Psychopharmacology

Psychopharmacology
Anti-Anxiety Drugs
The ANXIOLYTICS AND HYPNOTICS
These drugs are used to change the individuals responses to the environment.
The medications that can prevent the feelings of tension and fear are called ANXIOLYTICS.
Anti-anxiety drugs
The drugs that can calm individuals making them unaware of the environment are called SEDATIVES.
The drugs that can induce sleep are called HYPNOTICS.
The drugs in this class are the

BENZODIAZEPINES BARBITURATES
Use of The Drugs

Clinical indications for the use of the anxiolytics, sedatives and hypnotics 1. Prevention of anxiety 2. Formation of sedative state 3. Induction of sleep
The BENZODIAZEPINES
The benzodiazepines are the most frequently used anxiolytic drugs. These agents prevent anxiety states without causing much sedation, with less physical dependence than other agents.
The BENZODIAZEPINES
The following are the benzodiazepines

Alprazolam (Xanax) Chlordiazepoxide (Librium)

clonazepam clorazepate
Diazepam (Valium)
estazolam flurazepam lorazepam midazolam oxazepam quazepam temazepam triazolam
The BENZODIAZEPINES Special uses

Diazepam (Valium) Status epilepticus
Chlordiazepoxide Alcohol (Librium) withdrawal Alprazolam (Xanax) Panic attack
The BENZODIAZEPINES
The Mechanism of Action of the Benzodiazepines
These agents act on the Limbic system and the RAS (reticular activating system) to make the GABA ( Gamma-aminobutyric acid) more effective causing interference with neuron firing.
The BENZODIAZEPINES
The Mechanism of Action of the Benzodiazepines
The
GABA is an inhibitory neurotransmitter. This will result to an anxiolytic effect at lower doses than required for sedation/hypnosis.
The BENZODIAZEPINES
These agents are indicated for the treatment of 1. anxiety disorders 2. alcohol withdrawal 3. hyperexcitability, and agitation 4. pre-operative relief of anxiety and tension and in induction of balanced anesthesia.
The BENZODIAZEPINES
Pharmacodynamics: The adverse effects CNS effects= sedation, drowsiness,

depression, lethargy, blurred vision GIT= dry mouth, constipation, nausea,
vomiting CVS= Hypotension or hypertension, arrhythmias, palpitations, and respiratory difficulties. Hematologic= blood dyscrasias and anemia GU= urinary retention, hesitancy, loss of libido and sexual functions changes.
The BENZODIAZEPINES
Nursing Considerations:
Maintain patients on bed for at least 3 hours after drug administration. Instruct to avoid hazardous activities like driving and machine operation. Instruct to avoid consuming ALCOHOL while taking the drug.
The BENZODIAZEPINES
Nursing Considerations: Provide comfort measures to help patients tolerate drug effectsinstruct to urinate before taking drug give high fiber foods use side-rails and assistance with ambulation.
Have available FLUMAZENIL as an antidote for benzodiazepine overdose.
The BARBITURATES
These are also anxiolytics and hypnotics with a greater likelihood of producing sedation, with increase risk of addiction and dependence.
The BARBITURATES
The following are the barbiturates

amobarbital aprobarbital butabarbital mephobarbital pentobarbital
Phenobarbital
secobarbital
The BARBITURATES
The Mechanism of Action of the Barbiturates They depress the motor output from the brain. The results of their MOA are sedation, hypnosis and anesthesia, and if extreme, coma.
The BARBITURATES
Clinical indications of the Barbiturates 1. Relief of anxiety manifestations 2. For sedation 3. For patients with insomnia 4. For pre-anesthesia
5.
6.
seizures/epilepsy
The rapid acting barbiturates are also used for the treatment of acute manic reactions and status epilepticus
The BARBITURATES
Pharmacodynamics: The Adverse effects CNS= CNS depression, somnolence, vertigo, lethargy, ataxia, paradoxical excitement, anxiety and hallucinations. GIT= nausea, vomiting, constipation/diarrhea and epigastric pain CVS= bradycardia, Hypotension and syncope. Respi= serious hypoventilation, respiratory depression and laryngospasms Others= hypersensitivity and Stevens-Johnson syndrome.
The BARBITURATES
Nursing Considerations Provide stand-by life support facilities in cases of severe respiratory depression or hypersensitivity reaction. Taper the drug gradually after long-term therapy to avoid withdrawal syndrome. Provide comfort measures including small frequent meals, access to bathroom facilities, high-fiber foods, environmental control, safety precaution and skin care.
The CNS stimulants

These are drugs used to treat certain disorders 1. exogenous obesity 2. attention-deficit hyperactivity disorders (ADHD) 3. narcolepsy
The CNS stimulants

What is unusual is the ability of the CNS stimulants to CALM hyperactive children, which allows them to focus on one activity for a longer period.
The CNS stimulants

The following are the CNS stimulants: 1. Methylphenidate (Ritalin)= most
commonly used for ADHD

2. Dextroamphetamine= a CNS stimulant that is used for short tem therapy for obesity. 3. Modafinil= used for narcolepsy 4. Pemoline= used for ADHD
The CNS stimulants

The Mechanism of Action These agents act as to stimulate the cortical and reticular activating system (RAS) of the brain. This is by releasing neurotransmitters from the nerve cells leading to increased stimulation of
the post-synaptic neurons.
The CNS stimulants
The paradoxical effect of calming hyperexcitability through CNS stimulation seen in ADHD is believed to be related to the increased stimulation of an IMMATURE Reticular Activating System leading to the ability to be more selective in response to incoming stimuli.
The CNS stimulants

Pharmacodynamics: Adverse effects of the CNS stimulants CNS= nervousness, insomnia, dizziness, headache, and blurred vision GIT= anorexia, nausea and weight loss CVS= hypertension, tachycardia arrhythmias, and angina Others= rashes, physical/psychological dependence.
The CNS stimulants

Implementation The nurse must ensure that the drug is only given to the indicated conditions
Administer the drug before 6 pm to reduce the effect of insomnia BEST given AFTER meals to prevent the effect of anorexia
Consult with school personnel to monitor the patient under therapy Provide safety measures such as side-rails and assisted ambulation
The CNS stimulants

Evaluation Evaluate the effectiveness of the drug: 1. Calming effect in the patient with ADHD 2. Alertness for patients with narcolepsy

Psychopharmacology

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Psychopharmacology

The ANXIOLYTICS AND HYPNOTICS

The ANXIOLYTICS AND HYPNOTICS

The ANXIOLYTICS AND HYPNOTICS

The ANXIOLYTICS AND HYPNOTICS

The drugs that can induce sleep are called HYPNOTICS.

The ANXIOLYTICS AND HYPNOTICS

The drugs in this class are the

Use of The Drugs

Alprazolam (Xanax) Chlordiazepoxide (Librium)

The BENZODIAZEPINES Special uses

Chlordiazepoxide Alcohol (Librium) withdrawal Alprazolam (Xanax) Panic attack

depression, lethargy, blurred vision GIT= dry mouth, constipation, nausea,

Have available FLUMAZENIL as an antidote for benzodiazepine overdose.

amobarbital aprobarbital butabarbital mephobarbital pentobarbital

The CNS stimulants

The CNS stimulants

The CNS stimulants

commonly used for ADHD

The CNS stimulants

the post-synaptic neurons.

The CNS stimulants

The CNS stimulants

The CNS stimulants

The CNS stimulants

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