Drug used for mania and bipolar disease (Lithum salt): as used for prophylactically of treating manic-depressive patient and in treatment of manic episodes. Is a mood stabilizer, is effective in treatment of 75% of acute mania and hypomania, although many cellular process are altered by treatment of Lithum salt, the mechanism of action is unknown, it's toxic, given orally, exc. By the kidney, low therapeutic index, Adverse effect headache, dry mouth, polydipsia, polyuria, polyphagia, GIT distress so given with food, tremor, dizziness, fatigue, confusion, convulsion, ataxia, slurred speech, thyroid function monitoring, it take 2-3 weeks to develop it's action so given combination of drugs Diazepam, antipsychotic drug, valproic acid, carbmazepine.
Drug used in Al Zheimer's dementia: Dementia Is syndrome due to disease of brain, it's progressive and chronic in nature, there's disturbance of multiple higher cortical functions memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgment, without clouding of consciousness evidence indicates that cholinergic transmission is diminished.
Drug used for attention / hyperactivity disorder:
The children is inattention, impulsivity, motor over activity before age of 7 years. Dexamphetamine, Methylphenidate (amphetamine derivative). They used in hyperactive children, narcolepsy, appetite control at high dose.Treatment 1) Dopaminergic drung: 2) Levodopa + carbidopa Levodopa: (natural precursor of dopamine) Carbidopa:(dopa-decarboxylare inhibitor ) Levodopa is readily absorbed from small intestine by active transport, t1/2 1.5 h, it can pass BBB by active transport within the brain it decarboxylated by dopa decarboxylase to the neurotransmitter dopamine. Amajor disadvantage is that levodopa extensively decarboxylated in periphery so only 1-5% of oral dose reach the brain. By the development of decarboxylase inhibitor which don't enter CNS they prevenr extra cerebral metabolism of levodopa.
Advere effect: Postural hypotension, nausea, depression, cardiac arrhythmia hallucination, dreams, agitation, confusion, dyskinesia, involentary limb jerking, head lip tounge movement.
2) Dopamine agonist: Act on dopamine receptor (Bromocriptine) It's a derivative of ergot. Is a D2 receptor agonist and α- partial agonist. It's commonly used with levodopa. (stim. Dopamine, inhibit prolactine). Side effect: nausea, vomiting, postural hypotension & dizzines,vasospasm. Other Dopamine agonist Lisuride t1/2 2h pergolide t1/2 6h Cabergoline t1/2 80 h
3) Selective inhibitor of it's metabolism (MAO) inhibitor: MAO is an enzyme present intra neuron to modulate intra neural content of neurotransmitter catecholamine are present. Selegiline: It’s a selective irreversible in hibitor for MAO B, which metabolize dopamine in the CNS, slelegiline it protect dopamine from the intra neural degredation.
4) Dopamine release: Amantidine The drug is used in the treatment of influenza but they found it has useful effect on parkinsonism by increase the synthesis & release of dopamine and by diminishing neural reuptake, it has also anti muscarinic effect, much less effective than levodpoa.
CNS Stimulants
-Methyl xanthines (theophylline) in tea , theobromine in cocca , caffeine in coffee , tea ,cola , energy drinks. -Nicotine -Cocaine -Am phetamine -Methyl phenidate