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Psycho Pharma

The document summarizes various psychopharmacological agents, including their mechanisms of action, effects of increasing or decreasing levels, side effects, and considerations for use. It covers chemical mediators like epinephrine and serotonin, antidepressants (MAOIs, SSRIs), antipsychotics (typical and atypical), antiextrapyramidal agents, mood stabilizers like lithium, and anticonvulsants. For each class of drug, it provides brief descriptions of representative drugs, their actions, and common adverse effects.

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Mark Joseph
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311 views8 pages

Psycho Pharma

The document summarizes various psychopharmacological agents, including their mechanisms of action, effects of increasing or decreasing levels, side effects, and considerations for use. It covers chemical mediators like epinephrine and serotonin, antidepressants (MAOIs, SSRIs), antipsychotics (typical and atypical), antiextrapyramidal agents, mood stabilizers like lithium, and anticonvulsants. For each class of drug, it provides brief descriptions of representative drugs, their actions, and common adverse effects.

Uploaded by

Mark Joseph
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Psychopharmacology Chemical Mediators Metaepinephrine- Excitatory Chemical Mediator Effects: Increase- Hypertension, pheochromocytoma (adult), neuroblastoma (pedia) Decrease-

depression, lethargy, somnolence Epinephrine- Excitatory chemical mediator Effects: Increase- hypertension, anxiety, insomnia Decrease- Shock, hypotension, weakness Norepinephrine- Excitatory chemical mediator Effects: Increase- Hypertension, pheochromocytoma (adult), neuroblastoma (pedia), Hyperreflexia Decrease- Shock

Acetylcholine- Inhibitory and excitatory chemical mediator Effects: increase- Anxiety, hallucination, illusion, delusion Decrease- Parkinsons disease, Alzheimers disease, myasthenia gravis GABA (Gamma-aminobutyric acid)- Inhibitory chemical mediator Effects: increase- major depression, constipation, suicide Decrease- anxiety, bipolar, suicide Glutamate- Excitatory chemical mediator Effects- increase- hypertension Decrease- shock Serotonin- inhibitory and excitatory chemical mediator Effects: increase- schizoaffective, insomnia, personality disorder Decrease- schizophrenia, anergia, suicide Dopamine- inhibitory and excitatory chemical mediator Effects: increase- schizophrenia, mania, bipolar Decrease- Parkinsons disease, schizopherenia, ADHD

ANTIDEPRESSANT MAOI (Monoamine oxidase inhibitor) Action: inhibits the synthesis of GABA Side Effects: Hypertension- check for BP Antidote: Ca-channel blocker (NIfedipine & Verapamil) Mannitol Phentolamine Drugs: Tranylcypromine (Parnate) Isocarboxazid ( Marplan) Phenelzine (Nardil) MAOI + TCA = Toxicity MAOI + SSRI = Serotonin syndrome (SS) MAOI + tyramine = hypertensive crisis

Tyramine rich foods Avocado Beer Cheese except cottage cheese Dried fruits S/Sx of hypertensive crisis (2-3 days after the last administration of the drug) Occipital pounding headache Blurring of vision Hypertension After meal Management: Semi-fowlers Drugs Monitor BP

SSRI (Selective serotonin reuptake inhibitor) Action: inhibits the reuptake of serotonin

Heterocyclic Monocyclic, bicyclic, tricyclic Sedating (night: Imipramine, Elavil, Tofranil), Non-sedating (AM: Norpramine) Management: After meal- GI upset No driving-drowsiness PR- tachycardia Taper dose Avoid sunlight CBC-WBC- aggranulocytosis (leukopenia)- sore throat Antidote: Mannitol (TCA)

Drugs:
Flouxetine (Prozac) Paroxetine ( Paxil) Sertraline ( Zoloft) Fluvoxamine (Luvox) SSRI + TCA = toxicity SSRI + MAOI= SS SS- seizure/ delirium, heart failure, brain abscess Antidote: Fluzicin, Mannitol Management: PR and RR No driving- drowsiness Taper dose After meal

ANTIPSYCHOTIC Typical/Classic -zine Haloperidol Thorazine Atypical -pine -done Olanzapine Clozapine Risperidone Classical S/Sx: EPS- 1wk tardive dyskinesia Orthostatic hypotension Agranulocytosis Photosensitivity Keritoconjunctivitis

Throrazine- bone marrow suppression Aplastic anemia- bone marrow transplant Orthostatic hypotension
Haldol- Neuroleptic malignant syndromeTemperature EPS- Phenergan Atypical S/Sx: Agranulocytosis No EPS/ less EPS Bone marrow depression PUD (gastric ulcer)-pain- after meal Orthostatic hypotension- BP

ANTIEXTRAPYRAMIDAL SYMPTOMS Classifications: Muscle relaxant: Valproates Valproic acid-Depakene- weight gain Divalpronex-Depakote- hepatotoxicSGPT, SGOT Depakone- Nephrotoxic-Creatinine & BUN; Ototoxic- Webers test Hydralazine (apresoline)- muscle atony Dopaminergic: Dopamine (levodopa) Amantadine (Symmetrel) Carbidopa levodopa Antihistamine: Benadryl
Anticholinergic: Atropine Sulfatedrowsiness Trihexypheiedil ( Artane) Biperiden Hydrochloride ( Akineton)bone marrow suppression Robinul- xerostommia(dry mouth) Antimuscarinic: Bromocriptine Mesylate ( Parlodel)- GI disturbance Benztropine Mesylate ( Cogentin) ANTIEPS in the Philippines (commonly used) Parlodel Artane Depakene Atropine sulfate Diazepam/Dopamine Akineton Benadryl

ANTI MANIC-MOOD STABILIZER

Lithium (Eskalith, Lithotab, Lithane)


Considerations: Monitor Na- normal: 135-145mEq/L 3-5 g/day of Na (1/2 knorr cubes, 34tbsp of salt) Lithuim=Na Serum lithium- normal: 0.6-1.2 mEq/L Maintenence: 0.5-1.5 mEq/L 1.2-1.5 dizziness, vomiting, diaphoresis 1.5-2.0 vomiting, anorexia, nausea, diarrhea, abdominal cramping 2-3 arrythmia, metabolic acidosis, multiple organ failure syndrome 3-4 coma, death 12 hour after the last dose 1st month once per week >1 month once per week Increase OFI- 3-4 L/day Diarrhea/constipation To flushed lithium Photosensitivity Nephrotoxic Hepatotoxic Antidote: Mannitol Ca+ carbonate Ca+ gluconate

ANTICONVULSANT General muscle relaxant Phenobarbital- respiratory depression Mngt: Bronchodilator, ET + O2, Epinephrine Primidone- bone marrow suppression Mngt: reverse Isolation Phenytoin- pink urine, rashes/urticaria, hepatotoxic, catatonic Valproates Carbamazepine (teqetrol)- Bone marrow suppression, PUD, agranulocytosis Gabapentin (nuerontin)-nephrotoxic Steve Johnson Syndrome- side effect of anticonvulsant -Burn like rashes

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