1 / 48

Activating CNS agents

Activating CNS agents. Lector prof. Posokhova K.A. PSYCHOTROPIC DRUGS. Drugs with depressive type of actoin Neuroleptics ( antipsychotic ) Tranquilizers ( anxiolytics ) Sedative drugs Normotymics ( tymoleptics , tymoanaleptics ) Drug with stimulative action Antidepressants

base
Download Presentation

Activating CNS agents

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Activating CNS agents Lector prof. Posokhova K.A.

  2. PSYCHOTROPIC DRUGS Drugs withdepressivetype of actoin • Neuroleptics (antipsychotic) • Tranquilizers (anxiolytics) • Sedative drugs • Normotymics (tymoleptics, tymoanaleptics) Drug withstimulativeaction • Antidepressants • Psychomotor stimulants • Nootropic drugs • Drugs which increase general tone (adaptogens) Psychotomimetics(psychodysleptics) • LSD • Cannabis sativa L.

  3. ANTIDEPRESSANTS

  4. WHO: 3-6 % of Earth population suffer from depression Depression and somatic-vegetative symptoms which accompany depression are quite often psychical disorders which happen in general medical practice. There are: • Endogen (psychogenic)depression – schizophrenia, maniac-depressive psychosis • Secondary (somatogenic)depression – organic diseases (oncology patients, hypertension, ulcer disease, climacteric disorders etc.)

  5. More than 50 % of patients with depressive disorders don’t realize that they have any psychological problems and complain only on certain somatic discharges Most frequent complaints of patients with depression Feeling of hopelessness, indifference, fear, panic attacks, tiredness, weakness, headache, dizziness, dream disorders, dyspepsia, unpleasant feelings and pain in different parts of the body Depressive conditions “mask” as vegetal-vascular, neuro-circulative dystonia (various vegetative disorders), gastro-intestinal pathology, pathology of cardio-vascular, respiratory systems, manifest as diskinesia, functional motor disorders, insomnia, toothache, disorders of sexual activity, recidivate eczema and many other disorders

  6. Function of adrenergic synapse in physiological conditions

  7. ANTIDEPRESSANTS Drugs which inhibit neuronal uptakeof monoamines • Nonselective action (blockuptakeof noradrenaline and serotonine): imisin, amitriptilin • Selective action: а) heterocyclic compounds (block neuronaluptakeof noradrenaline): amoxapin, maprotilin (ludiomil); б) selective blockers of neuronal uptake of serotonin: fluoxetin (prozak, framex), sertralin (zoloft), paroxetin (rexetin) Inhibitors of monoaminoxidase (IMAO) • nonselective (block МАО-А and МАО-В): а) irreversibleaction – nialamid; b) reversible action – transamin • Selective ІМАО (block МАО-А): moklobemid, pirasidol

  8. Blockers of neuronaluptake of serotonin Modern point of view on mechanism of development of depression Primary deficiency ofserotoninin synaptic cleft Compensatory growing of quantity and sensitivity of postsynaptic5-НТ2receptors Compensatory decreasing of quantity and sensitivity of presynaptic5-НТ1receptors in hippocampus and nuclei row (these structures play an important role іn development of depression)

  9. Blockers of neuronaluptake of serotoninfluoxetin, sertralin, paroxetin Mechanism of action Increasing of active concentration of serotonin in synaptic clefton a level of postsynaptic 5-НТ2 serotonin receptors of cerebral structures

  10. Blockers of neuronaluptake of serotoninfluoxetin, sertralin, paroxetin

  11. Mechanism of action of IMAO

  12. Usage of antidepressants Schizophrenia, MDS Atherosclerosis of brain Reactive depressions Parkinsonism Organic diseases of CNS Oncology patients General somatic diseases

  13. Psychotropic action of antidepressants • Drugs withpsychosedativeaction: Аmitriptilin, maprotilin, asafen, fluvoxamin 2. Drugs withpsychostimulativeaction: Imisin, nialamid, fluoxetin 3. Drugs withregulativeinfluence Pirasidol

  14. Principles of antidepressants usage • Endogen depression – the deeper it is, the larger doses, rate of their increasing and duration of treatment should be administered • Step-by-step dose increasing till obtaining of effect, administration of effective dose during 4-6 weeks – 3-6 months, gradual decreasing of dose (during 5-6 weeks) • Effect can appear only after 7-14 days after beginning of therapy (this fact should be taken into consideration in patients with suicidal dispositions) • In case of rapid abolishing withdrawal syndrome may develop

  15. Side effects of antidepressants • М-cholinoblocking action: dry mouth, increasing of intraocular pressure, disturbance of accommodation, constipation, ischuria (important in a case of adenoma of prostatic gland!), tremor, hallucinations, disorders of consciousness, excitation • Alpha-adrenoblocking, papaverine-like effect: sharp hypotension, orthostatic collapse (especially in combination of amitriptiline with clopheline), for correction of which adrenomimetics cannot be used (it is necessary to increase volume of circulating blood, put the legs up)

  16. Side effects of antidepressants • Acute attacks of epilepsy • Cardiotoxicaction (sudden death), three- cyclic antidepressants increase arrhythmogenic activity of drugs for general anesthesia, antihistamines etc. • Combination of three-cyclic antidepressants with IMAO is absolutely contraindicated:danger of development of hypertensive crisis, seizures, rapid excitation, tachycardia, cardiac arrhythmias, increasing of temperature

  17. Rules of transferring from one kind of antidepressants to another • From three-cyclic to IMAO – break time– 2-3 days • From IMAO to three-cyclic – break time – not less than 2 weeks

