Psychopharmacology%20Basics - PowerPoint PPT Presentation

View by Category
About This Presentation
Title:

Psychopharmacology%20Basics

Description:

Compared to other types of treatment, these medications are ... People who, years ago, might have spent many years in mental ... (Celexa) ANTIANXIETY ... – PowerPoint PPT presentation

Number of Views:366
Avg rating:3.0/5.0
Slides: 69
Provided by: kenca9
Learn more at: http://cstl-cla.semo.edu
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Psychopharmacology%20Basics


1
PsychopharmacologyBasics
2
An important aspect of treatment of emotional
disorders is with psychotherapeutic medications.
Compared to other types of treatment, these
medications are relative newcomers in the fight
against mental illness.
3
People who, years ago, might have spent many
years in mental hospitals because of crippling
mental illness may now only go in for brief
treatment, or might receive all their treatment
at an outpatient clinic.
4
Symptom Relief, Not CureJust as aspirin can
reduce a fever without clearing up the infection
that causes it, psychotherapeutic medications act
by controlling symptoms. Like most drugs used in
medicine, they correct or compensate for some
malfunction in the body. Psychotherapeutic
medications do not cure mental illness, but they
do lessen its burden.
5
Like any medication, psychotherapeutic
medications do not produce the same effect in
everyone. Some people may respond better to one
medication than another. Some may need larger
dosages than others do.
6
Pharmacology offers hope to many who would
otherwise have a dismal prognosis.
7
Pharmacology Study of Drugs
  • Drug any substance that when administered to a
    living organism
  • Produces a change in function
  • Water, metals (iron) or insecticidies can be
    classified as drugs
  • In common usage, the term DRUG refers to any
    medication used to treat disease.

8
Pharmacology Divisions
  • Pharmacodynamics study of drugs on living tissue
  • Pharmacotherpeutics study of use of drugs in
    treating disease
  • Posology study of the amount of drug required to
    produce therapeutic effects
  • Pharmacy science of preparing and dispensing
    medications
  • Toxicology study of harmful effects of drugs of
    living tissue

9
Clinical Psychopharmacology concerned mainly
with the use of drugs to treat abnormal human
behavior.
10
Where do drugs come from?
  • Plants
  • Animals
  • Synthetic produced in labs

11
What actually is a drug?
  • A chemical compound with a specific chemical
    structure

12
  • Receptor site specific area on a cell membrane
    where drug attaches self. Binding drug
    action.
  • Agonists produces drug action
  • Antagonists blocks drug action

13
No drug produces only ONE effect
  • Intended (or therapeutic) effect along with
    several other effects
  • Side effects
  • Side effects generally not harmful unless TOXIC

14
Drug Safety
  • The federal
  • FOOD and DRUG ADMINISTRATION
  • F D A
  • has established guidelines governing the approval
    and use of all drugs
  • Public safety is priority

15
  • Every drug must fill two requirements before used
    in humans
  • Must be effective in the disease state for which
    approved
  • Must not produce toxic effects at therapeutic
    doses

16
What is a clinical trial?
  • A clinical trial is a research study to answer
    specific questions about vaccines or new
    therapies or new ways of using known treatments.
  • Clinical trials (also called medical research
    and research studies) are used to determine
    whether new drugs or treatments are both safe and
    effective.
  • Carefully conducted clinical trials are the
    fastest and safest way to find treatments that
    work.

17
  • Ideas for clinical trials usually come from
    researchers.
  • Once researchers test new therapies or procedures
    in the laboratory and get promising results, they
    begin planning Phase I clinical trials.
  • New therapies are tested on people only after
    laboratory and animal studies show promising
    results

18
What is a protocol?
  • All clinical trials are based on a set of rules
    called a protocol.
  • A protocol describes what types of people may
    participate in the trial the schedule of tests,
    procedures, medications,and dosages and the
    length of the study.
  • While in a clinical trial,participants are seen
    regularly by the research staff to monitor their
    health and to determine the safety and
    effectiveness of their treatment

19
What are clinical trial phases?
  • Clinical trials of experimental drugs proceed
    through four phases
  • In Phase I clinical trials, researchers test a
    new drug or treatment in a small group of people
    (20-80) for the first time to evaluate its
    safety, determine a safe dosage range, and
    identify side effects.
  • In Phase II clinical trials, the study drug or
    treatment is given to a larger group of people
    (100-300) to see if it is effective and to
    further evaluate its safety.

