Psihotropele

I. Psiholeptice neuroleptice
tranchilizante
sedative
II. Psihoanaleptice antidepresive
excitantele SNC
nootrope
analeptice (medulare,
bulbare, generale)
III. imoizoleptice preparate de litiu
valproa!ii
carbamazepina
blocantele canalelor de calciu
I". Psihodisleptice dietilamida acidului lizerginic
psiloscibina, mescalina
I. #li$atici
- Clorpromazina % haloperidol
- &evomepromazina % droperidol
- ri$lupromazina % tri$luperidol
- propazina (promazina) % benperidol
% metorina
II. Piperidinici
- tioridazina
- periciazina
- pipotiazina % pen$luridol
- perimetazina % pimozid
% $luspirilen
III. Piperazinici
- tri$luoperazina 'eriva!ii benzamidei
- $lu$enazina % sulpirida
- per$enazina % amisulpirida
- tioproperazina
- proclorperazina 'eriva!ii dibenzodiazepinei
% clozapina
Derivaii fenotiazinici
Derivaii butirofenonici
Derivaii difenilbutil piperidinici
Derivaii tioxantinici
- clorprotixen
- % tiotixen
- % clopentixol
- % $lupentixol
- zuclopentixol
Diverse grupe
- rezerpina
- sultoprid
- loxapina
- risperidon
- tiaprid
'eriva!ii indolului
- carbidina
I. Clasificarea neurolepticelor dup( structura chimic(
Clasificarea neurolepticelor
II. dup( aspectul clinic
A. neuroleptice sedative se caracterizeaz( prin e$ect sedativ intens )i
antipsihotic moderat cu $enomene neurovegetative
marcate.
clorpromazin(, levomepromazin(, clorprotixen, clozapin(, rezerpin(
B. neuroleptice medii (mici) posed( e$ect sedativ )i antipsihotic
moderat, $(r( e$ecte adverse marcate
tioridazina, propazina, periciazina, alimemazina, tiaprid, risperidon
C. neuroleptice polivalente posed( e$ect antipsihotic intens cu ac!iune
sedativ( sau dezinhibitoare )i deregl(ri
extrapiramidale marcate
haloperidol, droperidol, tri$luperidal, $lu$enamin(, tioproperazin(,
pipotiazin(, $luspirilen, pimozid, pen$luridol, olanzapin(, $lupentixol,
zuclopentixol, sultoprid.
D. Neuroleptice dezinhibitorii mani$est( e$ect antipsohotic moderat iar
cel sedativ slab sau absent cu $enomene
extrapiramidale moderate sau marcate
per$enazin(, tri$luopirazin(, sulpirid(, amisulpirid(, corbidin(.
TRAC!I"I#AT$"$
*rupele de remedii ce selectiv +nl(tur( st(rile de spaim(,
$ric(, +ncordare emo!ional(, dezadapta!ie la mediul
ambiant )i sunt e$ective +n neuroze )i st(ri intermediare
Clasificarea
,#-./0
(puternice)
Posed( ac!iune anxiolitic( )i sedativ(
pronun!at( )i marcat(, diapazon
terapeutic mare, in$luen!( negativ(
asupra reac!iilor psihomotorii,
per$orman!ei de munc(, coordon(rii
$ine a mi)c(rilor.
A. Benzodiazepine
% diazepam
% $enazepam
% clordiazepoxid
% oxazepam
% nitrazepam
% medazepam
% clonazepam
% bromazepam
% alprazolam
% temazepam
% clorazepat
B. ebenzodiazepinice
% benzoclidina
% trimetozina
% lonetil
C. Preparate co%binate
% amixid
% librax
% antares 123
D. Cu aciune antidepresiv&
% opipramol
% alprazolam
,IN./0
(de zi)
Se caracterizeaz( prin ac!iune
anxiolitic( )i sedativ( redus(,
$(r( in$luen!e negative v(dite
asupra reac!iilor psihomotorii,
per$orman!ei de munc(. Se
utilizeaz( +n tratamentul
ambulator.
