精神药物在老年病人中的应用

老年人因为患各种精神障碍常需使用精神药物,为了安全有效地用药,需结合老年人临床药理学特点和药物特点制定个体化的治疗方案。本文主要就抗精神病药和抗抑郁药在老年病人中的应用原则展开讨论。     

Effects of anesthesia on patients taking psychotropic drugs

Psychotropic drugs, often given in combination with each other or with other nonpsychiatric drugs, generally exert profound effects on central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anesthesia and surgery. This article reviews the effects of anesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors, and lithium carbonate.     

加强对三唑仑等精神药品的管理

<正> 在长期从事药物滥用的防治工作中,发现吸毒者中滥用精神药品的现象十分普遍,海洛因滥用者中使用三唑仑者占75％,滥用其它精神类药品者占25％。三唑仓等精神药品来源的途径主要有:(1)黑市购买;(2)从医院获得。有的吸毒者甚至每日都要     

新型精神药物的研究进展

精神药物的开发研究近年来有了很大的进展，发展了一系列称之为第二代的抗精神病药与抗抑郁药。与第一代药物比较，第二代药物 的药理机制有所不同，治疗作用更广泛，安全性和耐受性更好。第二代抗精神病药的特点是作用谱更广，对阴性症状、认知缺陷有较好疗效；有更好的耐受性，提高了患者的治疗依从性。第二代抗抑郁药的特点是因不良反应较少扩大了适用的人群。本文对近来在中国上市的这类新药做一介绍。     

Clinical pharmacology of psychotropic drugs

No Abstract     

Utilisation of drugs for diabetes mellitus

This article reviews the data from drug utilisation research on antidiabetic agents, oral hypoglycaemics and insulin. Study methods specific to this type of pharmacoepidemiological research are discussed and critiqued. A brief overview of the sources of drug utilisation data is presented, followed by a review of specific pharmacoepidemiological investigations. We evaluate the usefulness of these studies in assessing true drug consumption, in evaluating comorbidity in diabetic patients and in measuring the prevalence of diabetes. International comparisons of antidiabetic drug utilisation, also reviewed and analysed, demonstrate wide variations in the use of hypoglycaemic agents, which have arisen for reasons which are unclear. Drug utilisation research thus far has been limited by the paucity of studies relating these variations in antidiabetic drug use to specific clinical outcomes. There is a need to expand the applications of research on the use of antidiabetic agents, including assessment of patterns of morbidity across geographic boundaries and over time.     

Enkephalins and the action of psychotropic drugs

This paper reviews data concerning the possible role of opioid neuropeptides in the central action of psychotropic drugs. The results summarized provide an evidence that the long term interruption of the central dopaminergic mechanisms by administration of neuroleptics causes specific alterations in the content, release and biosynthesis of several opioid peptides. Moreover, the dynamic changes of the enkephalin level in brain structures after one year of fluphenazine administration were described. The acute and chronic treatment with benzodiazepines induced pronounced changes in brain enkephalin concentrations. The first evidences are provided that chronic antidepressant treatment changes the level of enkephalins in discrete brain areas.     

Workplace testing of drugs of abuse and psychotropic drugs

In France, workplace testing of drugs of abuse and psychotropic drugs is rarely performed; meanwhile it is a major public health problem. Furthermore, France is the European country that has been associated with the highest increase of the use of drugs of abuse, particularly cannabis. So workplace biological screening of drugs of abuse and of psychotropic drugs exposure is of major concern. New analytical techniques have been developed during the last years. The authors will consider analytical screening of drugs of abuse and particularly the comparison of analytical techniques applied to urine and saliva. The advantages and the disadvantages of these two matrices will be considered. Urinary and blood quantification will be reviewed, but also the interest of hair testing to explore chronic exposure. The research of psychotropic drugs in biological fluids is also a part of this paper. New analytical trends are promising and complete analysis of these substances will be soon routinely possible in blood using a single spot test.     

The chromatographic identification of psychotropic drugs

The thin-layer chromatography of three classes of psychotropic drugs—phenethylamines, tryptamines and erganes—has been investigated. Published methods are reviewed and Rf data, normalized by a graphical technique, are reported for extensions and modifications of some of these systems. Optimum forensic sorting procedures are recommended.     

The appropriate use of psychotropic drugs

The history of psychiatric services and treatment is reviewed from the sedatives and psychotherapy of the 1930s, through electroconvulsive therapy in the 1940s, Rauwolphia and Chlorpromazine in the 1950s, followed by barbiturates then benzodiazepines in more recent times. The move to treatment in the community rather than in institutional settings is discussed, as is the need for care in the use of psychotropic drugs.     

Interaction of psychotropic drugs with phospholipids

The interactions of psychotropic drugs with phospholipids, including lysophosphatidylcholine, phosphatidylinositol, and lysophosphatidylserine, were studied using calmodulin-dependent cyclic nucleotide phosphodiesterase partially purified from the cortex of hog brain. All the compounds used inhibited both calmodulin- and phospholipid-stimulated phosphodiesterase activity but not the basal activity. Fluphenazine was confirmed by kinetic analysis to be a competitive inhibitor, with both calmodulin and phospholipid. Using fluphenazine-Sepharose affinity chromatography, it was demonstrated that fluphenazine did not interact with the enzyme. The potencies of antipsychotics such as fluphenazine in inhibiting the various phospholipid-dependent activations decreased in the following order: lysophosphatidylcholine-, phosphatidylinositol-, and lysophosphatidylserine-dependent activation. On the other hand, antidepressant drugs exhibited similar inhibitory potencies towards lysophosphatidylcholine- and phosphatidylinositol-dependent activation. Antipsychotic and antidepressant drugs appear to have different characteristics with regard to lipid-drug interaction.