20
  • In Phase III studies, the study drug or treatment
    is given to large groups of people (1,000-3,000)
    to confirm its effectiveness, monitor side
    effects, compare it to commonly used treatments,
    and collect information that will allow the drug
    or treatment to be used safely.
  • Phase IV studies are done after the drug or
    treatment has been marketed. These studies
    continue testing the study drug or treatment to
    collect information about their effect in various
    populations and any side effects associated with
    long-term use.

21
What is a control or control group?
  • A control is the standard by which experimental
    observations are evaluated.
  • In many clinical trials, one group of patients
    will be given an experimental drug or
    treatment,while the control group is given either
    a standard treatment for the illness or a placebo.

22
What is a placebo?
  • A placebo is an inactive pill, liquid, or powder
    that has no treatment value.
  • In clinical trials, experimental treatments are
    often compared with placebos to assess the
    treatment's effectiveness.
  • In some studies, the participants in the control
    group will receive a placebo instead of an active
    drug or treatment

23
What is a blinded or masked study?
  • A blinded or masked study is one in which
    participants do not know whether they are in the
    experimental or control group in a research
    study.
  • Those in the experimental group get the
    medications or treatments being tested, while
    those in the control group get a standard
    treatment or no treatment

24
What is a double-blind or double-masked study?
  • Neither the participants nor the study staff
  • know which participants are receiving the
    experimental treatment
  • and which ones are getting either a standard
    treatment or a placebo.
  • These studies are performed so neither the
    patients' nor the doctors' expectations
  • about the experimental drug can influence the
    outcome.

25
Safety.
  • Before approved for humans, drugs must undergo
    several years of animal (several species) testing
    and evaluation
  • LD50 Lethal dose 50, dose that would kill 50 of
    animals tested
  • Therapeutic Index TI is ratio of ED50 and LD50
    of a drug
  • TI LD50 1000mg 10
  • ED50 100mg
  • Used only in animal studies to establish dosage
    levels for other testing procedures

26
Generic Drugs
  • Manufacturing medications is expensive
  • Clinical trials process
  • Marketing
  • Patent expires
  • Produced with less restriction
  • Usually less expensive
  • Effectiveness??????

27
Basic Concepts of Pharmacology
  • Site of action location within the body where
    the drug exerts its therapeutic effect.
  • Mechanism of action explains how the drug
    produces its effects

28
Biological Concepts
  • Most drugs in psychopharmacology affect humans by
    affecting the communication between neurons in
    the brain.
  • To understand these effects, you must understand
    something about cell membranes,
  • and the special protein structures in membranes
    that regulate the flow of substances and
    information in and out of the cell.

29
  • Then you can understand how this regulation can
    result in an electrical signal which travels down
    the neuron
  • and how this electrical signal can be transferred
    between neurons at synapses,
  • where neurotransmitters are released from one
    cell
  • to affect receptors on another cell.

30
Biological ConceptsMost drugs in
psychopharmacology work by affecting the
communication between neurons in the brain.
31
The brain is made of cells (called neurons) which
communicate with each other at places called
synapses. A synapse is a functional (but not
physical) contact between two neurons.
32
Neuron
33
Neuron
34
(No Transcript)
35
Synapse
36
Half Life
Effect
Time
37
The following chemicals have been shown to act as
neurotransmitters in the brain Dopamine
Norepinepherine Serotonin Acetylcholine Gamma
aminobutyric acid (GABA) Several Amino Acids
  • Neurotransmitters about 40 known or suspected
    neurotransmitters in the brain.

38
Acetylcholine Two types of receptors-nicotinic
receptors and muscarinic receptors. Nicotinic
receptors are on muscle fibers both types exist
in the central nervous system. Found in the
brain (mostly excitatory), spinal cord, ganglia
of the autonomic nervous system (mostly
excitatory) and at the target organs of the
parasympathetic branch of the autonomic nervous
system (both excitatory and inhibitory). Death
of acetylcholine neurons is the primary cause of
Alzheimer's Disease.
39
  • Epinephrine (adrenaline)
  • Drugs that block the activity of dopaminergic
    Synthesized by the adrenal glands.
  • Adrenal is Latin for "toward kidney" and epi
    nephron is Greek for "upon the kidney."

40
  • Dopamine Implicated in movement, attention
    neurons alleviate psychotic symptoms, leading to
    speculation that schizophrenia is caused by
    dopaminergic overactivity.
  • Cocaine and amphetamine work at dopaminergic
    synapses to increase activity, and prolonged or
    excessive exposure to amphetamine or cocaine can
    result in acute psychosis.

