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Презентация на тему Psychostimulants, adaptogens, analeptics, antidepressants, and nootropic drugs

Psychostimulants (Psychomotor Stimulants)1. Methylxanthines: Caffeine (Coffeinum-natrii benzoas ) tab. 0.1 g; amp. 10% and 20% - 1 ml)2. Phenylalkyl amines: Phenamine (Amphetamine)3. Phenylalkyl sydnonimines: Sydnocarb (tab. 0.005 and 0.01 g)4. Piperidine compounds: Meridil (tab.
Zaporozhye State Medical University Pharmacology and Medical Formulation  Department Psychostimulants  (Psychomotor Stimulants)1. Methylxanthines:  Caffeine (Coffeinum-natrii benzoas ) 	tab. 0.1 Mechanisms of Action of Caffeine1). Blockade of Phosphodiesterase => 					⇑ cAMP and ATP    Adenyl Cyclase	    cAMP 	or Pharmacological Effects of Caffeine : Stimulation of Medullary, Vagal, Phenamine (Amphetamine)-	a central sympathomimetic. It was synthesized in the late 1920s and Sydnocarb (Mesocarb) – chemically and pharmacologically similar tophenamine but ADAPTOGENS 1. Plant origin – Powders, T-res and Extracts from roots or Pharmacodynamics of Adaptogens: ? Physical and Mental Capacity ? Fatigue, ? Appetite Clinical Uses: Physical Overwork Physical and Mental Overfatigue Asthenic Syndrome State after Classification of ANALEPTICS	1. With prevalent action upon the BRAIN CORTEX 		Caffeine Clinical Uses of Analeptics Acute Respiratory Failure: Aggravation of COPD [Chronic Obstructive Etimizol amp. 1.5% - 3 ml, tab. 0.1 g – 	an analeptic Cordiamin (Niketamide) –    amp. 1 ml, vial 30 ml MAO A – NORADRENALINE and SEROTONIN, MAO B – DOPAMINE, PHENYLETHYLAMINE, TYRAMINEMAO Amitriptyline (tab. 0.01 and 0.025 g) –	a Tricyclic Antidepressant. Inhibits reuptake of Adverse Effects of Tricyclic Antidepressants Antagonism at M-cholinoceptors ? 			Atropine-like effects: 	Tachycardia Fluoxetine (Prozak – tab. 0.02 g)- a Selective Serotonin-Reuptake Inhibitor (SSRI) – MAO Inhibitors: Nialamide, Moclobemide and 	SSRI : Fluoxetine et al.	should not be Nootrop Drugs – activate learning, 		improve memory and intellectual activity I. ACTOPROTECTORS:1. Activators 3. Ca2+- Antagonists: Nimodipine, Cinnarizine4. Antioxidants: Tocopherole acetatate (Vitamin E)5. GABA and Actovegin - amp. 4% 2 and 5 ml, vial 20%-250 ml, Dr. Instenon – 1 ampoule 2 ml contains: 	Methylxantine Ethophylline - 100 mg	Analeptic Cerebrolysin amp. 21.5% 1, 5 and 10 ml  a peptidergic nootrop Piracetam (amp. 20%-5 ml, tab. 0.4 g) - 			a derivative of GABA Thank You for Attention!
Слайды презентации

Слайд 2 Psychostimulants (Psychomotor Stimulants)
1. Methylxanthines:
Caffeine (Coffeinum-natrii

Psychostimulants (Psychomotor Stimulants)1. Methylxanthines:  Caffeine (Coffeinum-natrii benzoas ) 	tab. 0.1

benzoas )
tab. 0.1 g; amp. 10% and 20%

- 1 ml)
2. Phenylalkyl amines:
Phenamine (Amphetamine)
3. Phenylalkyl sydnonimines:
Sydnocarb (tab. 0.005 and 0.01 g)
4. Piperidine compounds:
Meridil (tab. 10 mg)

Слайд 3 Mechanisms of Action of Caffeine
1). Blockade of Phosphodiesterase

Mechanisms of Action of Caffeine1). Blockade of Phosphodiesterase => 					⇑ cAMP

=> ⇑ cAMP and ⇑cGMP
2) Blockade of Adenosine

Receptors

Adenosine –
⮚ an Inhibitory Transmitter of the CNS
⮚ inhibits Adenyl Cyclase activity, causing Contraction of Airway Smooth Muscle


Слайд 4 ATP Adenyl Cyclase

ATP  Adenyl Cyclase	  cAMP 	or	   ───────?

cAMP
or ───────?

