Antidepressant Drugs

Drug treatment of depression is based on increasing serotonin (5-HT) or NE (or both) at synapses in selective tracts in the brain. This can be accomplished by different mechanisms.

Treatment takes several weeks to reach full clinical efficacy.

1. Tricyclic antidepressants (TCAs)
a. Amitriptyline
b. Desipramine
c. Doxepin
d. Imipramine
e. Protriptyline

2. Selective serotonin reuptake inhibitors (SSRIs)
a. Fluoxetine
b. Paroxetine
c. Sertraline
d. Fluvoxamine
e. Citalopram

3. Monoamine oxidase inhibitors (MAOIs)
a. Tranylcypromine
b. Phenelzine

4. Miscellaneous antidepressants

a. Bupropion
b. Maprotiline
c. Mirtazapine
d. Trazodone
e. St. John’s Wort

Antimania Drugs

These drugs are used to treat manic-depressive illness.

1. Lithium
2. Carbamazepine
3. Valproic acid

Isoflurane (Forane) MAC 1.3%, Blood/gas solubility ratio 1.4
- Better muscle relaxation than with the other halogenated anesthetic agents.
- Isoflurane markedly potentiates the action of the neuromuscular blocking agents.
- Produces rapid onset and recovery of anesthesia.
- Does not sensitize the heart to catecholamines.
- Produces respiratory depression, but produces less cardiovascular depression
- than does halothane.
- It has an extremely low degree of metabolism and is apparently relatively
- nontoxic.

Fifth Generation:

These are extended spectrum antibiotics.

Ceftaroline, Ceftobiprole

Examples of calculations of doses of vasoconstrictors

Ratio concentrations represent grams per millilitre

1:100,000 = 0.01 mg/mL or 10 µg/mL

1:200,000 = 0.005 mg/mL or 5 µg/mL

1:50,000 = 0.02 mg/mL or 20 µg/mL

1 cartridge of epinephrine 1:200,000 = 9 µg

1 cartridge of epinephrine 1:100,000 = 18 µg

1 cartridge of epinephrine 1:50,000 = 36 µg

1 cartridge of levonordefrin 1:20,000 = 90 µg

 Beta - Adrenergic Blocking Agents 
 
 Mechanisms of Action  
 
- Initial decrease in cardiac output, followed by reduction in peripheral vascular resistance. 
- Other actions include decrease plasma renin activity, resetting of baroreceptors,  release of vasodilator prostaglandins, and blockade of prejunctional beta-receptors.  

Advantages 

- Documented reduction in cardiovascular morbidity and mortality. 
- Cardioprotection: primary and secondary prevention against coronary artery events (i.e. ischemia, infarction, arrhythmias, death). 
- Relatively not expensive. 

Considerations 

- Beta blockers are used with caution in patients with bronchospasm. 
- Contraindicated in more than grade I AV, heart block. 
- Do not discontinue abruptly. 

 Side Effects
- Bronchospasm and obstructive airway disease. 
- Bradycardia  
- Metabolic effects (raise triglyerides levels and decrease HDL cholesterol; may worsen insulin sensitivity and cause glucose intolerance). Increased incidence of diabetes mellitus.  
- Coldness of extremities.  
- Fatigue. 
- Mask symptoms of hypoglycemia. 
- Impotence. 

Indications 

- First line treatment for hypertension as an alternative to diuretics. 
- Hypertension associated with coronary artery disease.
- Hyperkinetic circulation and high cardiac output hypertension (e.g., young hypertensives). 
- Hypertension associated with supraventricular tachycardia, migraine, essential tremors, or hypertrophic cardiomyopathy. 

Beta adrenergic blocker Drugs

Atenolol 25-100
Metoprolol 50-200 
Bisoprolol 2.5-10 

Methicillin

Methicillin is an antibiotic related to penicillin and other beta-lactam containing antibiotics. It is often used to treat infections caused by bacteria carrying an antibiotic resistance, e.g., staphylococci. As methicillin is deactivated by gastric acid, it has to be administered by injection.

Uses Methicillin serves a purpose in the laboratory to determine antibiotic sensitivity in microbiological culture.