What is the MoA of antipsychotics?
What are the side effects of specific medications for schizophrenia?
What causes the anti-emetic effect of neuroleptics?
What causes the acute dystonia and tardive dyskinesia of antipsychotics?
What are the endocrine effects and blockade of certain receptors of antipsychotics?
What are the different clinical uses of BZD and BARBs?
Anaesthetics Barbiturates only: THIOPENTONE Anti-convulsants DIAZEPAM (BZD) CLONAZEPam (BZD) PHENOBARBITAL (BARB) Anti-spastics: DIAZEPAM - because it has an action in the spinal cord and reduces the propagation of action potentials in the alpha motor neurones Anxiolytics Sedative/hypnotic
What are anxiolytics?
remove anxiety without impairing mental or physical activity (used to be referred to as minor tranquilisers)
What are sedatives?
reduce mental and physical activity without producing loss of consciousness
What are hypnotics?
What are the characteristics of ideal anxiolytics, sedatives and hypnotics?
Have a wide margin of safety Not depress respiration Produce natural sleep (hypnotics) Not interact with other drugs Not produce hangovers Not produce dependence/tolerance
What are the pharmacokinetics of barbiturates and unwanted effects?
What are the pharmacokinetics, metaboliosm, excretion, DOA of benzodiazepines?
Diazepam, Oxazepam and Temazepam
How are benzodiazepines metabolised?
Oxazepam is directly metabolised in the liver to inactive glucuronide;
temazepam metabolised initially into oxazepam, then converted into glucuronide.
Nordiazepam is an active metabolite
Which drugs are used as anxiolytics and which as sedatives and hypnotics?
For anxiolytics you need a long acting BDZ so it can last during the day
What are the advantages of benzodiazepines?
Wide margin of safety: overdose -> prolonged sleep (rousable, with rare respiratory depression), flumenazil can be given IV if patient has OD'd on BDZ which reverses the action as it is a competitive antagonist; mild effect on REM sleep; DOESN'T induce liver enzymes
What are the unwanted effects of BDZ?
What is Zopiclone?
Sedative/hypnotics; short acting t1/2=5h; acts at BZD receptor (cyclopyrrolone); similar efficacy to BZD; minimal hangover effects but dependency still a problem
What are some other anxiolytics - antidepressants, antiepileptics and antipsychotics?
Antidepressant = SSRIs: effective, delayed response, popular. Antiepileptic = Valproate, tiagabine. Antipsychotic = olanzapine, quetiapine, both with marked side effects. Propanolol = improves physical symptoms, like tachycardia and tremor. Buspirone = 5HT1A agonist, fewer side effects (
What is the epidemiology of Alzheimer's?
Main risk factor – Age Huge economic cost in the UK BUT low research investment Nov 2016 – ONS announces AD & dementia are leading cause of death in UK Genetics - APP, PSEN, ApoE (hereditary ~ 8%)
What are the symptoms of Alzheimer's?
Memory loss – especially recently acquired information Disorientation/ confusion – forgetting where they are Language problems – stopping in the middle of a conversation Personality changes – becoming confused, fearful, anxious Poor judgement – such as when dealing with money
What is the amyloid hypothesis?
What is the Tau hypothesis?
What is the inflammation hypothesis?
What re the 3 anticholinesterases and the NMDA receptor blocker used in Alzhemier's?
What are the treatment failures in Alzheimer's?