METHODOLOGICAL INSTRUCTIONS TO LESSONS № 2 FOR STUDENTS
Theme: CLINICAL PHARMACOLOGY OF DRUGS INFLUENCING ON CNS. CLINICAL PHARMACOLOGY OF ANALGESICS
Aim: To acquaint with actions, pharmacokinetics, therapeutic uses, adverse effects, concomitant use of drugs affecting the CNS (with suppressing and stimulating action).
Professional Motivation: Primary and secondary affective disorders are said to be among the most common conditions found in the practice of medicine. The chance of developing a depression during the course of a lifetime ranges from 8 to 20 percent. However, only 20 to 25 percent of depressed people receive treatment for their depression. Twice as many females as males suffer from mood disorders. All clinically used antidepressant drugs (also called thymoleptics) potentiate, either directly or indirectly, the actions of norepinephrine, dopamine, and/or serotonin in the brain.
Disorders involving anxiety are the most common mental disturbances. The symptoms of severe, chronic, debilitating anxiety may be treated with antianxiety drugs (sometimes called anxiolytic or minor tranquilizer), and/or some form of psycho- or behavioral therapy. Since all of the antianxiety drugs also cause some sedation, the same drugs often function clinically as both anxiolytic and hypnotic (sleep-inducing) agents.
Basic Level:
Students’ Independent Study Program
I. Objectives for Students’ Studies
You should prepare for the practical class using exist textbooks and lectures. Special attention should be paid to the following:
–clinical pharmacology of neuroleptic drugs (actions, therapeutic uses, adverse effects, cautions and contraindications);
–clinical pharmacology of anxiolytic and hypnotic drugs;
–clinical pharmacology of antidepressant drugs;
– clinical pharmacology of CNS stimulants.
II. Tests and Assignments for Self-assessment:
Multiple Choice:
Choose the ONE best answer.
1. Which one of following is an appropriate therapeutic use for imipramine?
A. Insomnia.
B. Epilepsy
C. Bed—wetting in children
D. Glaucoma.
E. Mania
2. MAO inhibitors are contraindicated with all of the following EXCEPT:
A. Indirect adrenergic agents, such as ephedrine.
B. Tricyclic antidepressants.
C. Beer and cheese.
D. Aspirin.
E. Dopamine.
3. All of the following are observed in patients taking neuroleptic agents EXCEPT:
A. Sexual dysfunction.
B. Increased blood pressure.
C. Altered endocrine function.
D. Constipation.
E. Orthostatic hypotension.
Real-life Situations to be solved:
1. A very agitated young male was brought in the emergency room by the police. Psychiatric examination revealed that he had snorted cocaine several times in the past few days, the last time being 10 hours previously. He was given a drug which sedated him and he fell asleep. What drug should be used in treating cocaine withdrawal?
2. A very upset mother brings in her 10 year old son to ask help in dealing with his bed-wetting. Which agents might alleviate this problem?
III. Answers to the Self-assessment:
Multiple Choice:
Real-life Situations to be solved:
1. The anxiolytic properties of benzodiazepines, such as lorazepam, make them the drugs of choice in treating the anxiety and agitation of cocaine withdrawal. Lorazepam also has hypnotic properties.
2. The tricyclic antidepressants and especially imipramine are effective in this condition because it contracts the internal sphincter of the bladder.
Visual Aids and Material Tools: Medical documents, tables, slides.
Students Practical Activities
Student must know:
–clinical pharmacology of neuroleptic drugs (actions, therapeutic uses, adverse effects, cautions and contraindications);
–clinical pharmacology of anxiolytic and hypnotic drugs;
–clinical pharmacology of antidepressant drugs;
– clinical pharmacology of CNS stimulants.
Student must be able to write a prescription on following drugs: diazepam, oxazepam, flurazepam, lorazepam, zolpidem, pentobarbital, chlorpromazine, thioridazine, haloperidol, amitriptyline, imipramine, maprotiline, fluoxetine, phenelzine.
Referenses:
- Mordern pharmacology with clinical applications. Charles R. Craig, Robert E. Stitzel – 5th Ed. – 2005.
- Davidson’s Principles and practice of medicine (nineteenth edition)/Christopher Haslett, Edvin R. Chilvers and others. –
Edinburgh
Prepared by ass. prof. Meretskyy V.M.
Methodical instruction was discussed
and adopted at the Department sitting
4.01.2013,
Minute № 7
Methodical instruction was adopted
and reviewed at the Department sitting
27.08.2013 Minute № 1
