Antidepressants. What you need to know?

Published on April 22, 2013 in Order Drugs Generic Online. 0 Comments Tags: , , , , , , , , , , , .

Should everyone in a bad mood or depression take antidepressants?
Although depression is very common among older people, not every person with a chronic bad mood or depression must take these powerful drugs.

Varieties of depression
Depression because the medication
Privratno of fate that a type of depression that can not be treated with drugs, it is depression, which is caused by the intake of drugs. If the patient is depressed, which began after a new drug, it is possible and it caused a depression. Below is a list of frequently occurring preparations, which may cause depression.
* Barbiturates such as phenobarbital.
* These tranquilizers like diazepam (ì), and triazolam.
* Kardiotropnyh drugs containing reserpine.
* These beta-blockers like propranolol (Inderal).
* These antihypertensive drugs like clonidine (Clonidine), methyldopa (dopegit) and prazosin (POLPRESSIN).
* Preparation for the treatment of arrhythmias, such as disopyramide (RITMODAN).
* These drugs used in the treatment of peptic ulcers, as tsimetedin (Tagamet) and ranitidine (Zantac).
* These anti-Parkinsonian medications like levodopa (PARIMDIN) and bromocriptine (Parlodel).
* Corticosteroids such as prednisone and cortisone (DEKORTIN).
* Anticonvulsants such as phenytoin (phenytoin), ethosuximide (SUKSILEP) and primidone (geksamidinom).
* Antibiotics such as cycloserine, etionimid, ciprofloxacin (Tsiprobay) and metronidazole (Cliona).
* Such drugs for weight loss, like amphetamines (during drug withdrawal).
* Pain or antiarthritics drugs like pentazocine (Fortran), indomethacin (indomethacin) and ibuprofen (SOLPRAFLEKS).
* These preparations against acne as isotretinoin (Roaccutane).
* Other drugs, such as disulfiram (Teturam) – is used in the treatment of alcoholism.
The best means of treatment for a depression – reduce the dose or possibly even stop taking it. If necessary, go to a different drug that does not cause depression.
Another cause of depression, alcoholism is to be treated fairly difficult.
Other causes of depression that do not require drug treatment – is situational or reactive depression – the “normal” reactions to  life’s problems, such as loss of a spouse, friend,     relative or work, and any other situation that may lead to discouragement any person. If the source of depression lies in the body’s response to the crisis, the antidepressants are ineffective. We should use alternative methods, such as the support of family and friends, a change of scenery or psychological advice from a specialist. Make yourself something nice to talk to one another and to exercise daily – all of which help you to overcome difficult situations.
   Diseases which can lead to depression
Depression can be caused by thyroid disease, some cancers, such as pancreatic cancer, colon cancer, brain cancer, lymphosarcoma, viral pneumonia or hepatitis. In addition, there is evidence that people who have had a stroke or suffering from Parkinson’s disease or Alzheimer’s easy to depression which in some cases can be treated with antidepressants.
What kinds of difficult to treat depression drugs?
If depression combined with more of the following symptoms are observed for at least several weeks, and medical history, examination and laboratory tests indicate the presence of a particular type of depression, the possible diagnosis – primary depression. Symptoms include depression, interferes with normal life, difficulty concentrating, low self-esteem, guilt, thoughts of suicide, chronic fatigue, lack of energy or agitation, sleep disturbances (increase or decrease the duration), change in appetite (increased or decreased) with a corresponding change in weight. Because depression is often characterized by thoughts of suicide, the patient is often a chance to make suicide attempt using antidepressants, and therefore at a time can be assigned to only a small amount of the drug. This severe form of depression characterized by the fact that the patient shows – and talking about it if asked – the feeling of “helplessness, hopelessness, worthlessness and uselessness … and a strong sense of guilt from the real or imagined shortcomings or reckless acts.”

Other types of inappropriate use of antidepressants
In addition to the depression caused by drugs, depression caused by various diseases, and situational or reactive depression – none of which is not treated with antidepressants – there are other instances of inappropriate use of antidepressants. According to one study, over 50% of older people taking antidepressants for more than a year, began receiving without a clear diagnosis of “depression.” One-fifth of them (or one of the four people who use antidepressants) used this drug as an alternative to sleeping pills or tranquilizers. Given the significant adverse effects of these drugs, their use for such purposes is not justified, since the risk of side effects outweigh the therapeutic efficacy ..

