Pharm Final Review (Ch. 20)

Psychotropic

Any substance affecting the mind.
Therapeutic effect on mental processes, emotions, or behavior

Psychotropic (classifications)

Classifications:
CNS stimulants
Antidepressants
Antimanic agents
Anxiolytics
Antipsychotic medications

*CNS stimulants

Promote CNS functioning
Uses:
Treat ADHD (frontal lobe responsible for impulse control)
Stimulate respiration in babies
Caffeine
Ritalin
Adderal
Also:
Modafnil
SNRI's: Strattera

*CNS stimulants
(side effects)

Side effects:
Nervousness
GI disturbances (anorexia, nausea, vominting)
Pediatric precautions
ADHD drugs: Category II drugs because of abuse by adults.

*Caffeine

CNS stimulant

*Ritalin

CNS stimulant

*Adderall

CNS stimulant

*Modafinil

CNS stimulant
Treat: narcolepsy, sleep apnea
Side effects: Headache nausea
Patient education: Need to determine cause of sleep disorder

*Strattera

CNS stimulant - SNRI
Nonstimulant and non-controlled
Treat: Attention-deficit hyperactivity disorder (ADHD)
Side effects:
Risk of suicidal tendencies
Decreased appetite
Nausea, vomiting
Strattera

*Antideptredssants

Treat depression (chemical imbalance)
Works on neurotransmitters: Dopamine, serotonin, and norepinephrine
Categories:
1. Tricyclic antidepressants
2. Monamine oxidase inhibitors (MAOIs)
3. Selective serotonin reuptake inhibitors (SSRIs)
4. SNRIs
5. Hetero

*Tricyclics

Antidepressants
Delayed action: 2-4 weeks for therapeutic effect.
Amitripyline
Tofranil

*Amitripyline

Antidepressant - Tricyclic

*Trofanil

Antidepressant - Tricyclic

*Tricyclics
(side effects / contraindications)

Side effects:
Sedative effect (given at bedtime)
Dry mouth
Increased appetite, weight gain
Lethal OD
Contraindications:
Pregnancy

*MAOIs

Antidepressants
Rarely used today
Cannot be given until 2 weeks after tricyclics have been discontinued because of side effects.
Marplan
Nardil
Parnate

*Marplan

Antidepressant - MAOI

*Nardil

Antidepressant - MAOI

*Parnate

Antidepressant - MAOI

*MAOIs
(side effects)

Side effects:
Nervousness, agitation
Headache
Hypertension, hypertensive crisis
Interactions:
All other antidepressants
Foods containing tyamine, tryptamine, tryptophan
(Ex. yogurt, cheese, chicken, raisins, alcohol, fermented/aged foods: salami)

*SSRIs

Antidepressants
First-line treatment of depression
Better patient compliance because of fewer side effects
Prozac
Zoloft

*SSRIs
(side effects)

Side effects:
Nausea, anorexia
Insomnia

*Prozac

Antidepressant - SSRI

*Zoloft

Antidepressant - SSRI

*SNRIs

Antidepressant
Cymbalta
Effexor
Pristiq

*Cymbalta

Antidepressant - SNRI

*Effexor

Antidepressant - SNRI

*Pristiq

Antidepressant - SNRI

*Heterocyclics

Antidepressants
Fewer side effects than trycyclics
Wellbutrin
Remeron

*Wellbutrin

Antidepressant - Heterocyclic
Activating antidepressant

*Remeron

Antidepressants - Heterocyclic
Calming Antidepressant
Treat anxieties

*Anxiolytics

Antianxiety medications
Xanax
Ativan
Valium

*Xanax

Antianxiety - anxiolytic

*Ativan

Antianxiety - anxiolytic

*Valium

Antianxiety - anxiolytic

*Versed (midazolam)
(potent benzodiazepine)

Anxiolytics
Properative medications
Relieve anxiety
Provide sedation
Light anesthesia
Amnesia of operative events

*Antipsychotic Medications/
Major Tranquilizers

Relieve symptoms of psychoses.:
Thorazine
Mellaril
Relieve agitation and nausea & vomiting:
Compazine
Atypical antipsychotics:
Abilify
Zyprexa

*Antipsychotics / Major Tranquilizers
(side effects)

Side effects:
Extrapyramidal reactions (severe CNS symptoms)
- Parkinson symptoms
- Tardive dyskinesia
- Dystonic reactions
- Akathisia