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Antipsychotics (neuroleptics)
This is a brief video on antipsychotics, also called neuroleptics, including their mechanisms, their indications, and side effects I created this presentation with Google Slides. Image were created or taken from Wikimedia Commons I created this video with the YouTube Video Editor. ADDITIONAL TAGS: Anti- psychotics (neuroleptics) First-generation antipsychotics First-gen side effects Extrapyramidal side effects Neuroleptic malignant syndrome Atypical antipsychotics By Unknown - http://www.flickr.com/photos/x-ray_delta_one/4298034735/, Public Domain, https://commons.wikimedia.org/w/index.php?curid=16041923 First generation (typical) antipsychotics Haloperidol and -azines High potency: haloperidol, trifluoperazine, fluphenazine Medium potency: perphenazine Low potency: chlorpromazine, thioridazine MoA: high affinity antagonist for dopamine (D2) receptor, thus increasing concentration of cAMP Indications: schizophrenia positive symptoms (and brief psychotic disorder, schizophreniform), schizoaffective, other psychoses, bipolar, delirium, Tourette, Huntington’s First-generation antipsychotics First-gen side effects Extrapyramidal side effects Neuroleptic malignant syndrome Atypical antipsychotics First generation (typical) antipsychotics: Side effects Delay cardiac conduction (prolong QTc interval), risk of torsades de pointes Anticholinergic effects → Blurred vision, constipation, dry mouth, urinary retention Worse with lower potency antipsychotics Antihistamine effect → sedation Anti alpha1 effect → orthostatic hypotension Endocrine: hyperprolactinemia → osteoporosis, amenorrhea, galactorrhea, gynecomastia, and sexual side effects Caused by D2 blockage on tuberoinfundibular pathway Extrapyramidal symptoms Neuroleptic malignant syndrome First-generation antipsychotics First-gen side effects Extrapyramidal side effects Neuroleptic malignant syndrome Atypical antipsychotics First generation (typical) antipsychotics: SEs: extrapyramidal side effects Caused by D2 blockage on nigrostriatal pathway Hours to days: acute dystonic rxn (sustained muscle contraction); tx with IM diphenhydramine or benztropine Days to weeks: akathisia (restlessness) Weeks to months: parkinsonism (tremor, cogwheel rigid, hypokinesia); tx with lower dose antipsychotic or diphenhydramine or benztropine Months to years: tardive dyskinesia (hyperkinetic movement of head, limbs, trunk → perioral movements (tongue, facial grimacing, and lip puckering) are common) Tx by switching 1st-gen→2nd-gen or 2nd-gen→clozapine First-generation antipsychotics First-gen side effects Extrapyramidal side effects Neuroleptic malignant syndrome Atypical antipsychotics First generation (typical) antipsychotics: SEs: neuroleptic malignant syndrome Idiosyncratic reaction presenting with confusion, vital sign (autonomic) instability, hyperpyrexia (high fever), rhabdomyolysis (myoglobinuria), renal failure, cardiovascular collapse Fever Encephalopathy Vitals unstable Enzyme increase Rigidity of muscles Treat with dantrolene Don’t confused with malignant hyperthermia! First-generation antipsychotics First-gen side effects Extrapyramidal side effects Neuroleptic malignant syndrome Atypical antipsychotics Atypical (2nd generation) antipsychotics Aripiprazole, -apines, -idones aripiprazole, asenapine, clozapine, olanzapine, quetiapine, iloperidone, lurasidone, paliperidone, risperidone, ziprasidone MoA: weaker D2 antagonist and serotonin (5-HT2a) agonist Indications: schizophrenia (positive and negative symptoms) Side effects: Delay cardiac conduction (prolong QTc interval), risk of torsades de pointes Less anticholinergic and EPS effects Metabolic (weight gain, diabetes, high lipid) → -apines Agranulocytosis → clozapine (very potent) Hyperprolactinemia → risperidone First-generation antipsychotics First-gen side effects Extrapyramidal side effects Neuroleptic malignant syndrome Atypical antipsychotics
Просмотров: 11545 MedLecturesMadeEasy
Antipsychotics, Mood Stabilzers Anxiolytics
SKIP AHEAD: 1:01 – Antipsychotic Mechanism 1:58 – Antipsychotics and their Indications 3:30 – Neuroleptic Malignant Syndrome (Typical Antipsychotic Side Effect) 4:18 – Extrapyramidal Symptoms (Typical Antipsychotic Side Effect) 6:19 – Atypical Antipsychotics and their side effects 8:57 – Mood Stabilizers 12:58 – Anxiolytics and Benzodiazepines We will start with a quick review of some material from my previous video on psychosis. Symptoms of schizophrenia can be broken down into 2 categories, Positive and Negative Symptoms. Positive symptoms include behaviors or sensations that are not normally present. Examples include hallucinations, delusions, and catatonia. These symptoms are thought to be related to an excess of dopamine. I remember this by remembering that “doPamine has a P in it”. So P for Positive and P for Dopamine. Negative symptoms are the absence of normal behavior. Examples include a lack of initiative, diminished speech, disheveled appearance & flat affect. These symptoms are