Best and Worst of treatments for depression
Any patient suffering from severe depression should be examined by a psychiatrist who recommend needed in each case antidepressants.
The decision to choose a particular formulation depends mainly on the frequency of adverse drug effects in particular as antidepressants, all have about the same efficiency. If a person is suffering from depression, and a drug that does not cause the development of significant side effects proved to be effective, then this preparation and will be the best choice.
The main side effects of antidepressants
The four most common adverse effects include groups anticholinergic, sedative, hypotensive (blood pressure lowering) and cardiotropic effects. Because of these effects are frequently observed fractures of the hip and car accidents.
The advertisement states that the selective serotonin reuptake inhibitors such as fluoxetine (PROZAC), sertraline (Zoloft) and paroxetine (Paxil) cause fewer adverse effects than tricyclic antidepressants known as amitriptyline (TEPERIN) and imipramine (imipramine). Canadian researchers recently reported that selective serotonin reuptake inhibitors have no advantage over the previously used antidepressants in terms of the risk of hip fracture.
Anticholinergic effects. Mental effects: disorientation in time and space, delirium, worsening short-term memory, the weakening of attention. Physical effects: dry mouth, constipation, difficulty urinating (especially in men with an enlarged prostate), blurred vision, decreased sweating, combined with increased body temperature, sexual dysfunction, deterioration in glaucoma.
The antihypertensive effects: decreased blood pressure to unacceptable levels
Orthostatic hypotension or decrease in blood pressure that occurs when a sharp rise of a sitting or lying position, – frequent adverse effect of antidepressants, especially in the elderly. It may be more pronounced if the patient is at risk as a result of antihypertensive drugs. The result of a sharp drop in blood pressure can be a trauma, heart attacks and strokes. Therefore, before reception of such drugs should measure blood pressure in supine and standing after two minutes. This procedure must be repeated after a few weeks of preparation.
As antipsychotics, many antidepressants can cause parkinsonism drug. This disease is characterized by the following symptoms: difficulty speaking or swallowing, loss of balance, a face like a mask, muscle spasms, tremor of limbs, unusual body movements.
These drugs can cause increased heart rate. They also reduce the conductivity, which is especially dangerous for people who have already been observed atrio-ventricular block. Therefore, before you start taking antidepressants should do an electrocardiogram.
All currently available antidepressant can cause hypomanic and manic states. It is extremely important for people taking antidepressants group serotonin reuptake inhibitors, which include medications such as fluoxetine, and antidepressants such as imipramine, which inhibits reverse neuronal capture of both serotonin and norepinephrine. This can lead to the development of strong psychotic reactions or require isolation of the patient because of his over-excitement.
If the negative effect of the preparation used is too large, or if you think that the drug is not effective, consult your doctor with a request to change the medication.
 How to reduce the negative effects of antidepressants
It is important to recognize that long-term antidepressant treatment is not always necessary, even if there is a direct indication for the use of the drug. In one study, after achieving sustained remission for four months, half of the patients continue taking the drug and the other half took a placebo. After two months of relapses were observed in only 25% of patients, the same in both groups.
Before starting drug therapy of some form of depression, the physician should carefully monitor the dynamics of treatment and, if necessary, to vary the dose or change the drug produces.
If administration is carried out with a view to a possible diagnosis of depression, you should be aware that this diagnostic procedure, and that the drug will only last for a while.
Before the treatment remove the electrocardiogram and measure blood pressure.
Start with a dose of 1/3 or 1/2 the conventional therapeutic dose for an adult, 15 – 25 mg a day, at bedtime. Increase the dose very slowly. To complete development efeekt may take three weeks. Analysis of drug should continue as long as the desired effect is achieved or until a negative response will develop stable.
You should know that your depression is a temporary condition that will recover and that the drug may be discontinued.
Take the prescription of the drug sufficient for only one week of use, as a large dose of the drug increases the chances of successful suicide attempts in people with severe depression.
Once for a few months there will be a stable remission, gradually reduce the dose.

Nootropics

Published on April 22, 2013 in Order Drugs Generic Online. 0 Comments Tags: , , , , , , , , , , , , , , .

This group includes substances that activate the highest integrative func-tions of the brain. The main manifestation of the action of nootropics is their ability to have a beneficial effect on learning and memory when they are violated. Apply nootropics to restore these functions, with their failure, resulting from degenerative disease of the brain, hypoxia, brain injury, stroke, intoxication, neurologic deficits in mentally retarded children, in Alzheimer’s disease, etc. Many nootropics have expressed antihypoxic activity.

On the higher nervous activity of healthy animals and healthy human psyche, these drugs have no effect. So, normally they do not change many of the behavioral reactions, reflexes, brain bioelectrical activity, motor activity.At the heart of the action of pharmacotherapeutic nootropov in terms of pathology is a beneficial effect on the metabolism (energy) processes mozga2 (increased synthesis of high-energy phosphates, proteins, activation of enzymes, stabilization of the damaged membranes of neurons). Some nootropics used in the practice of medicine, mimic the metabolic effects of y-aminobutyric acid (GABA).

Nootropics have a therapeutic effect on mental deficiency only after prolonged use, i.e. they have a significant latent period of action. These preparations are used in some cases in combination with other psychotropic agents in the treatment of psychiatric patients.

Most of the known nootropics has also antigipoksicheskoy and some anticonvulsant activity.

The group of nootropics include piracetam, Aminalon, Pantogram, piriditol, etc. The most widely spread piracetam.

Piracetam (Nootropil, Pyramus) is a cyclic derivative of GABA. Has a beneficial effect on stimulating mental activity (thinking, learning, memory) for its failure. An important property of piracetam is its anti-hypoxic effect. Stability of brain tissue to hypoxia on the increase. In addition, piracetam has a moderate anticonvulsant effect, preventing the spread of seizure activity.

Piracetam easily penetrates through tissue barriers. Rapidly absorbed from the intestine is passed through the blood-brain and the placental barrier. Stands out from the body primarily by the kidneys, mainly unchanged.

Piracetam is used primarily with mental deficiency associated with chronic vascular and degenerative lesions of the brain (in dementia associated with senile age, atherosclerosis, alcoholism, head injury, etc.) in mentally retarded children.

Piracetam introduce oral and parenteral one to several months.

Of the side effects sometimes observed diarrheal disorders, and sleep disorders.

Aminalon (gammalon, ganevrin, encephalon) is the drug of GABA produced in the central nervous system. GABA acts as a neurotransmitter braking and also plays an important role in the metabolic processes of nerve tissue. Last seen in the stimulation of tissue respiration (GABA acts as a substrate or breathing, or activates the enzymes of the Krebs cycle). Metabolic activity of GABA and lies at the heart of its psychotropic effect. The blood-brain barrier drug goes bad. However, with organic brain lesions increases the permeability of the blood-brain barrier (including aminalona).

Aminalona important properties are its ability to increase cerebral blood flow and oxygen tension in the tissues of the brain, as well as moderate-hypoxic activity.

Furthermore, small Aminalon has anticonvulsant activity, which is obviously due to the normalization of the GABA content in the brain and particularly in epileptogenic foci.

Aminalon causes a slight reduction in blood pressure with a bradycardia. The hypotensive effect is most pronounced on the background of hypertension.

At a high content of sugar in the blood hypoglycemic effect. On the contrary, with a normal level of blood sugar Aminalon often leads to moderate hyperglycemia (associated with glycogenolysis).

It is used similarly to Piracetam mainly with mental deficiency, caused by cerebral blood flow (atherosclerosis, stroke, trauma, skull, etc.), in alcoholic dementia and in mentally retarded children. Aminalon sometimes used in the treatment of epilepsy. You can also use the hypotensive action of the drug in the treatment of patients with arterial hypertension.

The action of the drug develops gradually. The course of treatment lasts a few months. Enter the product inside and intravenously.

Aminalon well tolerated. With prolonged use may diarrheal disorders, sleep disorders, sometimes – fluctuations in blood pressure.