% pzoroxan
% piracetam
% $enilbut
% propranolol
% trimetazina
% mebicarul
% meprobamat
% to$izopam
'edativele
I. 4arbituricele (+n doze subhipnotice)
% barbital, $enobarbital, amobarbital
II. 4enzodiazepinele
% diazepam, $enazepam, clordiazepoxid etc.
5. 4romurile
% natriu bromid, 6aliu bromid, calciu bromid
I(. 'e provenien!( vegetal(
0xtracte )i tincturi din7 odolean ("aleriana), p(ducel (Crataegus),
pasi$lor( (Passi$lora), talpa g+)tei (&eonurus), bu8or (Paeonie), cava
cava (antares 123)
(. 9
1
antihistaminice
di$enhidramin(, prometazin(, clorpiramin(, clemastin( etc.
(I. Preparate combinate
"alocordin, valocormid, valosedan, corvalol, belataminal, beloid,
extraveral, belaspon, altalex, novo pasit, persed etc..
Ti%oizolepticele (normotimicele)
1. Preparatele litiului
&itiu carbonat, litiu nicotinat
2. "alproa!ii
#cidul valproic, valproatul de natriu, valproat de calciu
5. Carbamazepina
:. 4locantele canalelor de calciu
"erapamil, diltiazem, ni$edipin(
Antidepresivele ( an III)
I. Clasi$icarea dup( mecanismul de ac!iune ( an III)
#. preparate ce inhib( recaptarea neuronal( a monoaminelor.
1. Neselective7 clomipramin(, a%itriptilin&) i%ipra%in&) doxepin&)
pipofezin&) butriptilin(, clovoxamin(.
2. Selectiv(7
a) ce blocheaz( preponderent recaptarea serotoninei7 fluoxetin&)
trazodon&) paroxetin( sertralin(, $luvoxamin(, citalaprom, $emoxetin(, i$oxetin(.
b) ce blocheaz( preponderent recaptarea noradrenalinei7
%aprotilin&) a%oxapin&) desipramin(, proptriptilin(, nortriptilin(, oxaprotilin(,
dosulepin(, lo$epramin( etc.
c) ce blocheaz( preponderent recaptarea dopaminei7
no%ifensin&) a%ineptin&) bupropion, diclo$ensin(.
4. preparate ce inhib( metabolismul monoaminelor (inhibitorii ,#.)
1. cu ac!iune ireversibil(7
a) neselectiv(7 niala%id&) fenelrina) tranilcipro%ina) iproniazida etc.
b) selectiv(7 ,#. # clorgilin&) pargilin(, garmin(,
,#. 4 deprenil) garmalin(, bazinaprin(
2. cu ac!iune reversibil(7
a) neselectiv(7 metralindol, caroxazon(, cimoxaton
b) selectiv( (,#. #)7 pirlindol) %oclobe%id&) toloxaton, tebrindol,
be$ol, bo$loxaton.
C. Preparate cu mecanisme diverse
/itanserin(, mianserin(, feoprozid&) cefedrin&) S adenozilmetionin(,
risperidon, iprindol, viloxazin(, ipipramol, alprozolam.
III. 'up( predominarea e$ectelor (an ")
#. cu e$ect sedativ
amitriptilin(, trimipramin(, doxepin(, amoxapin(, mianserin(, pipo$ezin(,
opipramol, $luvoxamin(, alprazolam, trazodon(, $emoxetin(buopriptilin(,
clovoxamin(, metazoclon(.
4. cu e$ect activator desipramin(, imipramin(, ce$edrin(, nortriptilin(,
tranilcipromin(, viloxazin(, $luoxetin(, amineptin(, moclobemid(, nialamid(,
$enelzin(, protriptilin(, bupronion, citalopram, stamoxetin( etc.
