients
Pregnant women
What is the mechanism of action of barbiturates?
Binding to GABA receptors
Give the actions of tranquilisers
Tranquilising Sedative Hypnotic Central myorelaxation and inhibition of movement coordination Anticonvulsant Anterograde amnesia
Give 4 therapeutic uses of tranquilisers
Anxiety disorders
Sleep disorders
Seizures
Muscular disorders
What are the two categories of types of adverse effects of benzodiazepines?
Lack of tolerance Physical dependence ( rebound withdrawal effects)
What might cause a person to be intolerant of benodiazepines?
Sedation Memory impairment Lack of concentration Motor incoordination Muscle weakness Acute confusional state
What rebound withdrawal effects might a patient experience upon stopping a benzodiazepine
Insomnia Anxiety Apprehension Irritability Palpitations, tremor, vertigo, sweating
What are the indications for neuroleptic drugs?
Schizophrenia
Manic states
Delirium
(psychotic states in general)
What is schizophrenia?
A debilitating mental illness characterised by disturbances in thinking, emotional reactions and behaviour
What are the main symptoms of schizophrenia?
Hallucinations
Delusions
Cognitive disturbances
What is the impact of schizophrenia on a patient’s life?
Persistent impairment in a patient’s social functioning and productivity.
Patients are often under medical care for the rest o their lives
Define psychosis
Psychosis is a deep painful disorder of the psyche manifested in an inadequate reflection o the real world (consciousness) with behavioural disturbances, changes in mental activity (thinking, emotions, learning, memory) and accompanied by hallucinations, delusions, and psychomotor disorders.
Is there any heritability to schizophrenia?
There is a strong genetic component to schizophrenia but even identical twins are not 100% concordant so there is a large environmental component
What is the mechanism of action of neuroleptics?
Blockage of D2-Dopamine receptors Blockage of H1-Histamine receptors Blockage of Alpha1-Adrenoceptors Blockage of 5-HT-Receptors Blockage of M-Cholinoreceptors
What areas of the CNS do neuroleptics affect by blocking D2-Dopamine receptors?
Mesolimbic and mesocortical systems
Hypothalamus - hypophysis
Extrapyramidal system
Trigger zone of vomitive centre
How do neuroleptics affect the mesolimbic and mesocortical systems?
Antipsychotic effect
Emotional indifferency
Depression
How do neuroleptics affect the hypothalamus (hypophysis)?
Decreasing of body temperature
Galactorrhea (increase in prolactin production)
How do neuroleptics affect the extrapyramidal system?
Symptomathetic parkinsonis, late (tardive) dyskinesia
How do neuroleptics affect the trigger zone of the vomitive centre?
Anti-vomitive effect
What effect do neuroleptics have by blocking H1-Histamine receptors?
Sedative effect
Anti-vomitive effect
What effect do neuroleptics have by blocking Alpha1-Adrenoceptors?
Dilatation of blood vessels - decrease of blood pressure - orthostatic collapse
What effect do neuroleptics have by blocking 5-HT-Receptors?
Bulemia - increasing of appetite - increasing of body weight
What effect do neuroleptics have by blocking M-Cholinoreceptors?
Increase of intraocular pressure
Decrease of gland secretion
Relaxation of smooth muscles, constipation
Decreasing of extrapyramidal side effects
