浙江大学医学院：《精神病学》课程教学资源（PPT讲稿）药物和其他物理治疗 Drugs and other physical treatments

CHAPTER 21 Drugs and other physical treatments Zhang lei SIR RUNRUN SHAW HOSPITAL

CHAPTER 21 Drugs and other physical treatments Zhang Lei SIR RUN RUN SHAW HOSPITAL

Aim Grasp Concepts and classification of psychotropic drugs Grasp the indications, contraindications, side effects of antipsychotic drugs, antidepressants, mood stabilizers, anxiolytic and psychostimulants Be familiar with the indications and side effects of electroconvulsive therapy (ect)

2 Aim ◼ Grasp Concepts and classification of psychotropic drugs ◼ Grasp the indications, contraindications, side effects of antipsychotic drugs, antidepressants, mood stabilizers, anxiolytic and psychostimulants ◼ Be familiar with the indications and side effects of electroconvulsive therapy (ECT)

History of physical treatments 图片由2bwcy上传至 Tiexue. Net图片版权归原创者所有

3 History of physical treatments

Pharmacokinetics of psychotropic drugs Absorption I Distribution ■ Metabolisn ■ Excretion

4 Pharmacokinetics of psychotropic drugs ◼ Absorption ◼ Distribution ◼ Metabolism ◼ Excretion

Pharmacokinetics of psychotropic drugs Measurement of circulation drug concentrations Pharmacodynamic measures a Plasma half-life ■ Drug interactions Pharmacokinetic interactions a Pharmacodynamic interactions ■ Drug withdrawal

5 Pharmacokinetics of psychotropic drugs ◼ Measurement of circulation drug concentrations ◼ Pharmacodynamic measures ◼ Plasma half-life ◼ Drug interactions ◼ Pharmacokinetic interactions ◼ Pharmacodynamic interactions ◼ Drug withdrawal

General advice about prescribing Use well-tried drugs a GIve an adequate dose Use drug combinations cautiously a Dosing and treatment duration a What patients want to know Compliance, concordance, and collaboration

6 General advice about prescribing ◼ Use well-tried drugs ◼ Give an adequate dose ◼ Use drug combinations cautiously ◼ Dosing and treatment duration ◼ What patients want to know ◼ Compliance, concordance, and collaboration

Prescribing for special groups Children and the elderly a Pregnant women: benefit and risk Anxiolytics and antidepressants Antipsychotic drugs and mood stabilizers a Neonatal toxicity a Breast-feeding

7 Prescribing for special groups ◼ Children and the elderly ◼ Pregnant women: benefit and risk ◼ Anxiolytics and antidepresssants ◼ Antipsychotic drugs and mood stabilizers ◼ Neonatal toxicity ◼ Breast-feeding

What to do if there is no therapeutic response Drug dose? a Other drugs a Diagnosis?

8 What to do if there is no therapeutic response ◼ Drug dose? ◼ Other drugs? ◼ Diagnosis?

The classification of drugs used in psychiatry a Antipsychotic: schizophrenia and mania Antidepressant: major depression Mood stabilizer: mania Anxiolytic: anxiety disorder a Hypnotic:insomnia a Psychostimulant: narcolepsy

The classification of drugs used in psychiatry ◼ Antipsychotic: schizophrenia and mania ◼ Antidepressant: major depression ◼ Mood stabilizer: mania ◼ Anxiolytic: anxiety disorder ◼ Hypnotic: insomnia ◼ Psychostimulant: narcolepsy 9

Antipsychotic drugs ypIc cal Chlorpromazine ■ Atypical ■ Risperidone ■ Olanzapine ■ Aripiprazole ■ Ziprasidone

10 Antipsychotic drugs ◼Typical ◼ Chlorpromazine ◼Atypical ◼ Risperidone ◼ Olanzapine ◼ Aripiprazole ◼ Ziprasidone