Psychopharm drugs Flashcards
Sedative-hypnotic drugs goal
normalize sleep
decrease anxiety without sleep effect
Sedative drug mechanism
increase GABAa effect
bind to specfic GABAa receptors
Increase Cl-, hyperpolarize cell
Sedative newer drugs
z drugs that still bind to increase GABAa effect
milder side effects
less rebound effect
New Anti-anxiety drugs
increase seratonin activity in CNS
decrease sedation/dependence side effects
mod effectiveness, slower onset
Adverse effects of sedative/anti-anxiety drugs
rebound effect behavior effect (sleep walking) residual effect (hang over effect) fall risk tolerance/depedence/AD?
Rehab concerns of sedative/antianxiety drug
treating symptoms not underlying cause
trend away from BZD
sedation vs benefits?
List of Anti-depressant drugs
Selective Seratonin reuptake inhibitors (SSRI)
Seratonin Norepinepherine reuptake inhibitors (SNRI)
tricyclics- older drug
Mono amine oxidase inhibitor
others
Mechanism of antidepressants
prevent recycling of amine (80%) through SSRI/SNRI
prevent amine breakdown (10-20$) through MAO inhibitors
increase amine=increase BDNF= neurogenesis in hippocampus to control mood
Tricycles adverse effects
sedation seizures orthostatic hypotension OD cardiac issue decrease AcH
MAO inhibitors adverse effects
excitatory effect on CNS, increase BP especially with catechomine release
SSRI/SNRI adverse effects
generally well tolerated
Seizures, GI problems
Seratonin syndrome
can occur from all anti-depressants
increase BP/HR, hallucination, confusion, agitation, GI problems, shivers
fatal if not detected early
OFF labeling
chronic pain LBP fibromyalgia raynaud's disease HA
Rehab concerns of antidepressants
initial 6wk lag of effect
initial increase in depression
reorganization of mood change
Bipolar condition treatment
lithium, anti-seizure/psychotic drugs
kidney toxicity greater than 15 mEa/L
Adverse effects of lithium
mild- metallic taste, weakness, naseua, tremors
mod- decrease vision, vomit, diarrhea
severe- hallucination/confusion, nystagmus, dysarthria
Antipsychotic drugs
traditional- block D2 receptors from hyperactivity
atypical- weaker D2 blockers, stronger blocking of seratonin
Adverse effects of anti-psychotic drugs
atypical- affects lipid metabolism, weight gain
typical- sedation, orthostatic hypotension, anticholinergic effect
both have adverse extrapyramidal tract effects tardive dyskinesia pseudoparkinsons akathisia other dystonias
Tardive dyskinesia
cause: denervation super sensitivity
risks: increase age, genetic, alcohol abuse, affective mood, >6month usage
Neuroleptic Malignant syndrome
s/s: catatonia, rigidity, tremors, fever
risks: decrease mental function, high dosage
if not ID can be fatal
Rehab concerns of anti-psychotics
orthostatic hypotension
sedation
extrapyramidal effects
Goal/Mechanism of Alzheimer Drug
improve behavioral and cognitive functioning
cholinesterase inhibor- prolong effect of AcH
indicated for early AD to improve cog functioning
Memantle
AD drug that blocks/inhibits NMDA receptor normalizes Glutamate (disrupted in AD) slows AD regression of memory/intellect
AD implications
government curbs the use of antipsychotics
drug use should be specific to symptoms
non-pharm treatments (familiarize environment)