The group classified as derivatives nootropov several vitamins: Pantogram (calcium gomopantotenat) ipiriditol (entsefabol, piritinol). In the rest of GABA pantogama incorporated into the structure of pantothenic acid. Pyritinol consists of residues of two molecules of pyridoxine (vitamin Be), connected by a disulfide bridge. Both medications have a favorable impact on the metabolic processes of the brain, and have anti-hypoxic properties.

Currently, a search is conducted nootropic drugs with different mechanisms of action (several systems influencing mediators / modulators and the corresponding receptors on the function of ion channels and ion currents to the tissue respiration on protein synthesis and phosphorylation, etc.).

Tranquilizers and sleeping pills

Published on April 22, 2013 in Order Drugs Generic Online. 0 Comments Tags: , , , , , , , , , , , , , , , , .

The general rule is that if the people receiving psychotropic medications – sleeping pills, tranquilizers, antidepressants or antipsychotics – deteriorating health, the priority should be to measure a dose reduction or discontinuation of the drug, rather than adding to the treatment regimen of another drug.
Tranquilizers
In the discussion on the use of tranquilizers and sleeping pills experts of the World Health Organization (WHO) stated the following: “Anxiety is a normal reaction to stress and drug therapy should be initiated only in cases of excessive anxiety, which makes it impossible for normal activity. … Long-term use is not effective, it Avoid … Short-term use (less than two weeks) to minimize the risk of drug addiction. ” They also concluded: “An elementary discussion of the causes of insomnia and anxiety, as well as informing the patient about the shortcomings of medical therapy can often help patients without resorting to prescription drugs.”
Two studies of alternative treatments have convincingly shown that the vast majority of cases the appointment of tranquilizers and sleeping pills is not necessary. 90 patients, mainly suffering from anxiety, were randomly divided into two groups. The first group received the usual dose of a benzodiazepine tranquilizer. Another group received the alternative treatment is to “listening, clarification, advice and calming.” Both methods were equally effective treatment, but patients of the second group were more satisfied with their treatment than patients in the group receiving tranquilizers.
In the second study, patients with chronic anxiety were given one of three tranquilizers or a placebo (sugar pill). Assess the level of anxiety were conducted weekly by patients and professional experts, at the end of the month the results showed that “all four methods of treatment are the same in terms of therapeutic efficacy in cases of marked concern.” Consequently, placebo as efficiently as tranquilizers.
Faced with falling sales sibazona (Valium) in the early 1980s, Roche (and other manufacturers of the drug) have begun aggressive advertising policy aimed at its use in elderly patients. Series of beautifully illustrated booklet entitled “Roche seminars on aging” was sent to physicians in 1982 Roche sibazon recommended as a suitable tool for elderly people with “limited” opportunities that are suffering, “not only from their limited physical abilities, but also on the social conditions and the environment. ” The advertising campaign has successfully worked as the frequency of use of tranquilizers in people 60 years and older between 1980 and 1985 increased significantly, especially in older women.
The fact that more than 1.7 million people age 65 and older have used tranquilizers daily for at least a year, is the best evidence of abuse of these drugs. If we take into account that the efficacy of these drugs for more than four months is questionable, the number of elderly people, the tranquilizers for a longer period staggering – average number of tablets (160), wherein each of the 10 million users tranquilizers 60 years purchases over a year, it is sufficient for the daily intake for more than 5 months.
Hypnotics
Excessive or erroneous assignment of sleeping pills leads to the fact that about half a million people take these drugs every day for at least a month. It is proved that such remedies are effective during this time or more, all of these patients were subjected to their health for no good reason.
The number of benzodiazepine hypnotics, which on average is assigned patients per year, enough for five months, which is 5 – 10 times more time to their proven effectiveness. Consequently, hypnotics erroneously assigned in from 80 to 90% of cases of use.
Growth in the use of such funds has been the subject of findings and recommendations in an extensive study of the Institute of Medicine of the National Academy of Sciences in 1979, speaking about the use of these tools, the researchers conclude: “sleeping pills may have only limited use in private medical practice: it is difficult to prove scientifically most appointments sleeping pills. With standard outpatient Commission recommends the appointment of a very limited amount of the drug sufficient to receive in a few days … Older patients sleeping pills should be appointed with special care and only occasionally. ”
Commenting on the specific use of hypnotics in older people, the authors note: “Of particular concern is the regular and prolonged use of this group of drugs, which is in itself is of questionable therapeutic efficacy and leads to increased risk of adverse effects from taking sleeping pills.”
Although the elderly are more likely than younger ones to complain about sleep disorders, studies have shown that sleep time does not increase with age, and total sleep time decreases very slightly, if at all diminished. Insomnia is most often occurs in older people who go to bed early, and, in addition, often sleep during the day. Thus, the researchers conclude that “it is necessary to give up a nap instead of treating insomnia caused them overnight.”
Folshtayn Dr. Marshall (Marshall Folstein), Johns Hopkins Hospital psychiatrist and expert on Alzheimer’s disease, says that “extremely rare to find older people they are (sleeping pills) is really needed.”
Another danger – is too high dosage. The study dose of sleeping pills showed that the majority (almost 80%) of people 65 and older take the “overdose” flurazepam (30 mg), although for the elderly is recommended dose of 15 mg. (In this book, we have included flurazepam in the category of “Do Not Use.”) Taking into account the recommendations of the National Academy of Sciences, which states that sleeping pills should only be used in a limited number of cases, an increasing frequency of prescriptions of these drugs for older people – especially in the long periods of time – is a serious threat to their health.
    What are the main danger of sleeping pills and tranquilizers?
Drug dependence, daytime sleepiness, amnesia, increasing the risk of avtoproisshestvy, poor coordination, leading to falls and hip fractures, impaired learning ability, to be confused speech and even death are the side effects of these drugs. This is especially likely when taking these drugs together with alcohol or other drugs depressing the central nervous system. It can happen to anyone at any age.
The body of elderly people can not produce these drugs as quickly as younger people. The elderly are also more susceptible to side effects of medicines. Despite this obvious fact, the elderly, firstly assigned more hypnotics and tranquilizers, and secondly, they tend to give a standard and not smaller dose, which could reduce the risk of side effects, and thirdly, they are prescribed reception these agents over longer periods of time than younger people. Consequently, there is a surprise that older people are more at risk of adverse effects, if such effects do occur, they tend to be more pronounced. One of the biggest obstacles for the detection and elimination of these problems is that the emerging problems associated with the aging process, and not with taking drugs. The deterioration processes of thinking, amnesia, learning impairment or loss of coordination in younger people while taking the drug is perceived as an alarm. If the same symptoms occur in older people, especially if they develop rather slowly, the reaction of the doctor often comes down to the remark: “Well, he (she) is old, what did you expect?”. This approach leads to the aggravation of the negative effects, as the doctor continues to previously initiated drug therapy.
