DRUGS 3.docx - Developed by JK KIST LECTURE SIX DRUGS USED IN PSYCHOSES Psychoses These are severe psychiatric illness with serious distortion of

DRUGS 3.docx - Developed by JK KIST LECTURE SIX DRUGS USED...

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Developed by JK KIST LECTURE SIX DRUGS USED IN PSYCHOSES Psychoses: These are severe psychiatric illness with serious distortion of thought, behavior, capacity to recognize reality and of perception. Patient is unable to meet ordinary demands of life ANTI-PSYCHOTIC DRUGS Classification 1) Phenothiazenes Aliphatic side chain: chlorpromazine, Influpromazine Piperidine side chain: Thioridazine Piperazine side chain: Trifluoperazine, Fluphenazine 2) Butyrophenones: Haloperidol, Trifluperidol, Perifluridol 3) Thioxanthenes :-Flupenthixol 4) Other heterocyclics:- Loxapine 5) Atypical Antipsychotics: Risperidone, Olanzapine , Ziprasidone Pharmacological Actions Pharmacology of chlorpromazine (CPZ) is described as the prototype others as they only differ from it. a. Central Nervous System (CNS) In a psychotic, CPZ reduces irrational behavior, agitation , aggressiveness, Disturbed thought is normalized gradually, anxiety is relieved. Hyperactivity, hallucinations, delusions are suppressed. All phenothiazine, thioxanthenes, butyrophenones have similar antipsychotic efficacy but potency differs in equipotent dose. Mechanism Of Action All antipsychotics (except clozapine - like atypical ) have potent dopamine D2 receptor blocking action Also block D1, D3 ,D4, receptor, but there is correlation with anti-psychotic potency. Blockade of dopaminergic projections to the temporal and prefrontal areas constituting the limbic system and in mesocortical areas is responsible for antipsychotic action b. Autonomic Nervous System Neuroleptics have varying degrees of alpha adrenergic blocking activity makes their anti-cholinergic properties is weak. c. Cardiovascular System
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Developed by JK KIST Produce postural hypotension, high dose of CPZ directly depress the heart and produce ECG changes ( Q-T prolongation and suppression of T-wave) Arrythmia may occur in over dose, especially with thiordazones d. Local Anesthetic effect CPZ is a potent local anesthetic. However not used for this action because of its irritation action. e. Endocrine. Neuroleptics consistently increase prolactin release by blocking the inhibitory action of Dopamine on pituitary lactotropes This may result into galactorrhoea, and gynaecomastia.
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