Первый слайд презентации: SIW “The main methods of treatment are pharmacotherapy and psychotherapy from a position of evidence-based medicine ”
Слайд 2: Plan
Introduction The term of Psychopharmacology Classification of group preparations Mechanism of action Indications and contraindications List of literature
Слайд 3: Introduction
Although psychotherapy and antidepressant medication are efficacious in the treatment of depressive and anxiety disorders, it is not known whether they are equally efficacious for all types of disorders, and whether all types of psychotherapy and antidepressants are equally efficacious for each disorder.
Psychopharmacology is a section of pharmacology devoted to the study of the effects of drugs on the higher nervous activity of the use of drugs for the treatment of mental illness. The selection of psychopharmacology in a special section of pharmacology is associated with the specificity and considerable complexity of the methodological techniques used by psychopharmacology.
Слайд 5: Classification
neuroleptics / antipsychotics; tranquilizers / anxiolytics; antidepressants; mood stabilizers; nootropics / noetics ; psychostimulants; psychodisleptics.
Psychotropic drugs are drugs of various origins that have the ability to restore impaired mental functions - attention, learning and memory, perception, mood and emotions, thinking Psychotropic drugs with predominantly Decriminating (inhibitory, depressing type of action) with predominantly EXCESSING (activating, stimulating type of action) Sedatives; Tranquilizers; Neuroleptics; Mood timers. Psychostimulants; Antidepressants; Nootropics; Adaptogens.
Neuroleptic (antipsychotics) is a group of drugs capable of reducing psychotic or affective symptoms (hallucinations, delusions, autism) and psychomotor agitation (aggressiveness and impulsivity) and thus slowing down the rate of development of psychosis and causing its regression.
Слайд 8: Classification
A. “Typical” (causing extrapyramidal disorders): phenothiazine derivatives - chlorpromazine ( aminazine ); etarazin ; diprazine ; levomepromazine ( tizercin ), flufenazine ( moditen depot); trifluoperazin ( triftazin ); periciazine ( neuleptil ); thioridazine ( readazine, sonapax ); derivatives of thioxanthene - chlorprothixen ( truksal ); flupentixol ( fluanksol ); cuklopentyxol ( clopixol ). butyrophenone derivatives - haloperidol ( haloper, senorm, tranco-dol ); droperidol B. “Atypical” (not causing extrapyramidal disorders): benzamides - sulpiride (restful, eglonil ); tiaprid amisulpride ( solian ); dibenzodiazepine derivatives - clozapine ( alemoxan, leponex ); olanzapine ( zyprexa ); quetiapine ( seroquel ). benzyloxazole derivatives - risperidone ( rispolept )
Слайд 9: Neuroleptics
Aminazine Droperidol Triftazin Haloperidol Chlorprothixen Cyclopentixol Clozapine Olanzapine Fluorophenazine Sulpiride Risperidone Types of action Antipsychotic; (basic) Sedative; Hypothermic; Antihypertensive; Antiemetic; Antihistamine; Anti-emic; Potentiating to the action of analgesics, hypnotics, anticonvulsants.
Слайд 10: Indication for treatment
Hallucinatory-delusional, hebephricinic, catatonic syndromes; manic arousal, agitated depression, psychotonic arousal during epilepsy, chronic paranoid states neurotic disorders (elimination of fear, anxiety, sleep disturbance) premedication (preparation for anesthesia and surgery as part of a lytic mixture) unrestrained vomiting during radiation and chemotherapy Controlled hypothermia during operations on “dry” organs neuroleptanalgesia hypertensive crisis Muscle hypertonus at stroke
Слайд 11: Contraindications
individual intolerance; history of toxic agranulocytosis; angle-closure glaucoma; prostate adenoma (for neuroleptics with anticholinergic properties); porphyria; parkinsonism; pheochromocytoma (for neuroleptics of the group of substituted benzamides ); a history of allergic reactions to antipsychotics; severe violations of the kidneys and liver; diseases of the cardiovascular system in the stage of decompensation; acute febrile states; intoxication with substances that inhibit the central nervous system; coma; pregnancy; breastfeeding (especially for phenothiazine derivatives).
ANTIMANIACAL drugs (drugs for treating mania, NORMOTIMICS or “mood stabilizers”) are medicines that can prevent mood changes in patients with bipolar affective (manic-depressive) disorders. Classification LITHIUM PREPARATIONS: lithium carbonate ( litosan, quilonium, contextmn ), Mikalit, lithium oxybutyrate Preparations of other pharmacological groups that have normochemical properties: Carbamazepine (antiepileptic) valproate (antiepileptic), clonazepam (sedative, muscle-relaxing, anxiolytic and anticonvulsant) nifedipine, verapamil
1. Salts of lithium. In manic-depressive psychosis, lithium preparations are used as a preventive therapy, and under condition of constant monitoring of the lithium content in the blood, it is well tolerated. And with increasing concentrations above a certain level, dosage adjustment is made. In the absence of the possibility of such control, the frequency of side effects increases. The main side effects: increased thirst, tremor, nausea, muscle weakness, drowsiness, arrhythmia, changes in thyroid function. 2. Derivatives of carbazepine (carbamazepine and oxcarbazepine). These drugs were originally used as anticonvulsants and in trigeminal neuralgia. Further study showed their effectiveness in the treatment of patients with affective disorders, paroxysmal pain, aggressiveness, behavioral disorders, alcoholism. 3. Valproates. The exact mechanism of action of valproic acid in bipolar disorder is unknown, but there is evidence that it increases the synaptic concentration of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter of the brain. Mild side effects usually occur at the beginning of therapy and, as a rule, disappear on their own. These include gastrointestinal disorders (nausea, vomiting, loss of appetite, heartburn, diarrhea), sedation, tremor. At the beginning of therapy, about half of the patients have a sedative effect. 4. Lamotrigine. Lamotrigine is a drug that was originally used to treat epilepsy. Further study revealed its effectiveness in the treatment and prevention of affective disorders (especially depressive). Side effects are usually mild, but rash may occur in 10% of patients. Other side effects of lamotrigine include headache, symptoms of CNS damage (diplopia, ataxia, blurred vision), as well as nausea and vomiting.