41
  • Norepinephrine Most noradrinergic synapses in
    the CNS.
  • At the target organs of the sympathetic nervous
    system, norepinephrine produces EPSPs.

42
  • Serotonin Plays a role in the regulation of
    mood, in the control of eating, sleep and
    arousal, and in the regulation of pain.
  • Drugs which inhibit serotonin increase dreaming
    and can cause hallucinations (LSD).

43
Anti-depressants..
  • can be roughly categorized into groups, depending
    upon their chemical structure and the way they
    work
  • 1) tricyclics and tetracyclics (TCA's)
  • 2) monoamine oxidase inhibitors (MAOI's)
  • 3) serotonin-specific reuptake inhibitors
    (SSRI's)
  • miscellaneous.

44
Commonly Rx Tetracyclics/Tricyclics
  • amitriptyline (Elavil, Endep, Enden,
    Tryptizol) amitriptyline (perphenazine,
    Etrafon, Triavil) amoxapine
    (Asendin) clomipramine (Anafranil)
    desipramine (Norpramine, Pertofrane)
    doxepin (Adapin,
    Sinequan)imipramine (Tofranil,
    Janimine)maprotiline
    (Ludiomil)nortriptyline (Pamelor,
    Ventyl, Aventyl)protriptyline HCL
    (Vivactil)trimipramine (Surmontil)

45
Serotonin-specific Reuptake Inhibitors (SSRI's)
  • These drugs, along with the tricyclic and
    tetracyclic drugs and the MAOI's, are considered
    the major antidepressant drugs
  • they are also effective in a wide range of
    disorders, including bipolar I disorder,
    dysthymic disorder, eating disorders, panic
    disorder, obsessive-compulsive disorder, and
    borderline personality disorder.

46
  • Because they generally have fewer adverse side
    effects than other classes of antidepressants
    they are more widely prescribed
  • one SSRI, fluoxetine (Prozac), the least
    cardiotoxic of all antidepressants, has become
    the most widely prescribed antidepressant and is
    one of the top ten most prescribed drugs in the
    US.

47
Commonly RX SSRIs
  • fluoxetine (Prozac)fluvoxamine (Luvox)
    paroxetine (Paxil)sertraline (Zoloft)
    (Serzone)
  • (Celexa)

48
ANTIANXIETY MEDICATIONS
  • Formerly called the "minor tranquilizers", the
    medicines in this group are primarily used in the
    treatment of anxiety
  • they are also used for some other disorders, such
    as depression, panic disorder, social phobia,
    bipolar I disorder, and substance withdrawal.

49
  • Because they have a higher therapeutic index and
    less abuse potential, the benzodiazepines
  • (which comprise the largest number in this group)
    have largely replaced the barbituates in
    treatment for these disorders,
  • and are also widely used a s sedatives and
    hypnotics as well as anesthetics,
    anticonvulsants, and muscle relaxants.
  • Antihistimines are occasionally used to treat
    anxiety disorders, as are the beta-blockers.

50
Commonly Rx Antianxiety
  • Alprazolam (Xanax) Atenolol
    (Tenormin)buspirone (BuSpar)chlordiaze
    poxide (Librium, Libritabs,
    Lipoxide)clonazepam (Klonopin)clonodine
    (Catapres)

51
ANTIPSYCHOTIC MEDICATIONS
  • This group, formerly known as the "major
    tranquilizers", or neuroleptics, is comprised
    mainly of a set of drugs known as
    dopamine-blockers,
  • These drugs target the idiopathic psychoses that
    have no known cause, such as schizophrenia,
    schizophreniform disorder, schizoaffective
    disorder, delusional disorder.

52
  • brief psychotic disorder, manic episodes, and
    major depressive disorder with psychotic
    features,
  • as well as being commonly used in the treatment
    of patients who are severely agitated and
    violent.
  • They have a wide application for a variety of
    disorders, including movement disorders, anxiety
    disorders, and psychoses that have organic
    causes.

53
  • Commonly RX Antipsychotic
  • chlorpromazine (Thorazine,)fluphena
    zine (Prolixin, )haloperidol
    (Haldol)loxapine
    (Loxitane)mesoridazine
    (Serentil)perphenazine
    (Trilafon)pimozide
    (Orap)risperidone
    (Risperdal)thioridazine
    (Mellaril)thiothixene
    (Navane)trifluoperazine
    (Stelazine)

54
Side Effects
  • Potent drugs usually have potent side effects,
    and the antipsychotic drugs are no exception!!!

55
ANTIMANIC MEDICATIONS
  • Many of the drugs that have already been
    discussed have been found to be efficacious in
    effecting mood regulation or stabilization, such
    as the benzodiazepines, carbamazepine, clozapine,
    the dopamine receptor antagonists, lithium,
    L-tryptophan, and valproate.

