![Neurotransmitter Basis of
Depression
• http://www.metacafe.com/watch/3486985/how_s
sris_and_mao_inhibitors_work/?fb_xd_fragment
#?=&cb=f1d74aef3bf2f9d&relation=parent.paren
t&transport=fragment&type=resize&height=200&
ackData[id]=1
• Drugs that prolong the action of serotonin
and dopamine, decrease sensitivity to
these neurotransmitters by down
regulating the excessive stimulation which
is thought to cause depression.](https://image.slidesharecdn.com/sedativeshypnoticsaffectiveandantipsychoticmedicationsforodlaexercise-111023090222-phpapp01/75/Sedatives-hypnotics-affective-and-antipsychotic-medications-for-odla-exercise-17-2048.jpg)
More Related Content
Similar to Sedatives, hypnotics, affective and antipsychotic medications for odla exercise
Sedatives, hypnotics, affective and antipsychotic medications for odla exercise
- 1. Pharmacology of theCentral Nervous System Sedatives, Hypnotics, Affective, and Antipsychotics
- 2. Teaching and Learning Objectives Sedative-Hypnotic and Antianxiety Drugs • Name the 2 major types of sedative- hypnotic and antianxiety drugs. • Describe the general mechanism of action of all 2 of the types of drugs. • Discuss problems and adverse effects of these types of drugs. • Compare/contrast sedative-hypnotic and antianxiety drugs.
- 3. Teaching and Learning Objectives • List the major types of antianxiety drugs • Describe the problems and adverse effects of these drugs • Discuss the implications for the PT management of patients taking sedative- hypnotic and antianxiety drugs • Modify PT interventions for persons taking these drugs
- 4. Teaching and Learning Objectives Antidepressive and Bipolar Drugs • Describe the clinical signs of depression • Describe the theoretical neurotransmitter basis of depression • Explain the mechanism of action of antidepressive drugs • List the 3 major groups of antidepressive drugs
- 5. Teaching and Learning Objectives • Describe the mechanism of action of the 3 groups of antidepressant drugs • Discuss the problems and adverse effects of the 3 groups • Explain the use of antidepressant drugs in the management of chronic pain • Define Bipolar Disorders • Discuss the use of Lithium for bipolar disorders
- 6. Teaching and Learning Objectives • Discuss the special concerns for rehabilitation in patients taking antidepressant and bipolar drugs • Modify PT management of patients taking antidepressant and bipolar drugs
- 7. Teaching and Learning Objectives Antipsychotic Drugs • Define Psychosis and list the associated symptoms • Describe the theoretical neurotransmitter basis of psychosis • Explain the mechanism of action of antipsychotic drugs • Explain the major difference in traditional and atypical antipsychotic drugs
- 8. Teaching and Learning Objectives • Explain the use of antipsychotic drugs in persons with dementia • Define “extrapyramidal” symptoms • Recognize extrapyramidal symptoms • Describe Tartive Dyskinesis • List non-motor side effects of antipsychotic drugs • Describe special PT rehabilitation concerns in persons taking antipsychotic medications • Modify PT strategies for patients taking antipsychotic drugs
- 9. Sedative-Hypnotic Drugs • Usedto relax ( low doses) • Used to promote sleep (higher doses) • Very commonly used by inpatients and outpatients. • 2 general categories of drugs Benzodiazepines Nonbenzodiazepines All sedative/hypnotic drugs act as GABA receptor agonists, ie., increase chloride entry to the post- synaptic membrane, thus inhibiting the synapse.
