side effects of psychotropics
TRANSCRIPT
Side Effects of Psychotropics
ByAHMED ALBEHAIRY,M.D
PSYCHIATRY CONSULTANT, MOH
Important items in S.E of psycho tropics
Acting on many neurotransmitters, localized to many organs.
Categorizations of side effects according to the action on neurotransmitter system.
??? Several SE have nt been ,neurotransmitters, specifically identified.
Drug induced syndrome, movements. Expectation of SE , dec. trouble . Treatment of SE. Choose the treatment according to SE.
SE caused by blockade of muscarinic Ach
Blurred vision. Constipation. Decreased salivation, sweating. Delayed or retrograde ejaculation. Delirium. Exacerbation of asthmatic pts. Hyperthermia. Memory problems. Narrow angle glaucoma. photophobia,. Sinus tachycardia. Urinary retension.
Antdopaminergic SE
Hyperprolactinemia.Menstrual dysfunction.Sexual dysfunction.Akathesia.Dystonia.Parkinsonism.T dyskinesia.
Antiadrenergic ( a1)
Dizziness.
Postural hypotension.
Reflex tachycardia.
antihistaminergic
Sedation
Weight gain.
Excessive serottonergic
Akathesia, agitation.Anxiety.GIT upset and diarrhea.Headache. Insomnia or somnolence.Nausea Sexual dysfunction
Multiple neurotransmitter system
Agranulocytosis .Allergic reactions.Anorexia.Cardiac conduction abnormalities.Seizures.
Monoamine receptors : review
5HT1A-----AD,ANXIOLYTIC. 5HT1B-----ANIMAL MODEL OF 5HT1DB 5HT1Da---ANTIMIGRAINE 5HT1DB,1F---ANTIMIGRAINE 5HT2A------ATYPICAL ANTIPSYCHOTICS 2B---- STOMACH CONTRACTION 2C--- REGULATION OF APPETTITE,SEIZURE,
ANTIPSYHOTIC 5HT3----ANTEMETIC,ANXIOLYTIC,COGNITIVE
ENHANCER 5HT4----MODULATION OF COGNITION 5HT6--- ATYPICAL ANTIPSYCHOTIC 5HT7 --- REGULATION OF C RYTHM
Monoamine receptors : review
H1 ANTAG---- SEDATION,WT GAIN.
H2 ANTAG----TTT OF PEPTIC ULCER
H3 ANAG-----INC ARROUSAL,APPETITE SUPRESSION.
Monoamine receptors : review
D1----D1 &D2 SYNERGISM, COCAINE EFFECT
D2---- EPS,ANTIPSYCHOTICD3---UKD4---S-D ANTAGONIST, ATYPICAL
ANTIPSYCHOTICS.D5---- UK
Monoamine receptors : review
A1,a,b,c antagonist---antihypertensive A2 agonist------sedative ,antihypertensive B1---- cardic function B2--- br athma B3--- adipose tissue function
M1--- cognition,seizures M2---- cardiac function M3 --- smooth ms contraction M4---- antparkinsonism,anticholinergic
Treatment of common SE
Sexual dysfunction. Anxiety, akathesia,insomnia. GIT upset. Headache. Anorexia. Wt gain Somnolence Dry mouth Blurred vision Constipation Othostatic hypotension EPS T DYSKINESIA
Common SE of lithium
Tremors:--- dec dose, indral GIT UPSET– dec dose Wt gain---adj wt loss, warn in advance Cognitive imp--- check thyroid,treat depression D I--- SWITCH KIDNEY IMP--- DEC DOSE OR SWITCH PSORIASIS--- OMEGA 3 ACNE—RETNOIC ,TETRACYCLINE HYPOTHYROIDISM--- ELTROXIN
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