Study of older people with hip fracture showed that 14% of these injuries related to the use of psychotropic drugs, including sleeping pills, tranquilizers, antipsychotics and antidepressants, especially tools such as sibazon, hlozepida and flurazepam.
Another serious adverse effect of benzodiazepines respiratory depression. Older people often have sleep apnea, when breathing stops after falling asleep. Dr. William Dement (William Dement), an expert on sleep study found that elderly people who use sleeping pills may stop breathing for long periods of time is dangerous, as a result of sleeping pills suppress the respiratory center. He also talks about the importance of the state of the problem: people older than 65 years should not use flurazepam because of the increased risk of apnea. The second problem in this category are diseases of the lungs. People with serious lung diseases should not use benzodiazepines, due to the fact that they depress the respiratory center, which can be life-threatening. Patients suffering from asthma should also avoid sleeping pills and tranquilizers.
Reducing the risk when taking sleeping pills and tranquilizers
The best way to reduce the risk of adverse effects – is to avoid taking these drugs except in cases of emergency.
     Alternative treatments for chronic anxiety
As the British psychiatrist Dr. Malcolm Ladera (Malcolm Lader), “until recently, the majority of patients with symptoms of chronic anxiety in the UK were appointed tranquilizers, benzodiazepines usually. However, more frequent reports on the development of drug dependence, even in the appointment of the normal therapeutic dose, have led to a revision of the strategy of treatment of chronic concern for the benefit of non-drug therapies.
Two doctors from the UK have used non-drug therapies for the treatment of mild to moderate forms of the syndrome of chronic anxiety and related disorders. They argue that “probably the best method of treatment is to consult a GP or any other health care professional. Such consultation should not be overly intense and it does not require any special training. Such advice should always include a careful determination of the causes of the disease. When this is done, the insomnia can often be reduced to acceptable levels by standard psychotherapeutic methods of influence. ”
What more can be done? Talking with people who have no relation to medicine, other, spouse, relative, member of the clergy can help determine the causes of anxiety and find a solution. The courage to talk about the difficulties – is a better solution than taking pills. In some cases, insomnia can be treated with psychotherapy. Regular exercise can improve the process of falling asleep.
Moreover, ingestion, beverages and medicines, with significant stimulant effects, can also cause sleeplessness.
    What tranquilizers and sleeping pills can still be used?
Although we are against the use of such drugs in the majority of cases, especially the elderly, in strictly defined cases, these funds may be administered by competent professionals for a short period of time. In the summary of all tranquilizers FDA states: “insomnia or stress with stress in everyday life usually does not require the use of anxiolytics (tranquilizers).” As stated at the beginning of this section, the elderly should never use barbiturates as hypnotics or sedatives. Other drugs, such as meprobamate, hydroxyzine (Atarax) and chloral hydrate should not be used as the elderly. Consequently, in the doctor’s arsenal are only benzodiazepine – eight of tranquilizers and sleeping pills five (in addition, it should be noted zopiclone (imovan) – one of the safest sleeping pills). All these drugs were equally effective as tranquilizers and sleeping pills. “The classification of certain drugs to tranquilizers or sleeping pills – is a matter of marketing, not pharmacology.”
These benzodiazepines 13 differ from each other set of side effects, which risk is particularly high in the elderly. The World Health Organization recommends that older people will not use the well-known hypnotic, as flurazepam, due to the high probability of adverse effects.
Older persons should be avoided and another widely used hypnotic, triazolam, because it has a much shorter duration, which can cause insomnia after discontinuation of the drug, anxiety, amnesia (forgetfulness or amnesia), aggressive behavior. In 1992, the Public Sitizen’s Health Research Group petitioned the FDA to ban the use of triazolam.
When discussing what kind of sleeping pills are the drug of choice for the elderly found that most are safe to use nozepam (tazepam) and temazepam (SIGNOPAM). It was also established that “nozepam is the safest of all benzodiazepines for the elderly,” because of a “short time of action and lack of active metabolites” (ie substances that the body converts the drug and that can create negative effects). In addition, studies show that nozepam is much less used as intoxicants, compared, for example Sibazonum.
In a comparative analysis of benzodiazepines and eleven in terms of the likelihood of amnesia (a serious problem, often seen in the elderly) expert on drug therapy in the elderly Peter Lamy stated that nozepam much less frequently than other benzodiazepines cause memory impairment.
Younger patients may also use temazepam and zolpidem. However, as indicated in the summary to this drug, even though it does not belong to the class of benzodiazepines, it may be habit-forming and should not be used more than one or three weeks.
In summary, we conclude that the only drug prescription, which we recommend for limited use in the elderly, is nozepam (tazepam).
If you are taking one of the benzodiazepines continuously for more than a few weeks, then you have every chance of development of drug dependence. Abrupt discontinuation of the drug is very dangerous. With the assistance of your doctor to develop a schedule according to which gradually decrease the amount of hypnotic or sedative by an average of 5 – 10% per day. This will significantly reduce the risk of withdrawal symptoms when you stop taking the medication.
Terms secure receiving nozepama
1. The dosage should range from 1/3 to 1/2 the conventional therapeutic dose 2. This means that the greatest initial dose should be 7.5 mg, one to three times per day, if the drug is used as a tranquilizer, or 7.5 mg at night when it is used as a hypnotic. (It is 1/2 tablets of 15 mg.)
3. Ask your doctor to limit the appointment of a sufficient quantity of the drug for seven days of admission.
4. At the end of each day while taking nozepama evaluate their own or with the help of other people what you have done to find the causes of insomnia. This includes an assessment of what you have done to address the external and internal causes of insomnia. Keep a journal in which you record these estimates. Since you have the drug only for one week, then the development of addiction is unlikely.
5. When taking this drug does not drive a car or operate dangerous machinery.
6. Do not drink alcohol. The combination of this drug with alcohol is dangerous increases CNS depression. Overdose of the drug in combination with alcohol can be fatal.
7. Before taking nozepama make sure that the doctor knows about all other medicines taken by you, CNS depressants, such as antidepressants, antipsychotics, antihistamines, narcotic analgesics, anti-epileptic drugs, and other hypnotics. When you receive nozepama conjunction with other drugs, has a sedative effect, increasing the risk of dangerous side effects.

