PSYCHOPHARMACOLOGY

1. PSYCHOPHARMACOLOGY

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

3. CLASSIFICATION: 1-Antianxiety and sedative-hypnotic Drugs 2-Antidepressant Drugs 3-Antipsychotic Drugs 5-Mood-Stailizing Drugs

4. 1-Antianxiety and sedative-hypnotic Drugs: Benzodiazepines

5. Cont.

6. Sedative-hypnotic Drugs: Benzodiazepines

7. Cont.

9. - 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)

10. 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)

11. Cont. -other newer antidepressant Moderate: evidence:Trazodone:insomnia,dementia with agitation,minor sedative hypnotic with drawal

14. Nursing consideration

16. Antipsychotic

17. Cont.

18. 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

19. Mood-Stabilizing DrugsDRUG CLASS

20. 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.

21. 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 .

22. Murine EPS Drug DosesIP doses are calibrated to give 0.2 ml for a 30 g mouse Atropine:0.5 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 choline:500 ng/g = 15 mg IP (Mix 7.5 mg into 10 ml for a x10 stock solution) Cefazolin:200 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) Digoxin:20 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 Isoproterenol:3 ng/g = 90 ng IP (Mix 0.25 ml of x100 stock in a total of 1 ml)Isoproterenol x100 stock = 2 mg/ml

23. Cont. Propranolol:1 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 Isoproterenol:1 ng/g = 30 ng IV (Mix 0.3 ml of x100 stock in a total of 1 ml)Isoproterenol x100 stock = 2 mg/ml Procainamide:30 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

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