chapter 16 pyschotherapuetic drugs book and pp notes.docx -...

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1 Chapter 16: psychotherapeutic drugs Psychotherapeutic Drugs Three main emotional and mental disorders Anxiety Affective disorders Psychoses Types of psychotherapeutic drugs Anxiolytic drugs Mood-stabilizing drugs Antidepressant drugs Antipsychotic drugs Affective Disorders (Mood Disorders) Changes in mood that range from mania (abnormally pronounced emotions) to depression (abnormally reduced emotions) Some patients may exhibit both mania and depression: bipolar disorder (BPD) Psychosis Severe emotional disorder that impairs the mental function of the affected individual to the point that the individual cannot participate in activities of daily living Hallmark: loss of contact with reality Examples Schizophrenia Depressive and drug-induced psychoses Anxiolytic Drugs Mechanism of action: Reduce anxiety by reducing overactivity in central nervous system (CNS). Benzodiazepines Depress activity in the brainstem and limbic system. Miscellaneous drug: buspirone (Buspar) Nonsedating and nonhabit forming May have drug interaction with selective serotonin reuptake inhibitors (SSRIs) (serotonin syndrome) Do not administer with MAOIs Benzodiazepines Largest and most commonly prescribed anxiolytic Indications: Used to treat alcohol withdrawal, insomnia, and muscle spasms as well as adjunct for depression Contraindications: Known drug allergy, narrow angle glaucoma and pregnancy due to sedative properties and risk for teratogenic effects Interactions: CNS depressants, oral contraceptives, azole antifungals, SSRIs, verapamil, diltiazem, opioids, valproic acid, rifampin, theophylline and phenytoin Adverse effects: Decreased CNS activity, sedation Hypotension Drowsiness, loss of coordination, dizziness, headaches, lethargy, amnesia, ataxia Nausea, vomiting, dry mouth, constipation, weight gain, weight loss Ex: Alprazolam (Xanax), Diazepam (Valium), Lorazepam (Ativan) Benzodiazepines: Overdose Dangerous when taken with other sedatives or alcohol Treatment is generally symptomatic and supportive.
2 Chapter 16: psychotherapeutic drugs Can result in somnolence, confusion, coma and respiratory depression (Romazicon) Flumazenil may be used to reverse benzodiazepines’ effects. Alprazolam Most commonly used as an anxiolytic Indications: GAD, short-term relief of anxiety symptoms, panic disorder, and anxiety associated with depression Adverse effects: confusion, ataxia, headache, and others Interactions: alcohol, oral contraceptives , and others Diazepam Long-acting benzodiazepine Indications: relief of anxiety, management of alcohol withdrawal, reversal of status epilepticus, preoperative sedation, and as an adjunct for the relief of skeletal muscle spasms Avoid in patients with hepatic dysfunction Adverse effects : headache, confusion, slurred speech, and others Interactions: alcohol, oral contraceptives, and others Lorazepam Intermediate-acting benzodiazepine Can be given by IV push; useful in the treatment of an acutely agitated patient

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