CNS P2 AntiPsychotic - AntiDepressnt Flashcards
what is the main reason of Schizophrenia?
increase of the Dopamine and serotonin overactivity
-location of dopamine and serotonin :
1-nigro straital pathway
2-putitry gland
3-V.c ( vomiting’s center )
4-mesolimbic pathway
what is the schizophrenia and its symptoms?
-its disorder in pertecular kind of psychological problem charichtrazed by abnormal social behaviour and failure recognise what is the real
- symptoms:
-we have two types of symptoms
1-positive :
1-1 delusions
1-2 unclear thinking
1-3 adutry hallousantion
2-negative:
2-1 reduced social engagement
2-2 Blunted Emotions
classification of Antipsychotic drugs
-there are two types
1- Typical :
1.1 Phenothiazine derivatives :
-Chlorpromazine,Thioridazine
1.2 Butirophenon Derivatives :
-Haloperidol (long acting ), Droperidol
2- Atypical :
2.1 Dobenzodizapine derivatives:
-Clozapine , Olanzapine
2.2 Benzooxazol derivatives:
-Risperidone
2.3 Piperazine derivatives:
-Aripiprazole
2.4 substuted benzmides
- Sulpiride , Amisulpride
-NB! since the disorder resulte of increase in the transmitters activity so they are blockers
differences between typical and Atypical
1-Typical :
1.1 mainly productive of positive symptoms and little of negative
1.2 cause extrapyramidal manifestation
1.3 cause hyperprolactima
2-Atypical:
2.1 productive of negative symptoms
2.2 practically don’t cause extrapyramidal disorders
explain the Drug : Chlorpromazine
- Drug : Chlorpromazine tab 0,025 ,
A 2,5%-1ml
-mechanism: its block the >
1- Dopamine receptor in :
1.1 Limbic system and misocortical areas > cause SE antipsychotic effect
1.2 CTZ ( vomiting center ) > cause SE Antiemetic effect
1.3 Basal ganglia > cause Extrapyramidal effect
1.4 Pituitary gland > cause increase prolactin release
2- Serotonin receptor ( 5-HT2A) > cause AntiPsychotic effect
3-Adronirgic receptor ( a1) > Postural hypotension , tachycardia
4-Histamine receptor (H1) > Sedation , antiprunic effect
5-Muscranic receptor : Atropine like action > dryness , blurred vision , Constapation
—— Uses :
1- Schizophrenia
2- Intractable hiccough
3- Severe nausea and Vomating
explain the Typical drugs
1-Thioridazine
2- Haloperidol
3-Droperidol
-Drugs : 1-Thioridazine tab 0.1
2- Haloperidol 0,0015 3-Droperidol A 0.5%-1ml
- mechanism: they blocks D1-D2 , a2, H1, and 5-HT2A ,5-HT1A but > they are mainly blocking and high effect on D2
-Pharmacological effect :
1- Antipsychotic 2-sedative 3- Antiemetic 4-decrease the skeletal muscles tone
-Side effect :
1-Parkinson like action
2-Neurleptic malignant
3-increase the IOP
4-Hyperprolactemia
- uses :
1-Psychosis
2-Vomating and nausea
3- hyperthermia
4- Neurleptianalgisa ( Droperidol)
explain the Atypical drug
1-Clozapine 2- Olanzapine
-Drug : 1-Clozapine Tab 0,025
2- Olanzapine Tab 0,025
-mechanism: blocks the Dopamine and serotonin receptors in the brain 5-HT2A,D4,M cholinergic,H1,a2
-pharmacological:
1-antipsychotic
2-Sedative and hypotensive ( Clozapine )
- Uses :
1- psychosis that resistant to Typical Drugs
-Side effect :
1- Agranulocytosis ( clozapine )
2- drawnness
3-QT prolongation
explain the Atypical drug Risperidone
-Drug : Riseperidone tab 0,001
-mechanism: blockes 5-HT2A , D2 , a2 , receptor
-pharmacological effect : Antipsychotic
-uses : As antipsychotic in case of Resistance To typical drugs
-side effect : Agitation , anxiety , QT prolongation
what is the pathophysiology of Depression , and types of depression , symptoms
1-Genetic : there is 4 genes were approved has relation with depression
2-Biological amines and receptors :
2-1 Amines : Serotonin , norepinephrine, Dopamine
2-2 receptors : D , 5-HT2A , 5-HT2C
—Types of depression:
1- Unipolar : major depression
2-Bipolar : maniac
—-Symptoms:
1-Emotional symptoms:
1-1Anhedonia 1-2 loss of self trust
1-3 loss of motivation
2-Biological symptoms:
2-1 Sleep disorder
2-2 loss of lipido
2-3 Chronic pain
Classification of Drug that treat the Antidepressant
1- Mono amine oxidase inhibitors
2-tricyclics antidepressant (Tca )
3-selctive serotonin reuptake inhibitor(SSRI)
4-Atypical
5- Selective NA reuptake inhibitors
explain the MAO and where are they located , types
-There is two typs of MAO
1- MAO-A: present in the cytoplasm of the neuron (CNS) and in the peripheral tissue (Liver ) and its act non-specifically on Norepinephrine,5-HT , Dopamine receptors
2- MAO-B : present mainly in the CNS and act mainly on Dopamine receptor
—- Types of MOA inhibitors
1- Selective MAO-A inhibitor : Moclobemide
2- non selective MAO inhibitor : Nialamide
1-
Explain the non-Selective MOA inhibitor Drug
-Drug : nialamide tab 25mg
-mechanism: its non-selective MAO inhibitor so its inhibit Mao A and Mao B irreversibly which lead to accumulation of the Monoamines in The CNS 5-HT, Dopamine in the synaptic cleft
-Pharmacological effect: Analgesic
-Uses : to treat Major depression if the depression is resistant to other drugs
-Side effect :
1-postural hypotension
2-sexual dysfunction
3-CNS stimulation
- Contra indication :
1- Cheese reaction
2- Serotonin syndrome
explain the Cheese reaction
-Tyramine its indirect sympathomimetics present in some food normally its metabolized by MAO A in the liver
but when the body under A MAO A inhibitor and the patient eat one of the food that consist of tyramine , the tyramine distrusted in the body and cause sever hypotension
- treatment: a blocker + B blocker
( prazosin + propranolol)
-Ex of this food : cheese , beer , fish
Explain the Selective MAO A inhibitor
-Drug : Moclobemide Tab 0.15
-mechanism: its selective MAO A inhibitor in the Neuronal Tissue and peripheral tissue ( liver )
which lead to accumulation of the
NA,5-HT, dopamine in the synaptic cleft
- Pharmacological effect: Psycho stimulating
-Uses : major depression
-Side effect:
1-postural hypotension 2-decrease lipido
3-sleep disorder
- cheese reaction ; high risk
explain the Tricyclic antidepressant drugs
-Drugs : 1- Imipramine tab 0,025
2- amitriptyline tab 0.025
- mechanism : TCA inhibit to the proteins transporter which is responsible for 5-HT and NA reuptake which lead to accumulation in the synaptic cleft >
1- inhibit the NA protein transporter
2- inhibit the 5-HT protein transporter
3-muscranic blocked > atropin like action
4- a-Adrinrgic blocking > postural hypotension
5-H1 blocking > sedation , confusion
6- lower the seizures threshold> and convalescent may occures
—pharmacological effect:
1- antidepressant and sedation
2- antiemetic
3-Psycho stimulation : imipramine
4- analgesic
- side effect :
1-postrual hypotension
2-sexual dysfunction
3- CNS sedation 
- Uses :
1- depression pain ( chronic ) : Amitriptyline
2- cheliden anuria : imipramine
3- major depression
-contra indication :
1- epilepsy patients
1- Serotonin syndrome
explain the Serotonin selective reuptake inhibitor drug
-Drugs : Fluoxetine capsules 0,02
-mechanism: its selectively 5-HT reuptake proteins transporter inhibitor
which lead to accumulation of the serotonin in the synaptic cleft
-pharmacological effect:
1- Psycho stimulation
2- analgesic
3-Anorexginic
- side effect:
1-withdrawal symptoms
2- sexual dysfunction
3-CNS sedation or insomnia
-Uses :
1- depression pain
2- Bulimia
3-OCD ( obsessive compulsive disorder)
4- generalized anxiety
5-major depression
explain the selective NA reuptake inhibitor
-Drug : Maprotiline tab 0,01
-mechanism: its selectively NA reuptake proteins transporter inhibitor
which lead to accumulation of the Norepinephrine in the synaptic cleft
-pharmacological effect:
1-Balanced of psychotic
2- Analgesic
-uses :
1- depression pain
2- major depression
-side effect:
1- sexual dysfunction
2- withdrawal symptoms
3- postural hypotension
