Презентация на тему Side effects of drugs used for the treatment of the diseases of the central nervous system

WHO as those impacting the CNS, are used to

treat mental disorders such as Schizophrenia Bipolar disorder (manic-depressive psychosis – MDP) Anxiety disorders Attention deficit-hyperactivity disorder.

Psychotropic drugs, fall into 4 categories:
Antipsychotics (Neuroleptics)
Mood stabilizers
Anti-anxiety drugs (Tranquilizers)
Antidepressants

Mania, Psychosis, Hallucinations, Depersonalization, Suicidal Ideation, Heart Attack, Stroke

and Sudden Death. The US FDA admits that probably 1-10% of all the adverse drug effects are actually reported by patients or physicians.

Psychotropic drugs can increase the risk for
weight gain, and therefore for Heart Disease,
Stroke and Diabetes.
These include:
Neuroleptics
Mood stabilizers
Antidepressants.
Patients need to pay close attention to their diet and activity levels.

Effects from psychotropic drugs include:
Decreased Kidney and Liver

Function
Concurrent Use of Other Drugs
Taking High Doses of Drugs
Longer Duration of Use

(Haldol) Fluphenazine (generic only) first came on the market in

the 1950s,and are used to treat both agitation and psychotic illnesses , and often have severe SE.

In the 1990‘s atypical antipsychotics were developed:
Clozapine
Sulpiride (Eglonil )
Tiapride
Risperidone

Sensitivity to the Sun, Sunburn
Dry Mouth, Blurred Vision
Rapid

Heartbeat
Constipation, Urinary Retention
Sleepiness, Drowsiness
Dizziness when changing positions
Orthostatic Hypotension
Skin Rashes
Decrease in sexual interest or ability
Menstrual problems for women
◆ Patients should sip water to relieve dry mouth and also wear sunscreen to prevent sunburns.

restlessness, muscle spasms, rigidity,
facial grimacing and tremors.
Dystonia – acute

spasm of the muscles:
the muscles of the trunk, shoulders, and neck go into spasm, so that the head and limbs are held in unnatural positions;
spasm of the facial muscles can prevent the patient from opening his jaws.
Parkinsonism refers to tremor and rigidity, similar to those seen in Parkinson's disease patients.
Akathisia - a state of agitation, distress, and restlessness .

involuntary constant movements esp. of the lower face,
Tongue

Protrusion,
Facial Grimacing,
Lip Smacking.
Every year, an estimated 5% of people taking typical antipsychotics get TD that can range from mild to severe.
The condition happens to fewer people who take the new, atypical antipsychotics, but some people may still get TD.
These symptoms also occur occasionally with the newer, atypical antipsychotic drugs, but far less often than with the older medications.

patients with schizophrenia who haven't responded to other medications.

It treats psychotic symptoms, hallucinations, and breaks with reality, such as when a person believes
he or she is the president.
But clozapine can cause a serious problem:
A decreased production of leucocytes,
agranulocytosis, which can lead to infections.
Monitoring of blood work is necessary for patients taking clozapine every week or two.
Other atypical antipsychotics such as
Sulpiride (Eglonil ), Tiapride, Risperidone
are effective, and none cause agranulocytosis.

weight, glucose and
lipid levels should be monitored regularly
while

taking an atypical antipsychotic.

prevent weight gain,
patients are recommended to plan to

do at least
60 min of moderate to vigorous intensity exercise
on most days,
Find an activity that causes to breathe a little heavier
and makes the HR quicken and pick smth
they enjoy, because people are more likely
to stick with it if they are having fun.
A brisk walk at a pace of ~3–4 miles / hour
is considered moderate intensity activity for
the average person.

the ingestion of a single tablet of Clozapine, Olanzapine

(Zyprexa) and Risperidone may cause significant toxicity in a toddler.

Ataxia (involuntary muscular movement), confusions, EPS (extrapyramidal symptoms),
coma and respiratory arrest
have been reported
following ingestion of
50-200 mg of Clozapine
in toddlers.