thought to be related to an excess of serotonin. As we will see antipsychotics affect dopamine and serotonin to varying levels. The indications for this class of drugs includes psychosis (mainly schizophrenia), Mania (mainly bipolar disorder), aggression and Tourette's disease. Typical Antipsychotics primarily block dopamine receptors in a non-specific manor. Therefore, these drugs work best for positive symptoms, and have little effect on negative symptoms. The non-specific mechanism of the drug also means there are lots of side effects. Some of these medications come in a slow release injectable form so they can be used in non-compliant and aggressive patients. There are a lot of high yield side effects so we will break them down one by one Neuroleptic Malignant Syndrome (or NMS) is a rare but potentially fatal adverse reaction of typical antipsychotics. It involves fever, altered mental status, rigidity and autonomic instability (such as tachycardia, hypertension, diaphoresis etc.). You may also see elevated myoglobin in blood or urine and elevated Creatine Kinase (CK). One of the ways I think about it is that it looks kinda sorta like Serotinin Syndrome that you can see with antidepressatns. If you see this you have to emergently stop the medication, provide supportive care and consider adding Dantrolene Extrapyramidal Symptoms (or EPS) are due to blockage of Nigrostriatal dopamine. It can present with a number of different symptoms. Akasthisia is a general sensation of restlessness Acute Dystonia is involuntary continuous muscle contractions often of the neck. Another common presentation of acute dystonia is Oculogyris Crisis when your eyes get locked looking upward and you have to lean over to see Dyskinesia (AKA Pseudoparkinsonism) presents like Parkinson’s Disease with symptoms like a pill rolling tremor, cogwheel rigidity & bradykinesia (or slow movement) Tardine Dyskinesia (or TD) is uncontrollable facial tics, grimacing & tongue movements As scary as these symptoms may look, they are generally not medical emergencies. In most cases you will continue to use the drug with perhaps a reduction in the dose or the addition of an anticholinergic mediation like Benzatropine or Diphenhydramine. Tardive Dyskinesia is the exception and requires cessation of the medication as it can be permanent. Usually you would switch a patient with TD to a 2nd gen antipsychotic. Hyperprolactinemia is a side effect due to Blockage of Tuberoinfundibular dopamine. It presents just like any other disease that increases prolactin. So you can have galactorrhea, gynecomastia, decreased libido and menstrual irregularities. The text for this video is too long and exceeds Youtube max allowed length. To read the rest please go to http://www.stomponstep1.com/antipsychotics-mood-stabilizers-anxiolytics-benzodiazepines-tardive-dyskinesia-extrapyramidal-symptoms/
Просмотров: 35835 Stomp On Step 1
Drugs (medication) that Raise Blood Sugar Levels
List of drugs that raise blood sugar. This information can come in handy in case you have high blood sugar and you are not sure what is causing it. Download Diabetes Diet eBook: https://goo.gl/UC5SZU We all get sick from time to time. We all have been given prescriptions other than our metformin or insulin. But did you know some medications can raise your blood sugar? I am confident that somewhere in that plethora of literature that accompanies most prescriptions is information that says that the drug will affect blood sugar. But how many of us actually read all that literature? Today I want to talk about common drugs that can raise your blood sugar. This list was compiled after researching the work of Mark T. Marino, MD. The list: Corticosteroids Thiazide diuretics Beta-blockers Niacin Antipsychotic drugs Striking a balance There is a longer list of drugs associated with diabetes, but the evidence for each of these is not very strong, or the medicine is only used rarely. For the more commonly used drugs that are known to worsen diabetes control, it is important to note that there remains a balance between intended benefits and unwanted side effects. Glucocorticoids can stop an inflammatory process like asthma, thiazide diuretics have been shown to be very successful at reducing high blood pressure and its complications, beta-blockers do protect against heart attacks, niacin does reduce coronary artery disease, and antipsychotic medicines can make the difference between hallucinating and perceiving reality. If you suspect that your blood glucose control may be adversely affected by a medicine you’re taking, speak with your health-care provider before making any changes. There may be an overall benefit to remaining on a drug that slightly increases blood glucose in some cases, or there may be alternatives that can be substituted. Unfortunately, no medicine is without its drawbacks, but by knowing what these drawbacks are, you can participate in an informed discussion with your health-care provider about the specific risks and benefits of a drug in your unique situation.