Psychotropic medications

Published on April 22, 2013 in Order Drugs Generic Online. 0 Comments Tags: , , , , , , , , , .

By altering drugs understand drugs, which have a preferential effect on the central nervous system and mental processes.

A distinctive feature of psychotropic drugs is their specific positive impact on mental functions exactly (unlike other drugs that have effects on the central nervous system and mental processes is a side often – minor).

Psychotropic drugs together a wide range of substances of different structure and chemical nature of that influence mental function, emotional state and behavior. Many of them have found use as valuable pharmaceutical agents not only in psychiatric and neurologic but also in somatic medicine (surgery, oncology, etc.) for the treatment and prophylaxis of psychotic disorders boundary level.

    From the history of the study of psychotropic drugs

Many of the substances currently used as a psychotropic drug, known since ancient times and is widely used in folk and traditional medicine. This applies primarily to the plant products (ginseng and lemongrass as tonics, valerian, motherwort, passionflower, and others as anti-anxiety) and animal (deer antlers, deer). Since time immemorial, known stimulating effect of tea and coffee, but the caffeine in its pure form and the accompanying alkaloids have been isolated only in the XIX century.

In the religious and cult rituals have long been widely used various hallucinogens: Indians of Central America – mezcal: the nations of Southeast Asia – opium, hashish, marijuana, people of the North – some toadstools, in European countries – henbane, datura, belladonna.

For several centuries, the medications are used in medicine as anesthetics of opium. Apparently, from the time of Paracelsus was known sedation (soothing) effect bromides, which later gained widespread use in the clinic and in some physiological studies (as in the laboratories of Pavlov bromides along with caffeine used to study the processes of excitation and inhibition in the central nervous system.)

However, a systematic study of psychotropic drugs began only in the first half of the XX century. Thus, the history of psychotropic drugs, Relieves depression, began with the use of amphetamine (amphetamine), which was introduced into clinical practice in the late 30′s. As medicament improves mood in patients with endogenous depression. However, the first major breakthrough in this area was associated with the detection of psychostimulant and euphoric action of derivatives of isonicotinic acid hydrazide (Ginko) widely used at that time in the chemotherapy of tuberculosis. Further research in this area has led to the creation of the first true antidepressant – iproniazid who appeared founder of the group of antidepressants – monoamine oxidase inhibitors, displacing amphetamine.

In the late 40′s – early 50′s. Clinicians have found that lithium, which were used with completely different goals (treatment of gout and kidney stones), have the ability to arrest the acute manic excitement in psychiatric patients and prevent affective attacks.

In 1946, Alpern and Ducrot noticed the drug phenothiazine, which had previously been used as an antiseptic and worming agent. It has been found that certain phenothiazine derivatives possess pronounced psychotropic properties. They have a sedative effect, enhance the effect of drugs, hypnotics, analgesics and local anesthetic agents. To date, a number of phenothiazine drugs are a big part of psychotropic drugs belonging to the class of neuroleptics. One of the first antipsychotic drugs, which have not lost their significance to the present, chlorpromazine is synthesized by Charpentier in 1952

In 1957 opened the first antidepressants (iproniazid, imipramine), and several later found tranquilizing properties of benzodiazepines and meprobamate. By the way, the term tranquilizers (from Lat. Tranquillare – do calm, serene) went to medical science as in 1957

In the 60s, thanks to the great advances in the chemistry of organic compounds have been synthesized and have been tested for several tens of psychotropic drugs, and the World Health Organization (WHO) has taken the first attempts to systematize these medicines. One of the first classification was proposed and delay Deniker in 1961. According to this classification, all psychotropic drugs are divided into four main classes: 1) psycholeptic funds that have a calming, chilling effect, and 2) Psychos possessing exciting, challenging, action psihoenergiziruyuschim 3) psychodysleptics (substances that have psihozomimeticheskim (psychedelic) action, that is, the ability to produce psychosis, and who were later excluded from the number of psychotropic drugs), and 4), mood stabilizers (timoizoleptiki, timoregulyatory) capable of aligning mood and prevent exacerbations in the development of the next phase power flowing psychosis.

In 1967, the Congress of Psychiatrists in Zurich psycholeptic proposed to divide drugs into two groups: a) antipsychotics, used mainly for severe disorders of the central nervous system (psychosis), and b) a tranquilizer used in less severe disorders of the central nervous system, mainly in the state of neurosis mental stress and fear. Similarly, the Psychos were divided into a group of antidepressants and psychostimulants group (psihotonikov).

Put forward in the 60′s. classification have been repeatedly revised, and now recovered for 7 – 8 classes of psychotropic drugs.

In 1972 Giurgea synthesized the drug piracetam, which has opened entirely new opportunities pharmacological effects on the central nervous system, beginning the group neuroprotective drugs.

Design, synthesis and testing of new medicinal drugs reached its apogee in the 80th – 90th. due to the considerable progress in the field of neurochemistry. The search for new, more effective and less harmful to the body of psychotropic drugs is intense, and at present.

  Classification and features of the pharmacological action of various classes of psychotropic drugs

Classification of psychotropic drugs is changed periodically, as some drugs are excluded from the list of drugs, due to its low efficiency or high toxicity, while others are introduced into medical nomenclature, after appropriate testing.

The most generally accepted classification today decided to allocate seven major classes of psychotropic medications:

  • Antipsychotics (neyroplegiki, or antipsychotics).
  • Tranquilizers.
  • Sedatives.
  • Mood stabilizers.
  • Antidepressants.
  • Nootropics (nootropics).
  • Psychostimulants.

