PSYCHOPHARMACOLOGY

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PSYCHOPHARMACOLOGY
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DEFINITION

• Psychopharmacology is the gold standard in
  treatment of neurobiological illnesses, more and
  more of which are found to have genetic
  underpinnings.

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CLASSIFICATION

• 1-Antianxiety and sedative-hypnotic Drugs
• 2-Antidepressant Drugs
• 3-Antipsychotic Drugs
• 5-Mood-Stailizing Drugs

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1-Antianxiety and sedative-hypnotic Drugs
Benzodiazepines
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Cont.
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Sedative-hypnotic Drugs Benzodiazepines
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Cont.
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Antidepressant Drugs
Indication for Antidepressant Drugs Major
depression Acute depression, maintaining
treatment of depression and prevention of
relapse, bipolar depression (when used with a
mode stabilizer) Atypical depression and
dysthymic disorder.
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• - Anxiety disorders
• Panic diorder,obessive-compulsive
  disorder(OCD),social phobia, generalized
  anxiety disoeder,posttraumatic
•  -selective serotonin reptake inhibitors(SSRIs)
• 1-strong evidence
• Bulimia, premenstrual dysphoric disorder full and
  half cycle administration)

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Cont.

• 2-Moderate evidence
• Obesity, substance abuse, impulsivity and anger
  associated with personality disorders, pain
  syndromes.
• 3-preliminary evidence
• Body dysmorphic disorder,hypochondriasis,anger
  attacks associated with depression, attention
  deficit/hyperactivity disorder(ADHD)

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Cont.

• -other newer antidepressant
• Moderate evidenceTrazodoneinsomnia,dementia
  with agitation,minor sedative hypnotic with
  drawal

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Nursing consideration
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Antipsychotic
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Cont.
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Mood-Stabilizing DrugsTarget Symptoms for
mood-Stabilizing drug therapy

• Mania
• Irritability
• Expansiveness
• Euphoria
• Manipulative ness
• Lability with depression
• Sleep disturbance (decrease sleep)
• Pressure speech
• Flight of ideas
• Motor hyperactivity
• Hypergraphia
• Hyper sexuality
• Hallucinations
• Catatonia

• Depression
• Irritability
• Sadness
• Pessimism
• Anhedonia
• Self-reproach
• Guilt
• Hopelessness
• Motor retardation
• Slowed thinking
• Poor concentration and memory
• Fatigue
• helplessness

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Mood-Stabilizing DrugsDRUG CLASS
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Lithium

• Lithium, a naturally occurring salt, is
  first-line treatment for patients with acute
  mania and for the long term prevention of
  recurrent episodes. Lithium also has a role in
  the treatment of recurrent bipolar depression,
  unipolar depression, aggressive behaviors,
  conduct disorder and schizoaffective disorder.

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Stabilizing Lithium Levels

• Common causes for an increase in lithium levels
• Decrease sodium intake .
• Diuretic therapy.
• Decrease renal functioning.
• Fluid and electrolyte loss, sweating, dirrhea,
  dehydration, fever.
• Overdose .
• Medical illness .

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Murine EPS Drug DosesIP doses are calibrated to
give 0.2 ml for a 30 g mouse

• Atropine0.5 mg/g 15 mg IP (Mix 0.2 ml of
  stock solution in a total of 1 ml)Atropine stock
  in vial 0.4 mg/ml
• Carbamyl choline500 ng/g 15 mg IP (Mix 7.5 mg
  into 10 ml for a x10 stock solution)
• Cefazolin200 mg/g/day 6 mg/day in two divided
  doses 3 mg IP bid (Mix 24 mg into 1.6 ml for 8
  individual doses)
• Digoxin20 ng/g bid 0.6 mg IP bid on Day 1
  (Mix 0.2 ml of stock in a total of 10 ml). On Day
  2 give 10 ng/g bid 0.3 mg IP bid (0.1 ml
  IP)Digoxin stock in vial 0.1 mg/ml
• Isoproterenol3 ng/g 90 ng IP (Mix 0.25 ml of
  x100 stock in a total of 1 ml)Isoproterenol x100
  stock 2 mg/ml

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Cont.

• Propranolol1 mg/g 30 mg IP (Mix 0.15 ml of
  stock in a total of 1 ml)Propranolol stock in
  vial 1 mg/ml
• IV doses are calibrated to give 0.05 ml for a 30
  g mouse
• Isoproterenol1 ng/g 30 ng IV (Mix 0.3 ml of
  x100 stock in a total of 1 ml)Isoproterenol x100
  stock 2 mg/ml
• Procainamide30 mg/g 900 mg IV (Add 2.2 ml of
  procainamide stock to 10 ml for a total of 12.2
  ml which gives a concentration of 18
  mg/ml)Procainamide stock in vial 100 mg/ml

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References

• Principles and practice of
• Psychiatric Nursing
• GAIL W. STUART
• MICHELE T. LARAIA
• 8TH EDITION
• 2005