C. cu e$ect echilibrant maprotilin(, dosulepin(, tianeptin(, lo$epramin(,
ritanserin(, sertralin(, paroxetin(, pirlindol, clomipramin(, midalcipram,
caroxazon.
'. cu e$ect anxiolitic opipramol, alprazolam, $luvoxamin(, sertralin(,
mianserin(, clomipramin(.
PREPARATELE HORMONALE ALE HIPOTALAMUSULUI
I. Analogii hormonului foliculostimulant i luteinizant.
% *onadorelina analogii ei sintetici7
- buserelina (supre$act, etc)
- gozerelina (zoladex)
- na$arelina (sinarel, etc)
- leuprorelina (lupron)
- deslorelina.
II. Analogii rilizing hormonului somatotrop.
- sermorelina (geret, groliberina)
III. Analogii somatostatinei.
- somatostatina (stilamina)
- octreotida (sandostatina)
I(. Analogii rilizing hormonului corticotrop.
- corticoliberina
(. Analogii rilizing hormonului tireotrop.
- protirelina (rele$act etc).
PREPARATELE HORMONALE ALE HIPOFIZEI
I. Analogii gonadotropinelor
A. Analogii hormonului foliculostimulant
% uro$olitropina ($erilitina etc)
B. Gonadotropina corionic uman
% (pregnil, pro$azi etc)
C. Gonadotropina uman de menopauz
% menotropina (pergonal, humegon etc)
(;S9 < &9 = 1 7 1)
% menotropina (pergogrin )
(;S9 < &9 = 2 7 1)
II. Analogii corticotropinei (ACTH
% corticotropina
% tetracosactida (sinacten etc)
III. Analogii !o"atotropinei (STH
% somatotropina (humatrop, genotropina etc)
% somatrem
I#. Analogii tireotropinei (TTH
% tirotropina (tireostimulina etc)
#. Preparatele $or"onale ale ne%ro$ipo&i'ei
A. Analogii vasopresinei
% desmopresina (adiuretina S')
% terlipresina (remestip)
2. Analogii oxitocinei
% oxitocina (sintocinon)
% demoxitocina (sandopart, dezaminoxitocina)
% metiloxitocina
PREPARATELE ANTIHORMONALE
I. Antie!trogenii( % clomi$en (clostilbegit, clomid etc.)
- tamoxi$en (tami$en, zitazonium etc.)
- toremi$en ($areston)
II. Antiproge!tati)ele(
% mi$epristona (mi$egina)
III. Antiandrogenii(
% ciproteron acetat (androcur etc)
% $lutamid ($lucinom, eulexin etc)
% nilutamid (anandron)
% $inasterid
% 'iane 5>
% Serenoa repens (permixon)
I#. Anticorticoi'ii(
% metirapona
% aminoglutetimida
% mitotan (lisodren)
#. Antitiroidienele(
% tiamazol (mercazolil)
% propiltiouracil
% preparatele iodului
% perclorat de potasiu etc.
#I. In$i*itorii !ecre+iei prolactinei(
% bromocriptina (parlodel, serocriptina etc)
% lizurid (lizenil)
% hinagolid (norprolac)
#II. In$i*itorii !inte'ei $or"on%l%i l%teini'ant (
% megestrol
% buserelina
#III. In$i*orii LH ,i FSH(
% danazol (danol, danovan)
I-. Analogii !o"ato!tatinei(
% octreotida
% somatostatina.
-. Antagoni,tii aldo!teron%l%i(
- spironolactona
- triamteren
- amilorid
ATIDIAB$TIC$"$ *RA"$
'unt co%pu+i de sintez& activi pe cale oral&) care pot fi eficace
,n unele for%e u+oare sau %edii de diabet) atunci c-nd boala nu
poate fi controlat& nu%ai prin diet& iar in.ectarea insulinei nu
este indispensabil&.