According to its pharmacological action of psychotropic drugs are very diverse. Thus, a group of neuroleptics has a peculiar soothing effect, with a reduction of responses to external stimuli, the weakening of psychomotor agitation and emotional tension, suppressed feelings of fear, a weakening of aggressiveness. Their main feature is the ability to suppress delusions, hallucinations, automatism and other psychiatric syndromes and provide therapeutic effect in patients with schizophrenia and other mental illnesses. They enhance the effect of drugs, hypnotics and sedatives, analgesics and local anesthetics and, conversely, diminish the effects of psychoactive drugs. For a number of neuroleptics characterized kataleptogennoe action. Some antipsychotics, except for antipsychotic action, have a sedative or an activating effect, and sometimes antidepressant effect. All this determines the profile of their actions and indications for use in psychiatry and other fields of medicine.

Tranquilizers, unlike neuroleptics have not expressed an antipsychotic effect. They contribute to, first of all, elimination of neurotic disorders and neurotic, reducing emotional tension, anxiety and fear. Tranquilizers facilitate the onset of sleep, enhance the effect of sleeping pills, narcotic and analgesic drugs. At the same time, some of the most potent tranquilizers are able to exert therapeutic effects in psychotic and psychopathic states. Most tranquilizers low toxicity, side effects are seldom caused. However, uncontrolled and unjustified taking them may develop drug dependence (lekomaniya).

Sedatives, tranquilizers compared to exert less pronounced sedative and anxiolytic effect. In contrast to the influence of drugs, they are not selective calming effect and have obscheugnetayuschee effect on central nervous system functions. Development of sedation associated with either reducing the excitation or inhibition with amplification processes in the brain. Sedatives do not cause muscle relaxation, ataxia, drowsiness, mental phenomena and physical dependence, so it is widely used in the outpatient treatment of neurosis, epilepsy, nervous tics, etc. For sedatives are also characteristic of good tolerance and no side effects.

Mood stabilizers have the ability to arrest the acute manic excitement in psychiatric patients and prevent affective attacks. In addition, many of the contemporary mood stabilizer medications to a certain extent help even out the mood and the normalization of the cycle “sleep – wakefulness.”

The common property of antidepressants is their timolepticheskoe action, ie, a positive impact on the patient’s affective sphere, accompanied by increased emotional tone, improved mood and overall mental state. Antidepressants cause a state of euphoria, relieve or reduce the sense of melancholy and depression. In psychiatric practice, antidepressants are widely used in the treatment of patients with depressive states.

Particular impact on the psyche of nootropic drugs. Nootropics activate the higher integrative brain function, restore the broken mnemonic and intellectual functions, reduce neurological deficits and increase the body’s resistance to extreme influences. Creation and introduction of metabolic therapy (nootropics) is one of the significant achievements of medical treatment of nervous and mental diseases. The most important properties of nootropics – neurometabolic positive effect, increasing bio nerve cells, the ability to produce energy in the conditions of hypoxia. In 1972 Giurgea coined the term “nootropic” for the effect of one of the drugs in this group – nootropil (piracetam), able to influence the integrative functions of the brain by facilitating transcallosal hemispheric relations and influence the phylogenetically more recent neocortical education. The peculiarity of drugs is their good tolerability, no side effects and no serious contraindications.

The group of psychostimulants are substances that have a stimulating effect on brain function and activating mental and physical activity. Psychostimulants activate backup capabilities of the body, increase mental and physical performance, enhance the body’s resistance to extreme stress, relieve feelings of fatigue and tiredness.

 Neurochemical mechanisms of action of psychotropic drugs

On the neurochemical mechanisms of action of psychotropic drugs are also very diverse. Their effect is mediated by a membrane-ionic mechanisms, and changes in intracellular metabolism, synthesis, release and inactivation of neurotransmitters, changes in the structural and functional properties of the postsynaptic neuron, etc.

Direct impact on ion permeability have primarily, inorganic compounds such as lithium salt and bromine. Li + ions to some extent act as a “competitor” of the ions Na +. Blocking sodium channels and thus reducing the sodium permeability, they reduce the frequency of action potentials, eliminating “convulsive” level neurons and thereby arresting fits of excitation. Ions Br-, apparently acting as agonists Cl-, causing inhibition of the nerve cell and providing sedation (sedative) effect.

Drugs that are used as antidepressants, have a stimulating effect on monoamine neurotransmitters nature – prevent their degradation by monoamine oxidase, and also reduce the intensity of the reuptake of monoamine nerve endings.

Nootropic drugs have a beneficial effect on the trophic nerve cells, stimulate the processes of synthesis of biologically active substances that play a role in energy-saving body. Nootropics activate the synthesis of proteins, RNA and ATP, improve glucose utilization, have a membrane-stabilizing action. The energy potential of the brain is increased by ATP turnover, increase the activity of adenylate cyclase inhibition nukleotidfosfatazy. Some nootropics (atsefen) increase the content of acetylcholine in the synaptic terminals and increase the density of cholinergic receptors.

Stimulants cause the mobilization of energy resources of the body, increasing the intensity of energy metabolism, have a stimulating effect on different parts of the central nervous system, facilitate the process of interneuron interaction.

Finally, the main groups of psychotropic drugs – antipsychotics and tranquilizers – have the most extensive range of neurochemical action. Areas of application – different neurotransmitter systems, the effect of drugs sold at all stages associated with synaptic transmission (synthesis, isolation, modulation, reception and degradation of neurotransmitters.

Some psychotropic drugs have a mixed effect and attributing them to a particular class can be considered to some extent arbitrary. Thus, the mechanism of action of some authors identify a particular group a) timoneyroleptiki b) timotrankvilizatory c) nootrankvilizatory, z) with the properties of neuroleptics, tranquilizers, etc.

For more information about the neurochemical mechanisms of action of psychotropic drugs are given in the following chapters devoted to the consideration of their individual classes and groups.

Geroprotectors – the defenders of youth

Published on April 22, 2013 in Order Drugs Generic Online. 0 Comments Tags: , , , , , , , , , , , .