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1. How to recollect the ADVERSE effects of VALPROATE ? 2. Mnemonics for ADVERSE effects of VALPROATE . Valproic acid affects chemicals in the body that may be involved in causing seizures. Valproic acid is used to treat various types of seizure disorders. Valproic acid is sometimes used together with other seizure medications. Valproic acid is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches. Valproic acid may also be used for purposes not listed in this medication guide. Do not use valproic acid to prevent migraine headaches if you are pregnant. If you take valproic acid for seizures or manic episodes: Do not start or stop taking the medicine during pregnancy without your doctor's advice. You should not use valproic acid if you have liver disease, a urea cycle disorder, or a genetic disorder such as Alpers' disease or Alpers-Huttenlocher syndrome (especially in a child younger than 2 years old). Valproic acid can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by a genetic mitochondrial (MYE-toe-KON-dree-al) disorder. Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes). You should not use valproic acid if you are allergic to it, or if you have: liver disease;a urea cycle disorder; ora genetic mitochondrial (MYE-toe-KON-dree-al) disorder such as Alpers' disease or Alpers-Huttenlocher syndrome, especially in a child younger than 2 years old. Valproic acid can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by a genetic mitochondrial disorder. To make sure valproic acid is safe for you, tell your doctor if you have: liver problems caused by a genetic mitochondrial disorder;a history of depression, mental illness, or suicidal thoughts or actions;a family history of a urea cycle disorder or infant deaths with unknown cause; orHIV or CMV (cytomegalovirus) infection. Some young people have thoughts about suicide when first taking valproic acid. Your doctor will need to check your progress at regular visits while you are using this medicine. Your family or other caregivers should also be alert to changes in your mood or symptoms. Do not use valproic acid to prevent migraine headaches if you are pregnant. If you take valproic acid for seizures or manic episodes: This medicine can harm an unborn baby or cause birth defects, and may affect cognitive ability (reasoning, intelligence, problem-solving) later in the child's life. However, having a seizure during pregnancy could harm both the mother and the baby. Do not start or stop taking valproic acid during pregnancy without your doctor's advice. Use effective birth control while using valproic acid, and tell your doctor right away if you become pregnant. Tell your doctor if you start or stop using hormonal contraception that contains estrogen (birth control pills, injections, implants, skin patches, and vaginal rings). Estrogen can interact with valproic acid and make it less effective in preventing seizures. Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking valproic acid. There may be other seizure medications that can be more safely used during pregnancy
Просмотров: 424 Dr Anshuman Tripathi
Etizolam - Simons Reagent - Normal Test Kit - Bunk Police
Subscribe for new videos - Thanks for keeping it real. Reagent Kit Used: http://bunkpolice.com/simons-reagent-kit/ USING THIS VIDEO FOR OTHER TEST KITS MAY PROVIDE UNRELIABLE RESULTS The use of low grade chemicals, sub-par manufacturing conditions, improper storage, exposure to heat / oxygen, and age of the test kit can have a considerable impact on the resulting reaction. DISCLAIMER A sample that has been tested should not necessarily be considered safe. Many factors come into play when examining reactions - including mixtures of substances and lighting. Bunk Police Test Kits are intended for identifying substances for harm reduction purposes only. We do not accept responsibility for the use or misuse of this information Proceed at your own risk ALL TESTS WERE CONDUCTED IN THE FOLLOWING GOVERNMENT APPROVED FACILITY Energy Control - Barcelona, Spain
Просмотров: 33 Acinad Romanoff
Medicine Responds to Addiction II
The “Medicine Responds to Addiction II” Symposium will bring together federal partners and national leaders from medical schools, residency, and fellowship programs to advance addiction medicine education and training and to explore Centers of Excellence in Addiction Medicine models.
