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-antitspsychitric agents-iv.ppt
1.
Psychiatric Agents
2.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Classes of Drugs to cover briefly Sedative and hypnotic drugs Benzodiazepines – know MOA (not explicitly taught) Antidepressants and antimanic drugs Antianxiety Drugs
3.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Sedatives reduce activity or excitement some degree of drowsiness common.
4.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Benzodiazepines – daytime sedation sedation before anethesia sleep inducement relief of anxiety and tension skeletal muscle relaxation anticonvulsant activity
5.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Benzodiazepines absorbed well from GI tract distributed widely some also given parenterally all metabolized in liver, excreted primarily in urine.
6.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Benzodiazepines help regulate emotional activity calm or sedate without causing drowsiness higher dosages, induce sleep increase time asleep + sleep is deeper, more refreshing decrease time spent in REM sleep
7.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Barbituates sedatives and hypnotics “barbital” always in the name reduce overall CNS alertness standard pharmacokinetics appear to act through CNS
8.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Barbituates – daytime sedation (short periods only) hypnotic effects (insomnia) preop sedation and anesthesia relief of anxiety anticonvulsant
9.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Barbituates – PT Caution – tolerance – psychological / physical dependence benzodiazepines relatively effective and safe and effective > almost replaced them as sedatives / hypnotics
10.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Antidepressants “Affective disorders” – disurbances in mood, characterized by depression or elation MAO inhibitors tricyclic antidepressants (TCA) other antidepressants
11.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 MAO inhibitors Excreted mainly in GI tract, and a bit by the kidneys – inhibit monoamine oxidase, – enzyme that normally metabolizes the norepinephrine and serotonin – NE and serotonin stick around longer – can interact with more receptors, longer
12.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 MAO inhibitors also used to treat phobias and other psychiatric conditions lots of drug-drug and drug-food interactions lots of caution when using them!!
13.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Tricyclic Antidepressants amitriptyline imipramine hydrochloride can read about this large class of very common antidepressants
14.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Selective Serotonin Reuptake Inhibitors serotonin sticks around longer in synapse “feel good” molecule SSRIs have typically PK and are highly protein bound
15.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 SSRIs used to treat major depressive episodes obsessive-compulsive disorder Zoloft > post-traumatic stress disorder
16.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 SSRIs Prozac (fluoxetine hydrochloride) Paxil (paroxetine hydrochloride) very effective, very interesting very important can take weeks before see therapeutic benefit!!
17.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Anxiolytics Some of the most commonly prescribed drugs Benzodiazepines Barbituates Buspirone
18.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Buspirone absorbed rapidly, extensive 1st pass metabolized to at least 1 active metabolite eliminated in urine and feces mechanism of action unclear
19.
© Johns Hopkins
University, Baltimore, Maryland /// Contributed by: Andrew Healey, 2001 Let’s review… We only glazed the surface Wide variety of drugs in use a lot Sedative and hypnotic drugs Benzodiazepines – know MOA Antidepressants and antimanic drugs Antianxiety drugs
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