Is being formed a new direction pharmacotherapy – geriatric pharmacotherapy. Its appearance is due to the observed worldwide progressive aging of the population, an increase in the population of older persons. In this group of patients, as a rule, there are several diseases simultaneously (polymorbidity) that naturally accompanied by increased consumption of drugs (polypharmacy). It is believed that on average a patient older than 60 years account for 5.4 diseases of various origins. With age often change as the pharmacodynamics and pharmacokinetics of drugs, there is a higher rate of side effects. Ignorance physician features of pharmacotherapy in elderly and old age can be a cause of iatrogenic disease.

Geriatric practice demonstrates the need thorough revision of many sections of pharmacotherapy in relation to geriatrics.

Each physician should have a clear idea of the impact of aging on the effectiveness of pharmacotherapy, the principles of dispensing drugs in geriatrics, the peculiarities of drug interactions in geriatric practice, on how to improve the stability of senile body to undesirable effects of drugs. In addition, the appointment of each drug the physician should be aware of the necessity, appropriateness and safety of its use, be sure to know the cost of drugs.

In the treatment of elderly and senile age should be taken into account that drug therapy should be only one of the elements of the complex therapeutic interventions. You can not weight ailments elderly medicate. Received treatment in elderly patients, especially, need to tailor the benefits and dangers.
The main line of geriatric pharmacotherapy – a more cautious use of drugs in the treatment of older people than younger ones. Put forward in geriatric provision necessary before prescribing cordon off all other possibilities for influencing the sick body of the old man, not to use drugs if another possible therapy, deserves a lot of attention. It is due to the peculiarities of the aging organism, easier development of iatrogenic diseases from the use of drugs, drug intoxication.

Everyday experience shows that there are severe, organic changes, and adverse social factors are often the reason that the elderly or old people feel sick. Appointment of medical therapy in such cases is often unnecessary and sometimes harmful. In geriatric practice is especially important consideration not only because the physical condition of the patient, but a hundred mental status, external reasons, changing the mood, sleep, mood, reducing the desire to live.

The basis of prevention and treatment in geriatrics is the principle of support and development processes of compensation and adaptation of the aging organism, which, as a rule, is peculiar yet sufficient range of adaptation, although qualitatively altered reactions. They are of great importance to mobilize the influence of labor processes, rational mode, special training, psychotherapy, etc. They need to be more fully utilized, if necessary, in combination with drug therapy, which is only one link in the whole complex of curative measures.

In some cases, drugs may be the cause of the disease. In long-term medical treatment requires periodic review of drug regimens to reduce the list of products.

During drug therapy for the elderly and old. people is particularly important factor in the full confidence of therapeutic properties of the drug, as well as knowledge of the impact of their PA system with prolonged use. Adverse effects of drugs on individuals who switched pension abroad, and especially elderly people, often is unpredictable.

Inappropriate prescription of drugs in geriatric practice due not only to the lack of knowledge in terms of pharmacological action pa body of an old man, but also the lack of knowledge of the physiological age norms. Harmful not only underdiagnosis (not recognize existing diseases and pathological processes), but overdiagnosis (misperception of age norms, these functional studies and clinical tests, the interpretation of them as symptoms of the disease), and in connection with the irrational use of medication.

Particular attention should be paid to receive the regular prescribed drugs. Elderly people, and especially the elderly and often forget to take medication or take again after a short time. In this regard, the hospital nurse must personally give a doctor, a means to the patient. At home, you should be postponed daily dose of drugs, so that the remaining tablets patient could see how many times it has been taken. In geriatric practice is convenient to use colored tablets or capsules. In the appointment of co-administration of multiple drugs at home in the morning appropriate decomposed, their all day in the lid of drug vials at the bottom of which put cut paper circles of different colors or make a note of another kind. If possible, avoid use of liquid dosage forms. Because of poor eyesight, hand-shake is often difficult to keep the patient dosing precision, particularly the number of drops. In addition, the lack of precise control over the density of packing can lead to leakage and, consequently, changes in drug concentration by evaporation, microbial contamination, decomposition.

 Basic principles and features of drug therapy in geriatric practice:

Risk of adverse effects of drugs on the body, caused by age-(which are often exacerbated by changes associated with pathological processes), in older people is significantly higher than that of younger people.
In old age, adaptation to stress of any kind,
including to toxic substances, significantly reduced. Therefore, the resistance of intoxication in the old body is less danger is even a slight intoxication.
In the treatment of older people is unacceptable and pragmaziya floor. Should be limited to the fewest number of drugs. Route of administration of drugs should be as simple. In appointing them to consider the mental health of the old man, and social conditions, the possibility of any foreign rule uhoda.Vazhneyshim geriatric pharmacotherapy is individualized doses, recommended the appointment of reduced doses of medication, especially early in treatment. By slowly increasing doses of the individual may establish tolerance to the drug. This mainly refers to the cardiac glycosides, sedative, hypotensive and neuroleptic agents, groups of opium and their synthetic analogues. Initial doses of these drugs is recommended to reduce the 2-fold compared with the doses for middle age. According to the therapeutic effect of the dose should be reduced and determine the maintenance dose, which, as a rule, is also lower than that of middle-aged people.
Treatment with antibiotics and antibacterial chemotherapy should be at normal doses according to the general rules. Please keep in mind that the risk of toxicity, side effects of these substances pas body of the old man and old age more, especially the lack of supply of vitamins, mostly in B (B1, B2, B6, B12).
It is important to consider not only the usefulness of the diet, but also water and salt intake of patients, the amount of urine. This is particularly important due to the very often not enough fluid intake older people, contributing to drug intoxication.
Prolonged administration of many drugs, including tranquilizers, painkillers., Hypnotics, makes them addictive and leads to higher doses are sick. what is the cause of drug intoxication. Recommended the appointment of
their short-term replacement drug of similar effect.
In order to prevent the toxic effects of physician
ments, and to enhance their effectiveness in the appropriate use of small doses of the complex pharmacological agents that provide a similar therapeutic effect, complement each other, but acting on different links of self-regulation body.
Congenital or acquired specific sensitivity
Tion to certain medicinal substances can occur in all ages. Drug allergies are not uncommon in older age groups.
The so-called geriatric facilities, tools, general stimulation to maintain metabolic processes and functions, and especially vitamin expedient to have some importance in the prevention and treatment of premature aging alternating and can be combined with a number of other drugs in the treatment of disease. Vitamin therapy should be considered as a factor in reducing the risk of drug toxicity and other side effects.

