哈尔滨医科大学药理学7课程.pptVIP

抗精神失常药PHARMACOLOGY OF ANTIPSYCHOTIC DRUGS (NEUROLEPTICS) SOME DEFINITIONS Neuroleptic: synonym for antipsychotic drug; originally indicated drug w/antipsychotic efficacy but with neurologic (extrapyramidal motor) side effects Typical neuroleptic: older agents fitting this description Atypical neuroleptic: newer agents: antipsychotic efficacy with reduced or no neurologic side effects NEUROLEPTICS ON THE UUHSC DRUG LIST TYPICAL NEUROLEPTICS: PHENOTHIAZINES: Chlorpromazine (Thorazine ? ) Thioridazine (Mellaril ? ) Fluphenazine (Prolixin ? ) THIOXANTHENE Thiothixene (Navane? ) OTHER Haloperidol (Haldol ? ) NEUROLEPTICS ON THE UUHSC DRUG LIST (Continued) ATYPICAL NEUROLEPTICS: Risperidone (Risperdal ? ; most frequently prescribed in U.S.) Clozapine (Clozaril ? ) Olanzapine (Zyprexa ? ) Quetiapine (Seroquel ? ) KEY CONCEPTS: All neuroleptics are equally effective in treating psychoses, including schizophrenia, but differ in their tolerability. All neuroleptics block one or more types of DOPAMINE receptor, but differ in their other neurochemical effects. All neuroleptics show a significant delay before they become effective. All neuroleptics produce significant adverse effects. GENERAL CHARACTERISTICS OF TYPICAL NEUROLEPTICS The older, typical neuroleptics are effective antipsychotic agents with neurologic side effects involving the extrapyramidal motor system. Typical neuroleptics block the dopamine-2 receptor. GENERAL CHARACTERISTICS OF TYPICAL NEUROLEPTICS Typical neuroleptics do not produce a general depression of the CNS, e.g. respiratory depression Abuse, addiction, physical dependence do not develop to typical neuroleptics. GENERAL CHARACTERISTICS OF TYPICAL NEUROLEPTICS Typical neuroleptics are generally more effective against positive (active) symptoms of schizophrenia than the negative (passive) symptoms. Positive/active symptoms include thought disturbances, delusions, hallucinations Negative/passive symptoms include socia