56
Commonly Rx Antimanics
  • diltiazem (Cardizem) nifedipine
    (Adalat, Procardia)nimodipine
    (Nimotop)verapamil (Calan,
    Isoptin)lithium carbonate (Cibalith-S,
    Camcolt, Priadel,
    Liskonum, Phasal-- these are not used in
    US)

57
SEDATIVES AND HYPNOTIC MEDICATIONS
  • This class includes the barbituates, which are
    among the first drugs to be used in clinical
    psychiatric treatment, being introduced in the US
    in 1903.
  • One of the oldest sedative-hypnotic drugs still
    in use, chloral hydrate, has been used since
    1869.
  • Because of their high abuse potential and lower
    therapeutic index, the barbituates are now less
    commonly prescribed than the newer compounds,
    such as the benzodiazepines and buspirone, which
    are considered much safer.
  • .

58
Side Effects
  • A high abuse potential is associated with these
    drugs, the barbituates in particular.
  • Drowsiness, confusion, constipation, blurred
    vision, edema, vertigo, paradoxical dysphoria,
    hyperactivity, cognitive disorganization,
    lethargy, fatigue, headache.
  • Many of the adverse side effects are similar to
    those of the benzodiazepines

59
Commonly Rx Sedatives/Hypnotics
  • Amobarbital (Amytal)
    aprobarbital
    (Alurate)butabarbital
    (Butisol) chloral hydrate
    (Noctec)ethchlorvynol
    (Placidyl)methohexital
    (Brevital)nitrazepam
    (Mogadon)pentobarbital
    (Nembutal)phenobarbital (Luminal,
    Barbita, Solfoton)secobarbital
    (Seconal)zolpidem
    (Ambien)

60
MEDICATION USED TO OFFSET THE SIDE EFFECTS OF
OTHER MEDICATIONS
  • This rather inclusive group encompasses the
    anti-parkinsonsism, anticonvulsant,
    anticholinergic, side-effect medicines which
    target the neuroleptic-induced movement
    disorders, such as..

61
  • parkinsonism, malignant syndrome, acute dystonia,
    acute akathisia, tardive dyskinesia, postural
    tremor and various other movement disorders that
    are
  • extrapyramidal side effects (EPS).

62
Side Effects
  • Oddly enough, medicines that target side-effects
    can themselves have side-effects, such as
  • hypotension and bradycardia, nausea,
  • vomiting, diarrhea, and constipation
  • anticholinergic effects, abuse potential,
    dizziness, insominia, irritability, depression,
    anxiety, nausea,

63
Commonly Rx
  • Anticholinergics and Amantadine
  • amantadine (Symmetrel,
    Symadine)benztropine mesylate
    (Cogentin)biperidin
    (Akineton)ethopropazine
    (Parsidol)procyclidine
    (Kemadrin)trihexyphenidyl (Artane,
    Tremin, Trihexane, Trihexy-5)

64
  • Beta-Adrenergic Drugs
  • (Beta-blockers)
  • atenolol (Tenormin)
    chlorthalidone (Tenoretic)metoprolol
    (Lopressor)nadolol
    (Corgard)propranolol (Inderal)

65
  • Antihistamines
  • cyproheptadine (Periactin)
    diphenhydramine (AllerMax, Banophen,
    Belix, Benadryl, Dephen Cough,
    Dormarex-2, Genahist, Hydramine, Nidryl,
    Nordryl, Nytol, Phendry, Sleep-Eze-3, Sominex
    2, Twilite)
  • bromocriptine (Parlodel)Dantrolenedantrolene
    (Dantrium)

66
Psychostimulants
  • MEDICATIONS USED FOR ATTENTION DEFICIT DISORDER
  • This category is devoted almost exclusively to
    the amelioration of attention-deficit/hyperactivit
    y disorder (ADHD) effects.
  • It includes the sympathomimetics, clonidine, and
    some of the tricyclic antidepressants.

67
Commonly Rx Psychostimulants
  • amphetamine (Benzedrine) clonidine
    hydro-chloride (Catapres)desipramine
    HCL (Norpramin, Pertofrane)dextroamphetamine
    (Dexedrine)imipramine HCL (Tofranil,
    Janimine)methylphenidate (Ritalin)pemoline
    (Cylert)

  • (Adderall)

  • (Concerta)

68
(No Transcript)
About PowerShow.com