PHAR CH 20

• Mental processes
• Emotions,
• Behavior

• Caffeine
• Amphetamine
• Methylphenidate

• Strong stimulant of cerebral cortex
• Produces brighter spirits and feeling of energy and alertness.

Primarily used in ADD/ Enhances focus in children, which decreases hyperactivity.

• Tricyclic Antidepressants (Elavil)
• MonoAmine Oxidase Inhibitors (MAOI)
• Selective Serotonin Reuptake Inhibitors
• Heterocyclic Antidepressanrs

Increases activity of norepinephrine and serotonin at the synapse.

• An enzyme
• Breaks down dopamine and norepinephrine
• Leaves more dopamine and norepinephrine in circulation.
• Results in some direct amphetamine- like actions.

• Used when other agents have failed.
• Significant food interaction- Tyramine

• Sources of Tyramine:
• Wine
• Cheese
• Aged foods- Salami, Pepperoni

Drug Interactions: dextromethorphan (OTC meds)

Causes a hypersensitive crisis High BP, severe headache, palpitations, chest pain and death.

phenelzine (Nardil)

SE's: Constipation, urinary retention

• Serotonin
• Norepinephrine
• Dopamine

First line of treatment for most depression.

Precautions: Increased risk of suicidal thoughts and actions in teens.

SE's: Headache, sexual dysfunction.

• venlafaxine (Effexor)
• fluoxetine (Prozac)

• burpropion (Wellbutrin)
• Useful in smoking cessation

• trazodone (Desyrel)
• Useful in agitated depressions (post crystal and meth addiction)

SWITCH FROM UNIPOLAR TO BIPOLAR TRAITS IS NOTED BY THE ONSET OF MANIC EPISODES.

Mania: Exuberent, hypreemotional, flights of ideas.

Manic Psychosis: State of irritability and hostility.

• Very effective for bipolar disorders
• Need 6-8 days for onset of effect.
• Monitor blood levels to avoid toxicity.

SE's: tremors, excessive thirst (polydipsia)

Effective fr anxiety disorders.

• A response to and enviromental stressor.
• Most commin symptom : Fear

• Reduce anxiety without causing sedation.
• Precautions: DO NOT mix with other CNS epressants (alcohol)
• High risk of tolerance and dependence- Use short term only.

• diazepam (Valium)
• aprazolam (Xanax)

Useful in relieving symptoms of neuroses and psychoses:

• Delusions
• Hallucinations
• Agitation
• Combativeness

• Uses: Drug induced psychosis (amphetamine)
• Manic phase of Bipolar Depression.

Newer genration antipsychotic

Uses: Schizophrenia, Bipolar disorders.

SE's: Weight gain, diabetes

Leads to liver damage, pancreatitis, vitamin deficiencies (thiamine, floate)

Fetal alcohol syndrome.

Acute withdrawal causes delerium tremens :DT's" (approx 48 hrs after stopping)

• CNs depressant
• #1 substance abuse problem in the US
• Rapidly absorbed via the GI tract.

• Tolerance
• Psychological Dpendence
• Physical Dependence
• Withdrawal

• Tolerance develops rapidly.
• Highly addictive
• Chronic use leads to psychotic symptoms.
• Risk of cardiac events from extreme chronic use.

• Active ingredient- tetrahydracannabinol. (THC)
• Potency varies
• Schedule L

• CNS stimulant with euphoric effects
• Highly addictive-dependence develops rapidly.
• Inhaled, injected or smoked.

Pharmaceutical preparation (4%) for local anesthesia.

• Schedule 1
• Amphetamine like actions with profound hallucinations and distortions of senses.
• Not for the weak of mins-Psychoses may occur with pre existing anxiety disorders.
• Treat overdoses with chlorpromazine (Thorazine)