'ulfa%idele
I genera+ie
- tolbutamida
- clorpropamida
- tolazamida
% acetohexamida
II. genera+ie
gliburid
glipizida
glibenclamida
gliclazida
% gli?uidona
Biguadinele
I de scurt&
durat&
(:%@ ore)
- eu$ormina
- met$ormina
II de durat&
lung&
/1:%1@ ore)
bu$ormin %
retard
di$ormin
retard
Tiazolidindionele
% ciglitazon
- pioglitazon
% englitazon
Tetrazaharidele
acarboza
miglitol
% emiglitat
Diverse
guargum
ar$azetina
linoglirid
% midaglizol
D$RI(A0II '1"2*"I"1R$ICI
C"A'I2ICAR$A
D1P3 4$$RA0II
I generaie
- clorpropamida
- tolbutamida
- tolazamida
- acetohexamida
- carbutamida
II generaie
- glibenclamida
- glipizida
- gliclazida
% glerenorm
% glicvidona
% glihornurida
D1P3 D1RATA AC0I1II
5. De scurt& durat& /6 7 8 ore9
- tolbutamida
- gli?uidona
:. De durat& inter%ediar& /8 7 58 ore9
- acetohexamida
- tolazamida
- glihenclamida
- glipizida
- gliclazida
;. De lung& durat& /:< 7 =: ore9
- clorpropamida
PR$PARAT$"$ !*R>*I"*R '$?1A"I
$strogeni Progestative Androgeni
5. aturali
- estron(
- estradiol
- estriol
:. 'e%isintetici
- etinilestradiol
;. esteroidieni
sintetici
- hexestrol
- dietilstilbas
trol
- dienestrol
- meterstrol
- octestrol etc.
5. aturali
- progesteron
:. 'e%isintetici
a) analogii progesteronului
(deriva!i de pregnan)
- hidroxiprogesteronul
- medroxiprogesteronul
- clormadinon(
- megestrol
b) analogii testosteronului
(deriva!i de estron)
- norestisteron
- levonorgestrel
- etinodiol
- alilestradiol
- linestrol
- etisteron
5. aturali
- testosteron
- dihidrotestosteron
:. 'e%isintetici
a) testosteronul sub $orm( de
eteri7
- acetat, propionat,
$enilpropionat, enantat,
decanoat, izocaproat
b) % metiltestosteron
- $luoximesteron
perorale
- mesterolon
c) preparate combinate
- testenat
- sustanon 2>3
ATIADR*4$
II
C&#SI;IC#/0
#
I. #ntagoni)ti
$iziologici
- estrogenii
- progesteron
II. #ntagoni)ti
competitivi cu
androgenii
- ciproterona
- $lutamida
- nilutamida
- 'iane%5>
III. #ntagoni)ti ce
inter$er( sinteza
testosteronului )i
altor androgeni
- $inasterida
- serenoa repens
I". #nalogii
hormonului
eliberator al
gonadotro$inelor
- gozerelina
- leuprolida
C*TRAC$PTI($"$ *RA"$
I. Contraceptive hormonale estroprogestative
A.
Monofazice
B. Bifazice C. Trifazice
0tinilestradiol
< gestoden
minulen,
$emulen
0tinilestradiol
< levonorgest
%rel
microginon 21,
2AB minisistot,
ovidon, rigevi%
don
0tinilestradiol
< noretisteron
Non%ovlon
0tinilestradiol
< norgestrel
&o%$emenal
0tinilestradiol
<
levonorgestrel
anteovin
0tinilestradiol
< clormadinon
neo%eunormin
0tinilestradiol <
levonorgestrel
tricvilar 21, 2AB
trinordiol, tri%
regol, trisiston
0tinilestradiol <
noretisteron
sin$azic, trino%
vum
II. Preparate ce
con!in gestagen
- &inestrenol
excliuton
- Norgestrelaret
III.
Contraceptive
postcoitale
- &evonogest
rel postinol
I". Contraceptive
%depo
- ,edroxiprogester
on 'epo%
provera
". Contracep%
tive implante
subcutanate
- &evonogestrel
norplant
- Norgestrel %
aret
"I. Contraceptive
vaginale
- 4enzalconii
clorid
$armatex
- Nonoxinol
conceptrol,
sterelin, pantex
oval
"II.