or ───?
GTP Guanyl Cyclase cGMP


cAMP 5-AMP
or ────────?
cGMP Phosphodiesterase 5-GMP
Inhibited by
Methylxanthines

Слайд 5 Pharmacological Effects of Caffeine :
Stimulation of Medullary,

Pharmacological Effects of Caffeine : Stimulation of Medullary, Vagal,

Vagal,
Respiratory and Vasomotor centers
?Cardiac Output

and ?Cardiac Work
(+) Inotropic and (+) Chronotropic Effects
Improvement of :
● Coronary, Cerebral and Renal Circulation,
● Eye Ground Blood Circulation
● Acuity of Vision and Color Vision
Smooth muscles relaxation, most prominent effect –
on Bronchi, esp. in asthmatics
Clinical Uses: CNS depression,
Neonatal Apnea, Hypotension.

Слайд 6 Phenamine (Amphetamine)-
a central sympathomimetic.
It was synthesized in

Phenamine (Amphetamine)-	a central sympathomimetic. It was synthesized in the late 1920s

the late 1920s and
has a large number of

analogs including
Dex amphetamine, Meth amphetamine,
Methylene-dioxy -meth-amphetamine (MDMA, or "Ecstasy").
Phenamine is chemically a phenylalkylamine, i.e.
its structure is similar to Noradrenaline and Adrenaline.
It has the same pharmacological profile as Ephedrine; orally active with long duration (4-6 hours).
Mechanism of action. Phenamine acts primarily by
releasing noradrenaline and dopamine in the brain,
inhibits catecholamines reuptake, MAO activity and
increases receptors sensitivity to catecholamines.
Clinical uses: attention deficit disorder,
narcolepsy (an uncontrollable desire for sleep).

Слайд 7 Sydnocarb (Mesocarb) –
chemically and

Sydnocarb (Mesocarb) – chemically and pharmacologically similar tophenamine but

pharmacologically similar to
phenamine but does not cause drug dependence,

hypnosis,
less influences on peripheral adrenoreceptors.
Sympathomimetic and cardiovascular actions are insignificant.
Mechanism of action:
?Catecholamines Reuptake
? MAO activity
? Receptors Sensitivity to Catecholamines
Clinical uses: Neurotic disorders, Narcolepsy, Asthenia, Apathy, Attention deficit hyperkinetic disorder, Excessive day time sleepiness, Decreased working capacity.
Adverse effects: anorexia, insomnia, abdominal discomfort and bowel upset, AP increase.

Слайд 8

ADAPTOGENS
1. Plant origin –
Powders, T-res and

ADAPTOGENS 1. Plant origin – Powders, T-res and Extracts from roots

Extracts from roots or fruit of:
Ginseng, Eleutherococcus,
Rhodiola, Schizandra,

Aralia
2. Animal origin – Extracts from
the young Siberian male deer’s antlers: Pantocrin, Rantatrin

Mechanism of Action:
1). Activation of RNA and Protein synthesis
2). ?Biochemical Disorders in Stress Reactions
3). Normalization of Pituitary-Adrenal and Immune System functions

Слайд 9 Pharmacodynamics of Adaptogens:
? Physical and Mental Capacity

Pharmacodynamics of Adaptogens: ? Physical and Mental Capacity ? Fatigue, ?

? Fatigue, ? Appetite Disorders
? Tolerance to Harmful

Influences,
High to, Cooling, Intoxications;
Ionizing Radiation
? Specific and Non- Specific Immunity
Improvement: Blood Circulation,
Breathing, Vision and Hearing,
Cardio-Protector and Hepato-Protector effect

Ginseng

Eleutherococcus


Слайд 10 Clinical Uses:
Physical Overwork
Physical and Mental

Clinical Uses: Physical Overwork Physical and Mental Overfatigue Asthenic Syndrome State

Overfatigue
Asthenic Syndrome
State after Infection and Somatic Diseases

Ionizing Radiation Influence

Adverse effect:
Overexcitement of Nervous and
Cardio-Vascular Systems,
Arterial Hypertension,
Hyperglycemia

Rhodiola


Слайд 11 Classification of ANALEPTICS
1. With prevalent action upon the

Classification of ANALEPTICS	1. With prevalent action upon the BRAIN CORTEX 		Caffeine

BRAIN CORTEX Caffeine

Caffeine-Natrium Benzoate
2. With prevalent action upon the MEDULLA OBLONGATA:
Bemegride– amp. 0.5%-10 ml
Etimizol – amp. 1.5%-3 ml
Cordiamin – amp. 1 ml, vial 15 and 30 ml
Sulfocamphocaine – amp. 10%-2 ml
3. With prevalent action on the SPINAL CORD:
Strychnine Nitrate