England Journal of Medicine that compared the older neuroleptics

with several newer ones. Far from proving effectiveness, of the 1,493 patients who participated

74% discontinued taking antipsychotics
before the end of their treatment due to
inefficacy, intolerable SE or other reasons.
64% of the patients stopped taking
Zyprexa after 18 months of taking -
commonly because it caused sleepiness,
weight gain or neurological symptoms
like stiffness and tremors.

by

Pain in muscles,
Hyperthermia,
Stupor

can end

fatally in the absence of intensive countermeasures.

are often referred to as antimanic drugs, and mood-stabilizers

- can cause side effects:
Loss of coordination, Excessive thirst, Frequent urination,
Blackouts, Changes in vision,
Slurred speech, heartbeat, itching, rash,
Seizures
Hallucinations (seeing things or hearing voices
that do not exist)
Swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs.
Patients should visit the doctor regularly to check the levels of lithium in the blood, and make sure the kidneys and the thyroid are working normally.

tend to cause:

Drowsiness
Memory difficulties, Amnesia
Decreased attention
Excessive Sedation
Confusion,

Dizziness
Orthostatic Hypotension
Dry mouth, blurred vision
⇧Intraocular pressure
Addiction and Intractable Dependence

an increase in fractures and thus with more serious

consequences of falls which jeopardize these patients’ safety.

Abrupt cessation can lead to severe withdrawal symptoms, including convulsions in some patients.
The withdrawal from drugs like
VALIUM (a brand of DIAZEPAM)
is more prolonged and often more difficult
than withdrawal from HEROIN !
Short-term treatment and a long tapering period
is recommended to limit these risks.

insomnia.
2008: The Australian Therapeutic Goods Administration
imposed a boxed

warning in the product information
for medicines containing Zolpidem (Stilnox).

The boxed warning stated:
“Zolpidem may be associated with potentially dangerous complex sleep-related behaviors which may include
sleep walking, sleep driving and other bizarre behaviors.”

and dopamine, that affect the mood and emotional responses.

constipation, bladder problems
Memory loss, Blurred vision
Sexual problems, Drowsiness

The SE

associated with SSRIs and SNRIs include:
an increase in suicidal thoughts
Mania - a state of excitation with reduced sleep and increased energy
Dizziness, insomnia or drowsiness;
Diarrhea, nausea;
Restlessness and Agitation (feeling jittery);
Sexual dysfunction

as the combination of MAOIs and tyramine can lead

to
increased BP, potentially causing stroke or cardiac arrhythmias.
An MAOI Skin Patch has recently been developed and may help reduce some of these risks.

DOSE for the right amount of time. It can

take 3 or 4 weeks until the medicine takes effect.
It's important to give the body time to adjust to the change.
If a medication does not work, it is helpful to be open to trying another one.
If a person with difficult-to-treat depression does not get better with a first medication, chances of getting better increase when the person try a new one or added a second medication to his or her treatment.
People don't get addicted, or "hooked,"
on the medications, but
stopping them abruptly can cause
withdrawal symptoms.

liver, and the enhanced hepatic P-450 system activity increases

the metabolism of other drugs such as:
Anticoagulants
Oestrogens
Glucocorticoides
Cardiac glycosides.
Adverse effects:
Diplopia, ataxia, unsteadiness, drowsiness,
Fluid retention, rashes, photosensitivity, hepatitis,
Leukopenia, agranulocytosis, aplastic anaemia
Lupus like syndrome
Sluggishness, both mental and physical
Serious liver toxicity.
Anyone being treated with carbamazepine should have frequent liver function tests.

the CNS
Nystagmus and ataxia
Nausea, vomiting
Gingival hyperplasia

- because the drug interferes with Folic Acid metabolism
Megaloblastic anemia - because the drug interferes with vitamin B12 metabolism

pancreas
Changes in weight
Nausea, Vomiting, Stomach pain
Anorexia, Loss of

appetite
Increase in TESTOSTERONE levels in teenage girls and lead to polycystic ovarian syndrome (PCOS).

PCOS is a disease that can affect fertility and
make the menstrual cycle become irregular, but symptoms tend to go away after the drug is stopped.
It also may cause birth defects in women who are pregnant.

warning.
The warning states that their use may
increase

the risk of Suicidal Thoughts and Behaviors.

People taking anticonvulsant medications for MDP or other illnesses should be closely monitored for new or worsening symptoms of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior.

pressure upon standing
Orthostatic hypotension
Nausea (generally mild and transient)
Ankle swelling
Confusion

, Hallucinations and Delusions
Daytime sleepiness
Management: Discontinuing drugs
Hydration
Arising slowly, especially after a meal
Sitting down if light headed
Medications to raise BP