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 💊أدويه الجهاز العصبي المركزي 8

#Pharmcology_of_CNS 8

#CNS 

#Antipsychotic_Drugs



💠The antipsychotic drugs (also called neuroleptics or major tranquilizers) are used primarily to treat schizophrenia

انفصام الشخصية


💠Schizophrenia is a type of chronic psychosis characterized by delusions,hallucinations (often in the form of voices), and thinking or speech disturbances.


💠Schizophrenia has a strong genetic component and probably  

reflects some fundamental biochemical abnormality, possibly a dysfunction of the mesolimbic or mesocortical dopaminergic neuronal pathways.


♻️ANTIPSYCHOTIC DRUGS


🌀بيتم تقسيمها لقسمين 

➰first-generation

ودي مقسمة زاتها ل:

➿low potency

➿high potency


➰Second-generation


في صورة حا تبين التقسيم دا تحت👇


✅First-generation antipsychotics

▪️The first-generation antipsychotic drugs (also called conventional, typical, or traditional antipsychotics) are competitive inhibitors at a variety of receptors, but their antipsychotic effects reflect competitive blocking of dopamine D2receptors.


▪️First-generation antipsychotics are more likely to be associated with movement disorders known as extrapyramidal symptoms (EPS), particularly drugs that bind tightly to dopaminergic neuroreceptors, such as haloperidol 


▪️Movement disorders are less likely with medications that bind weakly,such as chlorpromazine. No one drug is clinically more effective than another.


✅Second-generation antipsychotic drugs

▪️The second-generation antipsychotic drugs (also called “atypical” antipsychotics) have a lower incidence of EPS than the first-generation agents but are associated with a higher risk of metabolic side effects,such as diabetes, hypercholesterolemia, and weight gain.


▪️The second-generation drugs appear to owe their unique activity to blockade of both serotonin and dopamine and, perhaps, other receptors.



🔵Drug selection:

〰Second-generation agents are generally used as first-line therapy for schizophrenia to minimize the risk of debilitating EPS associated with the first-generation drugs that act primarily at the dopamine D2 

 receptor.


〰The second-generation  

antipsychotics exhibit an efficacy that is equivalent to, and occasionally exceeds, that of the first-generation antipsychotic agents.


🔵Refractory patients

〰Approximately 10% to 20% of patients with schizophrenia have an insufficient response to all first- and second generation antipsychotics.

في الحالة دي ممكن نستخدم clozapine


〰Clozapine can produce bone  

marrow suppression, seizures, and cardiovascular side effects,such as orthostasis. The risk of severe agranulocytosis necessitates frequent monitoring of white blood cell counts.

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Mechanism of action

Actions

Therapeutic uses

Absorption and metabolism

Adverse effects



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