Strength According to Analeptic Activity:
Bemegride – Cordiamin - Sulfocamphocaine - Etimizol




Слайд 12 Clinical Uses of Analeptics

Acute Respiratory Failure:
Aggravation

Clinical Uses of Analeptics Acute Respiratory Failure: Aggravation of COPD [Chronic

of COPD [Chronic Obstructive Pulmonary Diseases] with sleepiness,

inability to cough out
Respiratory depression during Infectious Diseases,
Shock, Syncopal conditions
Asphyxia (Respiratory Arrest) of Newborns and
during surgical operations
Poisons with Hypnotic drugs, Opioid Analgesics,
General Anesthetics

Слайд 13 Etimizol amp. 1.5% - 3 ml, tab. 0.1

Etimizol amp. 1.5% - 3 ml, tab. 0.1 g – 	an

g –
an analeptic of direct action
1. Direct

excitement of the Respiratory Center
2. ? ACTH production => Glucocorticoids’ level in blood
- is used as Anti-inflammatory and Antiallergic agent
to treat Arthritis, Polyarthritis, Asthma
3. Acceleration and Deepening of Respiration
4. ? HR, ? BP.
Clinical uses:
Respiratory failure in Shock; Collapse, Asphyxia; Respiratory Depression in Infectious Diseases; Prophylaxis of Lung Atelectasis and Pneumonia,
Arthritis, Polyarthritis, Asthma

Слайд 14 Cordiamin (Niketamide) –
amp. 1

Cordiamin (Niketamide) –  amp. 1 ml, vial 30 ml –

ml, vial 30 ml –
an analeptic of mixed

action

? direct exciting influence on Respiratory Center
? Stimulates N-Receptors of Carotid Sinus
Acceleration and Deepening of Respiration
↑HR, ↑BP
Clinical uses:
Respiratory failure in Shock, Collapse, Asphyxia; Respiratory depression in Infectious diseases; Prophylaxis of lung atelectasis and pneumonia
Adverse effects:
clonic seizures, face hyperemia

Слайд 17 MAO A – NORADRENALINE and SEROTONIN,
MAO B

MAO A – NORADRENALINE and SEROTONIN, MAO B – DOPAMINE, PHENYLETHYLAMINE,

– DOPAMINE, PHENYLETHYLAMINE, TYRAMINE
MAO A – NORADRENALINE and SEROTONIN,


MAO B – DOPAMINE, PHENYLETHYLAMINE, TYRAMINE

Слайд 18 Amitriptyline (tab. 0.01 and 0.025 g) –
a Tricyclic

Amitriptyline (tab. 0.01 and 0.025 g) –	a Tricyclic Antidepressant. Inhibits reuptake

Antidepressant.
Inhibits reuptake of
Noradrenaline and Serotonin
in

Nerve Terminals (Presynaptic Neurons) =>
=> ? their Level in the synaptic cleft.
More actively inhibits reuptake of
Serotonin than Noradrenaline => SEDATION.
Anxiolytic, Sedative and
Psychomotor Dampening effects.

Clinical uses:
Depression, Anorexia, Bulimia.

Слайд 19
Adverse Effects of Tricyclic Antidepressants
Antagonism at M-cholinoceptors

Adverse Effects of Tricyclic Antidepressants Antagonism at M-cholinoceptors ? 			Atropine-like effects:

?
Atropine-like effects:
Tachycardia
Inhibition of Exocrine Glands
Xerostomia (dry

mouth)
Urinary retention
Constipation
Blurred vision
Aggravation of Glaucoma and Epilepsy


Слайд 20 Fluoxetine (Prozak – tab. 0.02 g)
- a Selective

Fluoxetine (Prozak – tab. 0.02 g)- a Selective Serotonin-Reuptake Inhibitor (SSRI)

Serotonin-Reuptake Inhibitor (SSRI) –
specifically inhibits SEROTONIN reuptake
Advantages include:
Absence

of cardiotoxicity
Free of Anti-Cholinergic Effects, orthostatic hypotension
Loss of appetite and Weight Reduction
the ease of once-a-day dosing
Clinical Uses:
Depression, Bulimia nervosa, Obsessive-Compulsive disorder,
Anorexia nervosa, Panic disorder, Premenstrual Syndrome
Adverse Effects: Over arousal, Insomnia, Tremor, Anxiety,
Akathisia (a state of Agitation, Distress, Restlessness and
the Inability to sit still), sexual dysfunction, hot flashes, cough, flu-like syndrome