  18. It is absolutely contraindicated to administer adreno(sympato)mimetics in case of treatment with antidepressants Even small doses of adrenomimetic (sympatomimetic) substances in such patient can cause hypertensive crisis: • Nose drops for rhinitis • If few drops were added to solutions of local anesthetics • In case of administration of drugs which contain pseudoephedrine (they are widely used for cold at nowadays)

  19. Diet in case of administration of IMAO It is necessary to excludesuch products which contain DOPAandthiramine(which is formed from casein during the process of transforming under the influence of bacteria) aged cheese, kefir Marinated herring Smoked meat, fish Red vine, beer, yeast Beans oranges, tangerines, lemons, grape, bananas, chocolate, caviar (red and black)… … Any BAA are also dangerous In case of treatment with IMAO new products should be introduced intoration very carefully

  20. In case of administration of inhibitors of uptake of serotoninthe previously indicated side effects are observed much more rarely • Administration of antidepressants with any other drugs should be performed only after precise studying of possible negative consequences of their interaction

  21. PSYCHOMOTOR STIMULANTS

  22. PSYCHOMOTOR STIMULANTS • Derivatives of purine – caffeine • Phenilalkilamines – phenamine (amphetamine) • Phenilalkilsydnonimins - sydnocarb

  23. Properties of psychomotor stimulants • Stimulate intellectual activity, speed up thinking processes, temporarily eliminate tiredness, somnolence • Eliminate such manifestations of neurosis as: subdepression, fatigue, retardness • Aren’t able to eliminate endogen depression, which accompanies psychical diseases

  24. Caffeine Mechanism of action • Binds to adenosine (“purine”) receptorsin brain (endogen ligand of these receptors – adenosine decreases processes of excitation in CNS) • Inhibiting of phosphodiesterase, which leads to accumulation of cAMP and stimulation of many physiological processes and metabolism

  25. Caffeine

  26. Usage of psychostimulating influence of caffeine • For stimulation of psychological processes, workability, to eliminate somnolence • Enuresis, narcolepsy • In case of poisoning with alcohol • To speed up awakening after narcosis

  27. Influence of caffeine on cardiac-vascular system Vessels • Stimulation of vasomotor center – contraction of vessels, increasing of AP • Peripheral myotropic spasmolytic action – dilation of vessels, decreasing of AP Heart • Central action (increasing of n. vagus tone) – bradycardia • Peripheral action (direct influence on heart) – tachycardia, possible extrasystolia

  28. Influence of caffeine on cardio-vascular system • Contraction of brain vessels • Dilation of kidney vessels, increasing of diuresis • Dilation of coronary vessels In case of depression of centers of brain stem (medulla oblongata) caffeine shows stimulating properties, increases blood pressure, stimulates breathing –analeptic action

  29. SIDE EFFECTS OF CAFFEINE • If administered regularly – psychological addiction – theism, which is accompanied by development of abstinent syndrome (retardness, fatigue, somnolence, depression) • Tolerance • Teratogenic action (innate abnormalities) • Increasing of frequency of IHD, essential hypertension • Acute attacks of ulcer disease(it increases gastric secretion) • Acute poisoning in case of overdosing

  30. NOOTROPIC DRUGS(NEUROMETABOLIC CEREBROPROTECTORS)

  31. Neurometabolic cerebroprotectors • Derivatives of pyrrolidone – pyracetam (nootropil) • Derivatives of GABA – aminalon, sodium oxybutyrate • Neuropeptides – melatonin, sinacten-depot • Cerebrovascular drugs – sermion (nicergolin), cavinton (vinpocetin), stugeron (cinnarisin), pentoxyphylline (trental, agapurine), xantynole nicotinate • Derivatives of piridoxine – piritinol (encephabol) • Antioxidants – mexidol, tocopherole acetate • Other – cerebrolysine, actovegin, solkoseryl, plant preparations

  32. Properties of nootropic drugs • Improvement of brain blood circulation, promotion of collaterals development • Psychostimulating effect, antiasthenic action • Sedative, antidepressive action • Antiepileptic, antiparkinsonic action • Nootropic action • Mnemotropic action • Vasovegetative action • Antihypoxic action

  33. Administration of nootropic drugs • Atherosclerosis of brain, vascular parkinsonism, Alzheimer's disease • Disorders of brain blood circulation in case of traumas and intoxications, vascular diseases of brain • Diseases of CNS, accompanied by decreasing of intellect, memory • Disorders of psychology (in elderly with schizophrenia, depressions) • To decrease manifestations of abstinence (alcoholism, drug addiction) • In neurology (neurasthenia, migraine, neuralgias, radiculitis) • In pediatrics in case of mental insufficiency

  34. Piracetam (nootropil)

  35. Cerebrolysin

  36. Cinnarizin (stugeron)

  37. ADAPTOGENS

  38. Adaptogens Drugs of Ginseng, Schizandrum, Rodiola, Eleutherococcus, Leusea, Echinacea Apilac, propolis, mumie, heparin, dybazol

  39. GINSENG

  40. RODIOLA

  41. Eleutherococc

  42. Schizandrum

  43. Echinacea purpurea Maxima

  44. ADAPTOGENS Increase general resistance of the organism towards unfavorable factors Stimulating action Antistress action Anabolic action

  45. Side effects of adaptogens Increasing of AP disturbance of sleep if administered in evening time, overwhelming excitation, psychical dependence

  46. Analeptics (Bemegridum, Camphora, Cordiaminum) Camphora

More Related