Question

Discuss the therapeutic effects of the following medications as they relate to the pathophysiology of the indicated disorders they are used to treat:

Antipsychotics

Antidepressants

Benzodiazepines

Answer 1

Antipsychotics - are those psychotropic drugs which are used for the treatment of psychotic symptoms.Eg Chlorpromazine,Haloperidol.

Therapeutic effects are

Extrapyramidal symptoms

• Neuroleptic -induced parkinsonism-symptoms are rigidity,tremors,bradykinesia,stooped posture,drooling,akinesia,ataxia
• Acute dystonia-dystonic movements results from a slow sustained muscular spasm thatlead to an involuntary movement.it can involve the neck,jaw,tongue and the entire body(ophisthotonous).
• Akathisia-it is a subjective feeling of muscular discomfort that can cause patients to be agitated,restless and generally feel dysphoric.
• Tardive dyskinesia-it is a delayed adverse effect of antipsychotics.it consist of abnormal .irregular choreothetoid movements of the muscles of the head,limbs and trunck.
• Neuroleptic malignant syndrome-it is a rare but serious condition occuring in a small minority of patients taking neuroleptics,especially high potency compounds.
• Other effects are drymouth,constipation,cycopegi,mydriasis,urinary retention,impotence and impaired ejaculation.

Antidepressant- are used for the treatment of depressive illness and are called ad mood elevators Eg Imipramine,Fluoxetine.

Adverse effects

1 Autonomic side-effects-dry mouth,constipation,cyclopegia,mydriasis,urinary retention,delirium.

2 CNS effects-sedation,tremor and other EPS ,withdrawl syndrome,seizures,jitteriness syndrome,precipitation of mania.

3 Cardiac side-effects-TachycrdiaECG changes,arrythmias,direct myocardial depression

4 Allergic sideeffects-Agranulocytosis,cholestatic jaundice,skin rashes,systemic vasculitis

5 Metabolic and endocrine sideffects-weight gain

6 Special effects of MAOI drugs-hypertensive crisis,severe hepatic necrosis.

Benzodiazepines -Anxiolytics are also called as minor tranquilizers and belong to the benzodiazepine group of drugs..These drugs are the first choice i the treatment of insomnia. Eg Lorazepam

Therapeutic effects- nusea,vomiting,weakness,vertigo,blurring of vision,bodyaches,epigastric pain,diarrhea,impotence,sedation,drymouth,retrograde amnesia,impairement of driving skills,dependence and withdral symptoms.