Contracep%tive
intrauterine
- &evonogest
rel mirena
- *ine
5A3 S
C"A'I2ICAR$A !IP*TIC$"*R
I. 4enzodiazepine
- $lurazepam
- $lunitrazepa
m
- nitrazepam
- lormetazepa
m
- clotiazepam
- brotirolam
- temazepam
- oxazepam
"I. Nebenzodiazepine
#. 'er. imidazolinidinici
- zolpidem
4. 'er de ciclopirolon(
% zopiclona
II. 4arbiturice
- barbital
- $enobarbita
l
- amobarbital
- butabarbital
- ciclobarbita
l
- pentobarbit
al
III. 91%antihistaminice
- di$enhidramina
- doxilamina
- prometazina
- clorpiramina
I".'eriva!ii *#4# )i
predecesorii serotoninei
- $enibut
- oxibatul de Na
- &%tripto$an
". 'eriva!ii ali$atici
A. Alde$ide
- cloralhidrat
.. Ureide aciclice
- bromizoval
- carbromal
"II. 'iverse grupe
#. ranchilizante
- diazepam
- clordiazepoxid
- clonazepam
- lorazepam
- medazepam
- prazepam etc
C. Neuroleptice
% clorpromazina
% droperidol etc.
'. Piperidindione
- glutetimida
- metiprilona
0. Chinazolone
% metacvalona
4. Sedative
- preparatele de
valerean(
- novo%pasit
+
;. Carbama!ii
- meprobamat
- etinamat
"III. Combinate
- reladorm
- nervo$lux
C"A'I2ICAR$A !IP*TIC$"*R D1P3 D1RATA AC0I1II
Durata Instalarea
efectului
Durata
efectului
T @
I. 'C1RT3
brotizolam, triazolam,
temazepam, clotiazepam,
midazolam, 6etazolam, oxazepam,
ciclobarbital, secobarbital,
pentobarbital, zolpidem,
zopiclon(, bromizoval, carbromal
rapid( (13%1> min) 2%> ore 2%13 ore
II. >$DI$
lormetazepam, nitrazepam,
$lunitrazepam, amobarbital,
glutetimid(, metiprilon(,
metacvalon( cloralhidrat,
di$enhidramin(, clorpiramin(,
prometazin(, meprobamat,
&%tripto$an, butabarbital.
23%:3 min :%C ore 13%:3 ore
III. "143
;lurazepam, diazepam,
clordiazepoxid, barbital,
$enobarbital.
:3%@3 min A%12 ore 53%D3 ore
2actorii inhibitori ai funciei tro%bocitelor la diferite etape
de activare +i preparatele antiagregante
Aciunea tro%bocitelor
;actorul Eillebrand
#nticorpi $a!( de glicoproteidele Ib
#nticorpi $a!( de $actorul Eillebrand
;ragmente peptidice inactive ale
$actorului Eillebrand
% 'ipiridamol%
Agregarea tro%bocitelor
Calea ciclooxigenazic( A
Ciclooxigenaza #spirina, #INS
romboxan #
2
sintaza 'ezoxiban
romboxan #
2
receptor %
Sintaza )i receptorul tromboxanic /idogrel
#denozin di$os$at iclopidina, clopidogrel
rombina Ilirudina, ilirulog. #ntagoni)tii
receptorului trombinic
Serotonina Fetanserina
;actorul activator trombocitar %
*licoproteidele II b G III a #nticorpii monoclonali (absiximab)
#ntagoni)tii peptidici (epti$ibatid)
#ntagoni)ti nepeptidici (xemilo$iban,
orto$iban, ledra$iban etc.)
