Pharm Lecture 5.docx - Anxiolytics and Antipsychotics...

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Anxiolytics and Antipsychotics EPS Extrapyramidal SyndromePsychosis/Goal of Pharm Treatment Thought to be caused by excess dopamine oMany meds in this sec block action of dopamine in some wayChemical structure of antipsychotics allows them to bind to dopamine receptors w/o triggering postsynaptic response that binding of dopamine normally would oAbility to block dopamine receptors without causing opening of ion channels and setting off an action potentialGoal of pharmacotherapy: Reduction of symptoms w/ least amount of side effects oMany pat stop taking meds due to side affects from blocking dopamineOther neurotransmitters: oGABA: regulates anxiety oSerotonin: arousal/general activity levels of CNS; sleep/wakefulness oNorepinephrine: arousal, mood affect, anxietyoDopamine: cognition, emotional response, motivationMore structurally specific the drug is = less sd effects (like a target) Akathisia 20% pt on antipsyc meds; treat with benzos (ex lorazapam) or beta blockers (ex propranolol) RestlessTrouble standing stillPaces floorFeet in constant motion; rocking back and forthAcute Dystonia5% of patients taking antipsychotics; treat with anticholinergic/antiparkinson drug Facial grimacingInvoluntary upward eye movementMuscle spasms of tongue, face, neck, back (back muscle spasms cause trunk to arch forward) Laryngeal spasms PseudoparkinsonismMimics symptoms of Parkinson’s Less common in lower strength antipsychotics

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