Слайд 21 MAO Inhibitors: Nialamide, Moclobemide and
SSRI : Fluoxetine

MAO Inhibitors: Nialamide, Moclobemide and 	SSRI : Fluoxetine et al.	should not

et al.
should not be co-administered due to the risk

of Life Threatening "Serotonin Syndrome"
as a result of excess SEROTONIN (5-HT):
?to, Muscle Rigidity, Myoclonus,
Rapid Changes in Mental Status and Vital Signs
Cardiovascular collapse

Drugs require WASHOUT PERIODS of 6 weeks before administering the other.

Слайд 22 Nootrop Drugs – activate learning,
improve memory and

Nootrop Drugs – activate learning, 		improve memory and intellectual activity I. ACTOPROTECTORS:1.

intellectual activity
I. ACTOPROTECTORS:
1. Activators of Brain Metabolism:
∙ Methyl

Xanthines:
Instenon
Caffeine
Aminophylline (Euphylline)
∙ Protein Hydrolyzates:
Actovegin
Cerebrolysin
Solcoseryl
2. Cerebral Vasodilators:
Nicergoline (Sermion)
Vinpocetine

Слайд 23 3. Ca2+- Antagonists: Nimodipine, Cinnarizine
4. Antioxidants: Tocopherole acetatate

3. Ca2+- Antagonists: Nimodipine, Cinnarizine4. Antioxidants: Tocopherole acetatate (Vitamin E)5. GABA

(Vitamin E)
5. GABA and its derivatives:
Aminalon (GABA)
Oxybutyrate Sodium

(GOBA)
Pantogam, Phenibut, Picamilon

II. Affecting Advantageously MEMORY:
1. Racetams - cyclic GABA derivatives:
Piracetam (Nootropil)
Aniracetam Oxiracetam
2. Pyridoxine (Vitamin B6) derivatives:
Encephabol

Слайд 24
Actovegin - amp. 4% 2 and 5 ml,

Actovegin - amp. 4% 2 and 5 ml, vial 20%-250 ml,

vial 20%-250 ml, Dr. 0.2 g,
is proved to

be the Most Effective Nootrop.
contains Deproteinized Hemoderivate from plasma of
the Calf blood with Low-molecular Peptides, Amino Acids, Nucleosides, Lipids, Electrolytes and Microelements.

After 60-90 min IV infusion of 20% 250 ml:
? Cardiac Index by 25%
? Stroke Index by 30%
? O2 Content in Arterial Blood by 13%
HR does not change
?? Intensity and Efficiency of Aerobic Processes
?? Energy and Contractibility of Muscles
? Prevents accumulation of LACTATE

Слайд 25 Instenon – 1 ampoule 2 ml contains:
Methylxantine

Instenon – 1 ampoule 2 ml contains: 	Methylxantine Ethophylline - 100

Ethophylline - 100 mg
Analeptic Etamivan - 50 mg
Vasodilator

Hexobendin- 10 mg
? ?Cardiac Output ?
? ?Perfusion Pressure in the Vessels of
the Edge Zone of Ischemia
STIMULATES:
the Respiratory and Vasomotor centers
Centers of vegetative regulation
Nuclei of the cranial nerves.
Clinical uses:
brain diseases of vascular and age-dependent nature, stroke, sequences of cerebrovascular insufficiency.

Слайд 26 Cerebrolysin amp. 21.5% 1, 5 and 10 ml

Cerebrolysin amp. 21.5% 1, 5 and 10 ml a peptidergic nootrop

a peptidergic nootrop with neurotrophic action.
1 ml

Є 215 mg of NEUROPEPTIDES
from the Swine’s Cerebrum.
Pharmacological action: nootrop,
Metabolic regulation
Neuroprotection
Functional Neuromodulation
Neurotrophic activity - analogous to natural Neuron Growth Factors

Слайд 29 Piracetam (amp. 20%-5 ml, tab. 0.4 g) -

Piracetam (amp. 20%-5 ml, tab. 0.4 g) - 			a derivative of

a derivative of GABA
Mechanism of action: Improvement of

metabolic and bioenergetic processes in neuron:
? Activation of synthesis of proteins and RNA
? Improvement of utilization of glucose
? Intensification of ATP synthesis
? Membrane-stabilizing action

In large doses and at repeated introduction
it is capable to strengthen
GABA-ergic inhibitory processes in brain

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