Просмотров: 1443 The Obama White House
Parkinson's: The Latest Approaches
"Falls, hallucinations, depression, dementia... everyone knows about the Masked Face of Parkinson's but what about the rest!" Associate Professor Simon Lewis Parkinson's disease is a chronic life long condition. It is the most common neurodegenerative disorder in Australia after Alzheimer's disease, with gradual onset and slow progression. Symptoms include tremor, rigidity, slowness of movement and impaired balance. The presentation of symptoms varies greatly between individuals diagnosed and no two people will be affected in the same way. A primary health care practice of 1,700 patients would have, on average, 4 patients with Parkinson's disease. Rural living is a statistically significant risk factor. This debilitating condition presents many and varied challenges for both the person with Parkinson's and their carers. With no known cure, treatment aims to minimise the impact of the symptoms on the person's quality of life. The individual treatment regimen needs to be reviewed and, when necessary, modified as the disease progresses. As with any complex chronic medical condition, management of people with Parkinson's can be enhanced by the holistic and ongoing care of a multidisciplinary health care team. This program looks at the latest advances in diagnosis, treatment and ongoing management of symptoms. Different models of care are examined, and the evidence-based pharmacological and non-pharmacological treatments are discussed. Produced by the Rural Health Education Foundation http://www.rhef.com.au/
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Abilify (Generic name: Aripiprazole)
Aripiprazole is used to treat certain mental/mood disorders (such as bipolar disorder, schizophrenia, Tourette's disorder, and irritability associated with autistic disorder). It may also be used in combination with other medication to treat depression. Aripiprazole is known as an antipsychotic drug (atypical type). It works by helping to restore the balance of certain natural chemicals in the brain (neurotransmitters).This medication can decrease hallucinations and improve your concentration. It helps you to think more clearly and positively about yourself, feel less nervous, and take a more active part in everyday life. Aripiprazole can treat severe mood swings and decrease how often mood swings occur.
Просмотров: 119 Health & Life
Delirium Webinar
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Family Weekend 2016: The Hassenfeld Child Health Innovation Institute's Spotlight on Autism
2016 Family Weekend Academic Forum The Hassenfeld Child Health Innovation Institute's Spotlight on Autism: Understanding Autism through the Lens of Rare Genetics and the Study of Infants Patick M. Vivier, MD, PhD, director, Hassenfeld Child Health Innovation Institute; director, interdisciplinary education programs, Brown University School of Public Health; Royce Family Associate Professor in Teaching; associate professor, pediatrics Stephen Sheinkopf, PhD, assistant professor, psychiatry and human behavior; assistant professor, pediatrics Daniel Moreno De Luca, MD, MSc, teaching fellow, psychiatry and human behavior Faculty from the Hassenfeld Child Health Innovation Institute will review current approaches that researchers at Brown are taking to understand both the emergence of autism in infancy and the biological mechanisms involved in autism through the study of rare genetic variation. This presentation will also highlight two major autism research programs at Brown University: The Rhode Island Consortium for Autism Research and Treatment and the Hassenfeld Child Health Innovation Institute's Autism Initiative: Autism: a Precision Medicine Approach. To learn more about Brown's Family Weekend, please visit http://www.brown.edu/familyweekend. October 21, 2016 Brown University
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Scruffy Puppy - Empty Dress
From the Empty Dress E.P (Copyright 2011, All Right Reserved)
Просмотров: 283 Scruffy Puppy