Chapter 20 Psychotropic Medications, Alcohol, and Drug Abuse Edited by Dr. Ryan Lambert-Bellacov, chiropractor for Back in the Game in West Linn, OR

2 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

CNS Stimulants 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

4 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

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

9 MAOIs Side effects Contraindications Interactions

10 Selective Serotonin Reuptake Inhibitors (SSRIs) First-line treatment of depression Fewer side effects Greater safety Increased patient compliance Block reabsorption of serotonin

11 SSRIs Side effects Caution Interactions

12 Selective Norepinephrine Reuptake Inhibitors (SNRIs) Nonstimulant –Attention-deficit hyperactivity disorder (ADHD) Non-controlled Side effects Contraindications and precautions Interactions

13 Heterocyclic Antidepressants Uses Side effects Interactions Precautions Interactions

14 Antimanic Agents Lithium Bipolar disorders (manic-depression) Side effects Signs of lithium toxicity Precautions Interactions

15 Anxiolytics Antianxiety medications Uses Side effects Contraindication or extreme caution Interactions

16 Preoperative Medications Relieve anxiety Provide sedation Light anesthesia Amnesia of operative events Anxiolytic effects Conscious sedation Side effects

17 Preoperative Medications Side effects Precautions Contraindications Interactions

18 Antipsychotic Medications and Major Tranquilizers Relieve symptoms of psychoses Relieve nausea and vomiting Potentiation of analgesics Side effects –Extrapyramidal reactions –Abnormal involuntary movement scale

19 Antipsychotic Medications and Major Tranquilizers Contraindications Precautions Interactions Patient education

20 Alcohol Ethyl alcohol, ethanol Psychotropic drug and CNS depressant Number one drug problem in the United States Alcohol poisoning

21 Alcohol Fetal Alcohol Syndrome (FAS) Treatment Chronic Alcoholism

22 Drug Abuse Use of drugs without therapeutic purpose Drug addiction –Tolerance –Psychological dependence –Physical dependence –Physiological withdrawal effects

23 Drug Abuse Habituation Chemical dependency Health care workers have access to prescription drugs –Can get involved in illegal use of psychotropic drugs

24 Amphetamines Produced and prescribed legally Can be produced in illegal labs Symptoms of chronic abuse Symptoms of acute toxicity Treatment

25 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

26 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

27 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

28 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

29 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."Back in the Game 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 re- injury.PHYSICIAL THERAPY 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.