  Recommendations on the principles of rational geriatric pharmacotherapy:

1. Before treatment should be to make an accurate diagnosis and to determine whether drug use, as Not all elderly diseases require medical treatment.
2. Carefully identify all the conditions of use of drugs patients:

• the patient can receive advice and treatment from several doctors, so information about the already ongoing ‘treatment will
avoid adverse drug interactions;

• Smoking, alcohol, coffee consumption can lead to action usileshpo drugs.

   Good to know the mechanism of action of the drug assigned:

Aware of the possibility of age-related changes in the distribution of drugs tion; appoint well-studied drugs.

• Begin therapy with low doses of drugs:

• the standard dose is often high for elderly patients;

Effect of age on hepatic drug metabolism
substances in the liver are not always predictable, but renal excretion of drugs and their metabolites decreases with age;
Elderly patients are more susceptible to drugs that affect

3. Titrate the dose to the desired effect:

• identify attainable therapeutic effect
gradually increase the dose to such a reception diets specific therapeutic outcome, and if you can not achieve the desired, try to use the maximum tolerated dose (when further increasing it leads to the emergence of side effects);; • in some cases, combination therapy is more adequate to our and effective.

  Facilitate visa applications drugs ensure adherence to treatment:

• Avoid complex dosing regimens, the most acceptable
• A reception from 1 – 2 times a day, thoroughly instruct patients and their families in
the admission of drugs, explain what is written out drugs, offer record taking drugs;
continuously monitor compliance nozhilym patients
regime of medication.
The effectiveness of treatment for older patients is determined not only a properly chosen therapeutic tactics, but also the level of komlayepsa patient. The term “compliance” entered the medical terminology in 1976 and is defined as the degree to which the patient’s behavior with regard to use of the drugs, compliance with appropriate diet or desired lifestyle coincides with the doctor. Compliance is required for success in the treatment of chronic diseases, prognosis and is important from an economic point of view. A heaving achieve better efficiency to improve the treatment of patient adherence to treatment. Frequent and well-known situation in the treatment of a failure to follow the doctor. This is especially true for patients with older age groups and the lack komidayensom elderly patients and their frequent social psychological maladjustment.
  “Geriatric” drugs (geroprotectors)

Development of gerontology is “not too distant future may actually increase the average human lifespan. Of great importance in this case is based selection tools that can support the structural and functional parameters of the body to a level that enables adaptation to the conditions of existence and the strong longevity.

In modern geriatric pharmacology as a separate group can be allocated drugs used not only to treat diseases as humans with premature aging, but also for the prevention of premature aging. These funds are conditional and not quite correctly called geriatric, used for “drug therapy old age”, and sometimes even / (A “rejuvenation”, which is clearly not in their actions and possible geriatric therapy. These biologically active agents, combinations of drugs that have obgtsestimuli pa-regulating effect of the aging organism designed na normalization of impaired metabolism and functions, tones up the nervous system and increase its trophic function.

Often referred to as geroprotectors aptioksidanty, but these concepts are not synonymous. The origin of the term “geropro-detector” must experiment, conducted in the 70-ies of the last century, at the Institute of Chemical Physics. These experiments, the theoretical basis of which was svobodnora-dikalnaya hypothesis of aging (Harman, 1956; N.MEmanuel, 1958), were designed to increase life span by dietary enrichment with synthetic antioxidants and nutrients. The effectiveness of re-roprotektorov estimated increase in the average duration that not all antioksidapty slow down aging, preference is synthetic antioxidants (NM Emanuel, 1984), should be taken into account that:
1) individual variability of vitamins A, E, C and carotene in the blood plasma of people is very high, up to 6-fold, age-related changes are mild;
2) decreases with age of lipoprotein carriers;
3) as the pharmaceutical drugs used to synthesize vitamin deprived associated plant complexes, thinly aptiradikalpuyu regulatory activity;
4) the use of large doses aptmoksidantov may lead to suppression energetically significant reactions of reactive oxygen species.

Today has not been made any kopsensusnyh recommendations based on evidence that would indicate the need to appoint a high introduction aptioksidaptnyh micronutrients. But is general consensus that their action in a complex defense system eliminates the undesirable effects of lipids. If this delicate balance is disturbed, and the focus shifts to the detriment Apti-oxidation process, the body responds “oxidative stress” (“oxidative stress”), which promotes the development of several chronic diseases and premature aging. An undesirable lipid recorded more often, due to the unfavorable environment, stress, etc.

Some antiokemdanty food (vitamins C, E, (3-karotnn) play a very important role in the human body. Antioxidant mechanism of action is based on their ability to deactivate radicals and terminate the chain formation of radicals, which are characterized by the most frequent type of fat oxidation – peroxidation, Rule of Law . the most important antioxidants naturally occurring in plants are the tocopherols, ascorbic acid, carotene, phenolic acids, flavonoids. Antioxidants are the animal proteins and amino acids. Tocopherols are in oil, with the largest number found in oils high in linolsvoy acid. Tocopherol is also found in animal fats, where it comes from food, which is prepared animals. more bodies uy antioxidant phenolic acids and flavonoids, known for more than 3000 representatives. They are found in high concentrations in the outer layers of fruits and leaves. aptioksidantnymi important flavonoids are quercetin kemferol, mi retsntin, luteolin, apshenip. highest concentration of quercetin found in the bulbs, tomatoes and green cabbage. kemferola High concentrations found in green cabbage

Balanced Solutions Compounding Pharmacy Issues Voluntary Recall

Published on April 22, 2013 in Order Drugs Generic Online. 0 Comments Tags: , , , , .

Balanced Solutions Compounding Pharmacy Issues Voluntary Recall
All sterile non-expired products recalled due to a lack of sterility assurance
Balanced Solutions Compounding Pharmacy (Balanced Solutions), a division of Axium Healthcare Pharmacy, Inc., of Lake Mary, Fla., is voluntarily…

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