Psychotherapeutics Flashcards
Psychiatric disorder types
Organic
Function
Organic
Congenital or caused by injury
Functional
Partially of psychogenic origin
Psychosis, affective disorder, neurosis
Psychosis
Disturbance of the functioning of ones personality with the loss of the perception of reality Most common schizophrenia Positive symptoms (agitation, delusions, auditory hallucinations) Negative symptoms (flat affect, apathy)
Affective disorder
Unipolar (involutional, reactive) Or bipolar (alternating periods of depression and mania) also called manic depressive disorder
Necrosis
Less severe than psychosis
Anxiety, panic disorder, phobia, OCD
Emotional origin with physical symptoms
Antipsychotic agent groups
Conventional agents (were used most often) Atypical agents (used when resistance built to conventional agents)
Conventional antipsychotic agents
Low potency=more sedation, more autonomic side effects, more peripheral side effects
High potency=more extrapyramidal side effects, less sedation
Conventional antipsychotic agent pharmacological effects
Antipsychotic (calming emotions, suppress hallucinations and delusion)
Antiemetic (control nausea and vomiting)
Intractable hiccups
Drug withdrawal
Atypical antipsychotic agents pharmacological effects
Improved efficacy and fewer side effects
Effective against positive and negative symptoms
Atypical antipsychotic agents
More nausea Less anticholinergic side affects Less sedation Lower incidence of extrapyramidial No antiemetic effects
Atypical and conventional side effects
Sedation Extrapyramidal effects Orthostatic hypotension cV effects Seizures Anticholinergic effects
Extrapyramidal effects
Acute dystonia (muscle spasms)
Parkinsonism
Akathisia (compulsive motor activity)
Tardive dyskinesia (irreversible involuntary movements)
Tardive dyskinesia
Women 40+ Large doses of phenothiazines Gradual onset Irreversible Movements coordinated and rhythmic Effect exacerbated by drug withdrawal Severe tmj pain
Anticholinergic effects
More often in conventional
Blurred vision, xerostomia
Antipsychotic drug interactions
Cns depressant (additive, sedation, respiratory depression) Epinephrine Anticholinergic agents (additive, worsen dry mouth)
Antidepressant agents use
Depression
Chronic pain adjuvant
Migraine
Antidepressant agents
Tricyclic Second generation Selective serotonin reuptake inhibitors Bupropion Others Monoamine oxidase inhibitors
Tricyclic antidepressant
First generation
Differ in side effects
-in
Tricyclic pharmacological effects
Feeling of well being, elevates mood
6 weeks to experience full effect
Sedation common (develops tolerance)
Tricyclic adverse effects
Cns depressant
Anticholinergic
Increase heart rate, blood pressure, heart attack
Tricyclic drug interactions
Amphetamines/Cns stimulants (increase heart rate and bp)
Maoi agent (fatal)
Anticholinergic (additive)
Tricyclic uses
Depression
ODC
Anxiety
Second generation
Fewer side effects
Fewer anticholinergic effects
Less cardio toxicity
Less sedative
Selective serotonin reuptake inhibitors
Less side effect
Equal antidepressant effect to tricyclic
Ssri adverse effects
Cns stimulation
Gi
Oral effects (dry mouth, taste changes, canker sores, glossitis)
Bupropion
Dopamine-norepinephrine reuptake inhibitor
Also used for smoking cessation
Bupropion adverse effects
Seizures
Gi
Cns
Monoamine oxidase inhibitors
Inhibit mao enzyme
Drug interaction
Interaction with food (wine, aged cheese, fish) results in hypertensive crisis
Last choice drugs for depression
Drug for bipolar depression
Mood stabilizers
Lithium
Valproate
Carbamazepine
Epinephrine
Caution with tricyclic