Слайд 14: Tranquilizers
(“Tranquillo-are” - to make calm, serene) or anxiolytics (from lat. Anxius - alarming, seized with fear, i.e. “anti-anxiety”), or ataraktiki (from lat. Ataraxia - equanimity of spirit, peace of mind) - medicinal means that have a calming effect, but in small therapeutic doses, eliminate internal psycho-emotional stress, anxiety, a sense of fear, hatred and fear of a neurotic nature.
Слайд 15: Classification
1,4-benzodiazepine derivatives = DB: Diazepam (Valium, Relanium, Sibazon, Seduxen ) - Chlordiazepoxide ( Elenium ), - Medazepam ( Rudotel ) - Alprazolam (Xanax); Tofisopan ( Grandaxine ); - Lorazepam ( Lorafen );. Tranquilizers of different chemical : 1. Serotonin receptor agonists: Buspirone ( Spitomin ) Afobazole, 2. M- holinoblokatory : AMIZIL 3. Different: hydroxyzine, mebikar.
Слайд 16: Mechanism of action
Severe ANXIOLYTIC (anti-anxiety) anticonvulsive Myorelaxative Hypno - sedative Vegetocorrective
Слайд 17: Side effects
benzodiazepines - drowsiness, lethargy, headache, disturbance of the mestrual cycle; serotonin receptor agonists ( buspirone, afobazole ) - very rarely headache, dizziness In case of poisoning with benzodiazepines - antagonist of BD receptors - FLUMAZENIL
Слайд 18: Indications for treatment
neurotic disorders, accompanied by a feeling of fear and anxiety, insomnia, etc.; seizure syndrome and epilepsy; migraine; climacteric disorders; eczema, pruritic dermatitis; depressive states; treatment of drug addiction and alcoholism; potentiation of the action of hypnotic drugs and analgesics; sedation before surgery.
SEDATIVE DRUGS ( from lat. sedatio - sedation) these are drugs that restore the functional state of the central nervous system by weakening excessive stimulation or enhancing the processes of weak inhibition in the nervous system in asthenic and psycho-emotional disorders preceding neurotic pathology.
Sedativa Inorganic nature: NaBr KBr Combine drugs Plant origin a) monopreparations from: Valerian Motherwort Mint Melissa Passiflora Hops Peony Bromocamphor Pertussin (thyme + KBr ) Corvalol (with mint) Corvaldine (with mint and hops) Valocordin (with mint and hops) Valocormid (valerian + longhi + + hops + bellow + menthol + NaBr ) b) combined: Gathering sedative (valerian + mint + trefoil + hops) Persen (valerian + mint + lemon balm) Novo- Passit Phytosed (hawthorn + motherwort + hops + oats + melissa + coriander + clover) Sanason (valerian + hops) Nervogran (mint + lemon balm + chamomile + valerian + yarrow) Nervoflux (Lavender + Melissa + Soladka + Hop + Valerian + Orange )
Слайд 21: Indications
preneurotic disorders with increased excitability and accompanied by: coronary spasm, a feeling of fear, anxiety, headache, fatigue, insomnia, increased convulsive readiness in children, hyperthyroidism climacteric disorders, cardiopsychoneurosis, smooth muscle spasms.
ANTIDEPRESSANTS - neuropsychotropic drugs that have the ability to alleviate the effects of depression of various origins, improving emotional status, mood, increasing overall activity
A. Monoamine oxidase inhibitors (MAO): irreversible action: nialamide ; reversible action: pyrazidol, befol, moclobemide ; B. Reverse neuronal uptake inhibitors: indiscriminate action: Amitriptyline ( saroten ), imizin, doxepin, imipramine, mianserin * ( lerivon ); selective action: - SSRI (serotonin) - sertraline ( zoloft ), fluoxetine ( prozac ); cytalapram ( cipramil ), paroxetine ( paxil ); - Ioza (norepinephrine) - maprotiline - IOSOL (serotonin and norepinephrine) – milnacipra ( ixel ) Classificaton
Tricyclic antidepressants (TCAs) (increase the accumulation of serotonin and norepinephrine in the CNS synapses, block m-XP, a2-AR, HP) Imipramine ( Imizin, Melipramine, Tofranil ) - Desipramine, Amitriptyline, Clomipramine Selective Serotonin Reuptake Inhibitors (SSRIs) Paroxetine (Paxil) Citalopram ( Tsipramil ) Fluoxetine (Prozac) Fluvoxetine ( Fevarin ) Sertralin (Zoloft) Selective Noadrenaline Reuptake Inhibitors (NRIs) Maprotiline, Desipramine
Слайд 25: Indications
Depressive states of various genesis; Psychopathy, Neurosis, Withdrawal syndrome; Nervous boulemia ; Chronic pain syndrome.
Severe intoxication can be caused by a dose exceeding 1g anticholinergic side effects +++ need for intensive cardiovascular therapy Lethal dose ~ 2g The first symptoms may appear from 1-2 to 6 hours after the appointment severe intoxication - cardiotoxicity +++ ventricular arrhythmia coma - convulsions - respiratory decompensation final bradycardia DEATH 2 to 6 hours after administration inside Tricyclic Antidepressants Side Effects
Последний слайд презентации: SIW “The main methods of treatment are pharmacotherapy and psychotherapy from a: List of literature
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