Drugs for psychiatric disorders

Article Abstract:

This report presents general recommendations for the prescription of drugs used to treat psychiatric disorders: anxiety, depression, obsessive-compulsive disorder, bipolar disorder, psychoses and organic mental disorder. Adverse effects are discussed and listed in tabular form as well. Although several drugs are used to relieve anxiety, the benzodiazepines, a groups of similar drugs with varying physiologic actions, are the first-choice treatment. If taken with alcohol or other depressants, these agents can cause dangerous side effects. Chronic benzodiazepine use may result in physical dependence. Shorter-acting benzodiazepines are preferred in treating the elderly. Depression is a common problem that is often difficult to diagnose; many depressed patients suffer from anxiety, substance abuse and physical complaints. Tricyclic antidepressants were the first choice drug in the treatment of depression for many years, however, fluoxetine has become the most popular antidepressant because of its increased effectiveness and fewer side effects. Tricyclics should not be prescribed for patients with congestive heart failure or conduction abnormalities. Bipolar disorder, or manic depressive illness, is best treated by lithium. Most patients go through an initial period of adjustment when they begin lithium therapy. The margin between therapeutic and toxic doses is narrow; frequent monitoring of blood levels is essential. Toxic symptoms include, among others, confusion and ataxia. Psychoses are severe, mental disorders that lead to personality disintegration and loss of contact with reality. Antipsychotic drugs have the fastest effects on acute psychoses, acute psychotic episodes associated with metabolic disorders, drug reactions and some symptoms of schizophrenia. Antipsychotic drugs include phenothiazines, clozapine and haloperidol decanoate. Clozapine may be effective in treating schizophrenia that is resistant to other agents. In addition, it does not cause tardive dyskinesia, a movement disorder that is associated with many other antipsychotic agents. Many patients are at risk for developing organic brain syndrome, which is characterized by stupor, delirium or dementia. Susceptible patients include, among others, patients suffering from Alzheimer's disease and other degenerative disorders, brain tumor, metabolic disorders and infection. Organic mental syndromes respond quickly to antipsychotic drugs in low doses; relatively nonsedating agents are recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Depression, Mental, Depression (Mood disorder), Psychotropic drugs, Anxiety, Bipolar disorder, Obsessive-compulsive disorder, Obsessive compulsive disorder, Psychoses, Psychotic disorders, Organic mental disorder, Organic mental disorders

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Drugs for ambulatory asthma

Article Abstract:

This article discusses the drugs to treat asthma that requires treatment either occasionally or continuously. Drugs for the treatment of acute life-threatening episodes are not discussed. Adrenergic drugs, with adrenalin-like activity, are one of the main types of medications used. Beta-2-selective drugs produce dilation of airways with less stimulation of the heart than older, less specific adrenergic drugs. These are usually given via inhalers, although spacers, aerosol-holding chambers, are useful for those with limited inspiratory volumes or children who can not coordinate inhalation with inhaler discharge. Albuterol, terbutaline, and pirbuterol are among the beta-2-adrenergics, and are most effective for relief of acute symptoms. Corticosteroids may be given systemically or topically (inhaled), and are generally used in treatment of chronic asthma, as response to these drugs is not quick. Continued steroid treatment can prevent asthmatic symptoms, probably due to anti-inflammatory effects. More toxicity is associated with oral than inhaled steroids. Theophylline is less potent than adrenergic drugs. However, it is especially useful in combination with chronic steroid therapy, and has very low toxicity when dosages are appropriately tailored to the individual patient. Cromolyn sodium is useful only to prevent asthmatic symptoms, and has almost no toxicity. Ipratropium is a bronchodilator which enhances the effects of beta-2-adrenergic drugs. For treatment of occasional asthmatic episodes, inhaled beta-2-adrenergic agonists are the drugs of choice. Patients who are not responsive should be given short-term therapy with systemic corticosteroids. Chronic asthma is now commonly treated with inhaled steroids; theophylline can also be used. Some authorities feel that inhaled cromolyn should be tried first, especially in children, due to its minimal toxicity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Asthma, Antiasthmatic agents

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Topical drugs for vaginal candidiasis

Article Abstract:

Many medications are available in the US for topical (applied locally) treatment of vaginal candidiasis, or vaginal infection caused by Candida yeasts. Most, such as butoconazole, clotrimazole, miconazole, and terconazole, are chemically similar; nystatin is another drug useful in treating yeast infections. Some of these medications are now available without a prescription. The formulations, dosages, and costs of the prescription and nonprescription medications are presented in tabular form. All are effective for the treatment of vaginal candidiasis. No advantage has been demonstrated for an individual drug, and longer treatment regimens have not been proven more effective than shorter ones. Adverse effects are similar for all the medications, and can include burning and itching, local edema, and pain on urination or during intercourse. Variable amounts of terconazole, butoconazole, and miconazole may be absorbed and spread systemically, so that headache, fever, or hives may occur. In animal studies, large oral dosages damage embryos. The data suggest that all of these medications are safe and effective, but the nonprescription forms are available only in longer-term preparations, and at greater cost than the single-dose prescription form of clotrimazole. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dosage and administration, Candidiasis, Vulvovaginal, Vulvovaginal candidiasis, Nonprescription drugs, Antifungal agents

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