Inhibitorii $os$odiesterazei dipiridamol
C&#SI;IC#/0# #NIC.&IN0S0/#HIC0&./
1. IJ./ /0"0/SI4I&0 0'/.;.NII&
(13 23 ,IN)
2. ,.'0/# /0"0/SI4I&0 N0.SI*,IN#
*#&#N#,IN#
0H0/IN#
PI/I'.SI*,IN#
'ISI*,IN#
#,40N.NII&
#,IPI/I'IN#
5. I/0"0/SI4I&0 C.,PIJII ./*#N.;.S;./ICI
#. C# ,0'IC#,0N0 P#/#.K.NI&
0C.I.P#I&
#/,IN#
4. C# P0SICI'0
C. C# SI4S#NL0 C9I,IC0 ,I&I#/0
II. 'IPM #CLIIN0# P/0P.N'0/0NM7
#. I4I&II 'I*0SI", "0HICII I/IN#/0
N0.SI*,IN#, 0H0/IN#, PI/I'.SI*,IN#,
'ISI*,IN#, #,IPI/I'IN#, *#&#N#,IN#
4. .C9II&II
0H0/IN#, P#/.K.NI&, 0C.I.P#I&,
N0.SI*,IN#, '0,0C#/II&
C. ,ISCI&#I/II S/I#0
*#&#N#,IN#, 0'/.;.NII&, 'ISI*,IN#,
PI/I'.SI*,IN#, #,40N.NII&, #,IPI/I'IN#,
N0.SI*,IN#
'. SNC
*#&#N#,IN# (;IH.SI*,IN#) 0H0/IN#
C&#SI;IC#/0# #'/0N.4&.C#N0&./
1.#&;# #'/0N.4&.C#N0&0
#. N0S0&0CI"0 ;0N.&#,IN# ;0N.KI40NH#,IN#,
.&#H.&IN#, NIC0/*.&IN#, /.P.'I;0NI&,
'I9I'/.0/*..KIN#, 'I9I'/.0/*.#,IN#,
C&./P/.,#HIN#, &0".,0P/.,#HIN#,
'/.P0/I'.&
4. S0&0CI"0 #&;# 1 P/#H.SIN#, 0/#H.SIN#,
#,SI&#SIN#, '.K#H.SIN#,
#&;IH.SIN#, IN'./#,IN#
#&;# 2 I.9I,4IN#
2.40# #'/0N.4&.C#N0&0
A. $'$"$CTI(0 P/.P/#N.&.&, .KP/0N.&.&,
PIN'.&.&, #&P/0N.&.&,
I,.&, S.#&.&, N#'.&.&,
4.PIN'.&.&, ,0IP/#N.&.&
B. CARDI*'$"$CTI($ 7 #&IN.&.&, #0N.&.&)
,0.P/.&.&, 4IS.P/.&.&,
#C04I.&.&, 40#K.&.&,
N04I".&.&
C. C1 ACTI(ITAT$ 'I>PAT*>I>$TIC3 ITRI'$C3 7
PIN'.&.&, .KP/0N.&.&, 4.PIN'.&.&, #C04I.&.&,
#&P/0N.&.&
D. C1 AC0I1$ >$>BRA*'TABI"I#AT*AR$
P/.P/#N.&.&, #C04I.&.&, .KP/0N.&.&,
#&P/0N.&.&
$. C1 AC0I1$ (A'*DI"ATAT*AR$ 7 C0&IP/.&.&,
C#/0.&.&, 40"#N.&.&
5. #&;# % 40# #'/0N.4&.C#N0&0
&#40.&.&, P/.K.'.&.&, C#/"0'I&.&
:. '.P#,IN.4&.C#N0&0
,0.C&.P/#,I'#, C&./P/.,#HIN#, 9#&.P0/I'.&,
'/.P0/I'.&, CIH#P/I'#
>. SI,P#.&IIC0&0
/0H0/PIN#, *I#N0I'IN#, 4/0I&II&, ,0I&'.P#
C"A'I2ICAR$A > C*"I*B"*CAT$"*R
1. $'$"$CTI($ #/.PIN#, SC.P#&#,IN#,
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