psychotropics

psychotropics

1. psychosis means: loss of contact with reality/delusional/schizo

   • antipsychotics 1st and 2nd gene
     • Chlorpromazine(Thorazine), Haloperidol (Haldol) blocks D2 receptors
     • Aripiprazole (Abilify), Quetiapine(Seroquel), Risperiodone (Risperdal)
       • blocks D2 receptors and serotonin

2. antidepressants

   • tricyclic antidep (tcas)
     • elevates mood, amitriptyline, blocks nerepiephrine uptake and serotonin uptake so that more is available in the brain
       • adverse effects: orthostatic hypotension, sedation, dry mouth, constipation, blurred vision, seizures, hepatic failure, leukopenia, thrombocytopenia,
   • selective serotonin reuptake inhibitors (ssris)
     • MOA: blocks serotonin uptake--fluoxetine, sertraline, paroxetine, citalopram side effects: sex dys, nausea, insomnia, do not use with maois and grapefruit juice
   • serotonin norepinephrine reuptake inhibitors (snris)
     • Venlaflaxine (Effexor): side effects--dry mouth, suicidal tendency, urinary retention, steven johnsons, cannot mix with maois
   • monoamine oxidase inhibitos (maois)
     • Isocarboxazid, Phenelzine, Selegiline, Tranylcypromine
       • MOA: inactivates norepinephrine, dopamine, epiephrine, serotonin
         • only prescribed if other antidepr do not work, as it puts pts at risk for hypertensive crisis and cannot eat --aged cheeses, yeast, fish, meat, choc, some veggies, alcoholic drinks, fruits, st johns wort, or ginseng side effects: suicidal tendencies

3. anti anxiety medications

   • benzodiazepines: MOA: enhances inhibiting effects of GABA, rapid onset
     • Alprazolam (xanax), Chlordiazepoxide (Librium), Clonazepam (Klonopin), Clorazepate (Tranxilium), Clotiazepam (Veratran), Diazepam, Lorazepam, Oxazepam
       • side effects: also can be used to prevent seizures and alcohol withdrawal--sedation, dizziness, ataxia, confusion, dry mouth, blurred vision, orthostatic hypertension--od then respiratory depression

4. mood stabilizers

   • bipolar disorders/manic depressive disorders
     • lithium- valproic acid, carbmazepine Adverse reactions: sedation, dizziness, tremors, nausea, vomiting, diarrhea, unsteadiness, headache, wt gain, hematological changes--dry mouth, increased urination, need hydration
       • on lithium-monitor drug level due to narrow therapeutic range,

5. ADD/ADHD -treats stimulants -amphetamine, methylphenidates

   • tachy, hypertension, wt loss, growth slowed and sleep disturbed
   • nonstimulant meds:
     • antidepres/nortriptyline--clonidine (a2 adrenergic antagonists)--side effects termors, tachy, hypertension, insomnia

6. sleep hypnotics

   • clonazepam, diazepam, diphenhydramine, doxylamine + diphenhydramine, eszopiclone, lorazepam, melatonin, promethazine, triazolam, zaleplon, zopidem
     • withdrawal symptoms: rebound anxiety, adverse CNS depression
       • zopidem (Ambien) side effects: risk for delusions, hallucinations, short term use one month