Drugs For Treatment Of Psychiatric Disorder

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distorted capacity to process information,catatonic or disorganized behavior and aggression or violance

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psychosis

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a chronic deblitating mental desorder

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schizophernia

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symptoms of sch

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posative,negative and cognitive

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+ve symptoms commonly occur at

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acute phase of the disease

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+ve symptoms include

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delusion, paranoid,hallucinations(often sound) aggressive

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-ve symptoms include

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withdrawal fom social contact, anhedonia(an in ability to expirance pain)

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deficite in cognutive(attention & memory) function lid to

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self punshimet ,leading to suicide atempt

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which of the symptoms is more chronic & less responsive to antipsychotic drugs

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-ve symptoms

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env't cause is caused by ...... virus

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maternal

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schi apears as malfunction of which neuronal circut

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mesolimbic & mesocortics

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changes in mesolimbic path way

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+ve symptoms

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changes in mesocortex

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-ve and cognitive symptoms

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the main NT involved in sch

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dopamine and glutamate but 5HT,NE may also involved

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theories of etiology of psychosis

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dopamine theory and glutamate

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effective for +ve symptoms in dopa theory is blocking ..... in ..... pathway

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D2 in mesolimbic pathway

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increased dopa resptor is a sign of

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schi

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flaws of dopa theory

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blockade of dopa rs isn't fully successful treatment
NMDA antatgonist produce much more sch
atypical antipshc have much less effect on D2

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NMDA reseptor antagonist

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phencyclindine

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dopa theory fall to explain

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-ve symptoms

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negative and cognative dysfunction

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result from a decrease in the mesocortical dopamergic pathway were D1 dominate

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psychosis occur due to hyper or hypo activity of what receptors and pathways

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D2 mesolimbic & D1 mesocortex

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glutamate theory

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NMDA recaptor in both mesocortex and mesolimbic pathway cause both the +ve and - symptoms

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NMDA's non competitive inhibtors

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PHENCYCLIDINE,DIZOCILIPNE, KETAMINE

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5HT reseptors are abundent in ----- pathway

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mesocortical

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and used to expaline the .......symptome

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-ve

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classification of antipsychotic

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first-generation/atypical/convential & atypical/newer drugs

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FGA include

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phenothiazines(chlorpromazine), thioxanthines,butyrophenons

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SGA include

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clozapine,olanzapine,
risperdone,ziprasidone,paliperidone

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differance b/n typical and atypical

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incedence of EPS -------- less in atypical
efficacy against -ve symptoms ....... SGA better

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whT have greater effecancy for resistance pts

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clonzapine

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clinical symptoms of chlorpromazine

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asscoitiated with D2 blockade and 70% & 80% hyperprolactiemia and EPS

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have anti(cholinergic ,adrenergic and histamine) effecct

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chlorpromazine

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involutary mov't arising from the EPS effect is common in

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chlorpromazine

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block D2 less tightly and greater affinity for 5HT1a rec

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clozapine

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no significant effect on histamine ,cholinergic and adrenergic receptor

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clozapine

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SGA and FGA are similar in efficacy execpt

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clonzapine (used in resistant pts)

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antipsycothic work to reduce

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halucination and delusion,spontaneous physical mov't

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EPS are manifested as

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parkinson like symptoms,acute dystonias,akathisia and tardive dyskinasi(abnormal mov't of toung)

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EPS's parki like symptoms can be treated by

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anticholinargic, antiparkinsonan & amantadine

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parkinson like and acute dystonia

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occur commonly in the 1st week and decline with time and reversable on stoping of drug

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blocking of dopamine receptors in nigrostriatal cause

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tardive dyskinesia

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antisychothic drugs have

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atropine like effect (anti muscarinc)
antiemetic

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in the pancrease the have the effect of

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block D2 r and incr prolactine

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used to treat intractable hiccups

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chlorprmazine

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adver E

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weight gain,drownisses and sedation,atropine like effect(inc IOP,dry mouth and eye,constipation and urinary retantion

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all antipsychosis may lower the thrashold of ..

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seizure

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contradiction with seizure disorders

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chlorpromazine and clonzapine

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anti psychotic malignant syndrome

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muscle rigidity,rapid inc in temp and mental confusion

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anti psychotic malignant syndrome death occur by

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renal failure and cv failure

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anti psychotic malignant syndrome treatment

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dentrolene or bromocriptine and also amantadine

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leukopenia and agranulocyte is related to

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clonazipine

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jaundice occur in

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chlorpromazine

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all anti psychotic drugs are use full against

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+ve symptoms

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SGA/FGA which is more efective against -ve symptoms

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SGA

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mode of therapy is

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treal and error