Download Chapter 20 - Back in the Game Chiropractic Wellness

Chapter 20
Psychotropic
Medications, Alcohol,
and Drug Abuse
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
Psychotropic Medications
• Substance affecting the brain
• Therapeutic effect on mental
processes
• Classifications
– CNS stimulants
– Antidepressants
– Anxiolytics
– Antipsychotic
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
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CNS Stimulants
•
•
•
•
•
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Promote CNS functioning
Uses
Side effects
Contraindications or precautions
Pediatric precautions
Patient education
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
Antidepressants
• Depression
– Chemical imbalance
• Neurotransmitters
– Dopamine, serotonin, and
norepinephrine
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
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Antidepressants
• Categories
– Tricyclics
– Monamine oxidase inhibitors
– Selective serotonin reuptake inhibitors
– Heterocyclic antidepressants
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
Tricyclics
• Improve effect of norepinephrine and
serotonin by blocking their reuptake
pre-synaptically
• Strong anticholinergic activity
• Delayed action
• Frequently given at bedtime
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
Tricyclics
• Side effects
• Contraindications or extreme caution
• Interactions
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
Monamine Oxidase Inhibitors
(MAOIs)
• Increase concentrations of serotonin,
norepinephrine, and dopamine
• Inhibit monamine oxidase enzyme
• Rarely used today
• Given two weeks after tricyclics have
been discontinued
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
MAOIs
• Side effects
• Contraindications
• Interactions
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Selective Serotonin Reuptake
Inhibitors (SSRIs)
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•
•
•
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First-line treatment of depression
Fewer side effects
Greater safety
Increased patient compliance
Block reabsorption of serotonin
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SSRIs
• Side effects
• Caution
• Interactions
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Selective Norepinephrine
Reuptake Inhibitors (SNRIs)
• Nonstimulant
– Attention-deficit hyperactivity disorder
(ADHD)
•
•
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•
Non-controlled
Side effects
Contraindications and precautions
Interactions
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Heterocyclic Antidepressants
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•
Uses
Side effects
Interactions
Precautions
Interactions
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Antimanic Agents
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Lithium
Bipolar disorders (manic-depression)
Side effects
Signs of lithium toxicity
Precautions
Interactions
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Anxiolytics
•
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•
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Antianxiety medications
Uses
Side effects
Contraindication or extreme caution
Interactions
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Preoperative Medications
•
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Relieve anxiety
Provide sedation
Light anesthesia
Amnesia of operative events
Anxiolytic effects
Conscious sedation
Side effects
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Preoperative Medications
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Side effects
Precautions
Contraindications
Interactions
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Antipsychotic Medications and
Major Tranquilizers
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Relieve symptoms of psychoses
Relieve nausea and vomiting
Potentiation of analgesics
Side effects
– Extrapyramidal reactions
– Abnormal involuntary movement scale
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Antipsychotic Medications and
Major Tranquilizers
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•
•
•
Contraindications
Precautions
Interactions
Patient education
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Alcohol
• Ethyl alcohol, ethanol
• Psychotropic drug and CNS
depressant
• Number one drug problem in the
United States
• Alcohol poisoning
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Alcohol
• Fetal Alcohol Syndrome (FAS)
• Treatment
• Chronic Alcoholism
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Drug Abuse
• Use of drugs without therapeutic
purpose
• Drug addiction
– Tolerance
– Psychological dependence
– Physical dependence
– Physiological withdrawal effects
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Drug Abuse
• Habituation
• Chemical dependency
• Health care workers have access to
prescription drugs
– Can get involved in illegal use of
psychotropic drugs
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Amphetamines
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Produced and prescribed legally
Can be produced in illegal labs
Symptoms of chronic abuse
Symptoms of acute toxicity
Treatment
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Marijuana
• Tetrahydrocannabinol (THC)
• Classified as CNS depressant
• Euphoriant, sedative, and
hallucinogen
• Treatment
• Side effects
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
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Cocaine
• CNS stimulant
• Euphoriant and increased expenditure
of energy
• Medical use is local anesthetic
• Highly addictive
• Side effects
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
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Hallucinogens
•
•
•
•
Lysergic acid diethylamide (LSD)
Phencyclidine (PCP)
Side effects
Flunitrazepam (Rohypnol)
– Roofies
– Date-rape drug (induces amnesia)
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
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Role of Medical Personnel
•
•
•
•
Thorough knowledge
Education
Competent care
Complete and accurate record
keeping
• Report drug abuse
• Resources for medical personnel with
addiction problems
Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR
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•
•
•
Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than
making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body
whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through
it."
PHYSICIAL THERAPY
We believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual
techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep
their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent reinjury.
At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in
today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care
and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training
in sports medicine, heads Back In The Game.
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