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30 Cards in this Set

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psychotropic agents
What are the drugs which alter the functioning of the mind (effect thinking, emotions, perceptions, etc)?
affective disorders
What disorders do psychotropic agents help with?
affective disorders
characterized by extremes of mood (depression and anxiety).

1. Catecholamine Theory of Mood (affective disorders) - moods correlated with neurotransmitters Norepi.

depression - caused by low levels of brain NE

anxiety - caused by high levels of brain NE.

2. Drugs work by altering Norepi levels toward normal

antidepressant - increases NE toward normal.

antianxiety agents - decreases NE function toward normal

Theory now expanded to include other "monoamines" such as serotonin.
(affective disorders) - moods correlated with neurotransmitters Norepi.

depression - caused by low levels of brain NE

anxiety - caused by high levels of brain NE.
What is the Catecholamine Theory of Mood?
depression
caused by low levels of brain NE
anxiety
caused by high levels of brain NE.
antidepressant
increases NE toward normal.
antianxiety agents
decreases NE function toward normal
antidepressant agents
What agents are used to treat depression?
Tricyclics
What is the drug of choice for severe depression?
situational or reactive

endogenous or neurotic
What are the two major types of depression that tricyclics treat?
situational or reactive
i.e. depression for a reason like illness, death in family, etc. - often not treated.
endogenous or neurotic
some people depressed all their life

may evolve LATER in life (involutional)
neurotic
involutional
Drug treatment used chiefly in ________ or ________ type of depression and usually only if vegetative functions disrupted (i.e. eating, sleeping, constipation, weight loss, lack of energy, etc.)
amphetamines
__________ are no longer used to treat depression since duration is short and is followed by worse depression. Also, too easily abused.
Inhibits reuptake of NE upon release in synapse.
How do tricyclics work or what is the mechanism of action?
Tricyclics mechanism of action
Inhibits reuptake of NE upon release in synapse.
without
therapeutic
80% of depressed individuals recover ________ treatment. Takes 2-3 weeks before __________ effects of drug are evident.
1. sedation (occasionally)
2. anticholinergic - blurred vision, dry mouth, urinary retention, constipation. Tolerance may develop and withdrawl may occur which might be controlled with anticholinergic drugs. Cholineric rebound symptoms include nausea, anorexia, insomnia, more depression, and anxiety.

3. Cardiovacular - hypotension (mechanism not understood) arrhythmias may also occur (high or low rates)

4. Sexual dysfunction comon with all antidepressants.
What are the side or toxic effects of tricyclics
side or toxic effects of tricyclics
1. sedation (occasionally)
2. anticholinergic - blurred vision, dry mouth, urinary retention, constipation. Tolerance may develop and withdrawl may occur which might be controlled with anticholinergic drugs. Cholineric rebound symptoms include nausea, anorexia, insomnia, more depression, and anxiety.

3. Cardiovacular - hypotension (mechanism not understood) arrhythmias may also occur (high or low rates)

4. Sexual dysfunction comon with all antidepressants.
sedation
dry
anticholinergic
depression
arrhythmias
dysfunction
1. __________(occasionally)
2. anticholinergic - blurred vision, ____ mouth, urinary retention, constipation. Tolerance may develop and withdrawl may occur which might be controlled with ___________drugs. Cholineric rebound symptoms include nausea, anorexia, insomnia, more ___________, and anxiety.

3. Cardiovacular - hypotension (mechanism not understood) _________ may also occur (high or low rates)

4. Sexual __________ comon with all antidepressants.
1. hypotension, cardiac arrhythmias
2. drug interactions, esp. other sympathomimetics (e.g. amphetamines, MAO inhibitors, and adrenergic agents in general).
What are the contraindications of Tricyclics?
contraindications of Tricyclics
1. hypotension, cardiac arrhythmias
2. drug interactions, esp. other sympathomimetics (e.g. amphetamines, MAO inhibitors, and adrenergic agents in general).
MAO inhibitors
Used only if:

tricyclics have failed
patient can be trusted not to take overdose or with certain foods (tyramine)

previous history of good response to drug

often useful with "atypical depression", i.e. sleep and eat too much rather than too little.

name drug.
depression
hypertension
What are the clinical uses of MAO inhibitors?
hypotension
What is the major side effect with MAO inhibitors?
side effects of MAO inhibitors
1. CNS stimulation (agitation, restlessnes, insomnia) - this is in contrast to the tricyclics which were sedating

2. hypotension ***
3. hypertensive crisis
4. GI - nausea, CONSTIPATION
5. anticholinergic - blurred vision, dry mouth, urinary retention usually less of a problem than with the tricyclics. Often important to older patient.
1. drug and food interactions - includes tricyclics and all adrenergic agents. Must wait 10-14 days if switching from tricyclics to MAO inbititors.

2. Renal failure - drug will accumulate
What are the contraindications for MAO inhibitors?
contraindications for MAO inhibitors
1. drug and food interactions - includes tricyclics and all adrenergic agents. Must wait 10-14 days if switching from tricyclics to MAO inbititors.

2. Renal failure - drug will accumulate
Serotonin reuptake inhibitors
Tetracyclic
What are some NEW antidepressant agents?