- 10. GABA Neurotransmission Effects http://www.youtube.com/watch?v=- pfG6yHAQ5U&NR=1
- 11. Benzodiazepines Therapeutic effects: – Sedation –Sleep – Anxiety reduction • Diazepam (Valium) most well known example
- 12. Side Effects • Dependence-Withdrawal symptoms associated with cessation of the drug • Tolerance- Necessity of increasing dosage to attain therapeutic effect • Day after residual effects- especially important for PTs to be aware of. • Drowsiness and decreased motor performance day after taking drug • Anteriorgrade amnesia- poor recall of details and events for a period of time after taking the drug
- 13. Nonbenzodiazepines • Barbituates- hypnotics Uncommonly used today due to risk of overdose, tolerance and dependence. Tolerance- more drug necessary for an effect Dependence- withdrawal symptoms • Newer Drugs – Zolpidem (Ambien) and Zaleplon (Sonata) • Sedative/hypnotic effects • Less risk of overdose , tolerance and dependence
- 14. Antianxiety Drugs • Benzodiazepines Used at lower doses for antianxiety than as for sedative/hypnotic effects. • Nonbenzodiazepines Buspirone (BuSpar)- Acts through the serotonin receptor as an agonist, not GABA. Least risk of tolerance, dependency and sedation effects of available antianxiety drugs.
- 15. PT Implications ofSedative/Hypnotic/Antianxiety Drugs Assignment • May be helpful in gaining patient cooperation with therapy. • May be detrimental if patient drowsy, so scheduling therapy should take into account the time of maximal effect of sedation. • May increase the risk of falls, so that balance training and environmental modifications may be provided by the therapist. • Non-pharmacologic measures to reduce anxiety and insomnia such as therapeutic massage, exercise, and relaxation techniques may avoid the need or reduce the effective dose of these drugs. (Instructor may make a cloud display containing all of the answers and post for
- 16.
- 17. Neurotransmitter Basis of Depression • http://www.metacafe.com/watch/3486985/how_s sris_and_mao_inhibitors_work/?fb_xd_fragment #?=&cb=f1d74aef3bf2f9d&relation=parent.paren t&transport=fragment&type=resize&height=200& ackData[id]=1 • Drugs that prolong the action of serotonin and dopamine, decrease sensitivity to these neurotransmitters by down regulating the excessive stimulation which is thought to cause depression.
- 18. 3 Types ofAntidepressant Drugs • Tricyclics Amitriptyline, Imipramine • Monoamine Oxidase Inhibitors (MAOI) • Serotonin Reuptake Inhibitors (SSRI) - Prozac, Paxil, Zoloft Since all of these drugs act by desensitization of the synapse to the neurotransmitters, they often require 2-4 weeks for therapeutic effect to occur.
- 19.
- 20. Adverse Effects • Tricyclics Sedation Anticholinergic effects (confusion, delirium, dry mouth, urinary retention, tachycardia, orthostatic hypotension Potential for fatal overdose
- 21. Adverse Effects • MOAI CNS excitation (restlessness, irritability, agitation, insomnia Anticholinergic Hypertension crisis
- 22. Adverse Effects • SSRI Lesser degree of sedation, anticholinergic, and cardiovascular effects than tricyclics and MAOI. Serotonin Syndrome- Life threatening http://www.medclip.com/index.php?page= videos§ion=view&vid_id=105700
- 23.
- 24. Bipolar Disorders • Pendulum-likeswings between mania and depression. • Treatment designed to prevent the swings by dampening neuronal (synaptic) transmission. • Lithium is drug most often used. Tendency to accumulate in body reaching toxic levels. • Side effects include tremor, weakness, confusion, ataxia, dysarthria, nystagmus, increased DTRs, choreoathetoid movements, coma and death
- 25. Psychosis • Thought processdisturbance with impaired perception of reality. • Schizophrenia most common form Effects 1% of world population Symptoms include bizarre delusions, hallucinations, poor social relations and self-care. 70-80% genetic tendency.
- 26. Schizophrenia OveractiveDopamine neurotransmission Dopamine www.schizophrenia.com/DAreceptorblock.gif
- 27. Antipsychotic Drugs • Traditionalantipsychotics- Haldol, Prolixin, Thorazine, Mellaril Side effects include extrapyramidal signs, sedative and anticholinergic effects. • Atypical antipsychotics- First line drugs of choice Significantly fewer (lesser) side effects than traditional drugs Often used in Alzheimers and other persons with dementia to control agitation and aggression.
- 28. Side Effects ofAntipsychotic Drugs http://www.youtube.com/watch?v=Ki9t2sSBFmA