CCJ4938 Complete Study Guide for Exam IIIGoode Chapters 11 & 13-15Chapter 11: The Pharmaceutical Neuroleptics • Government controls drugs to decrease their harm to people • One way that people control drugs is by requiring medical prescriptions for their purchase and distribution. They do this by only making licensed medical professionals, usually physicians, render diagnosis, typically of an ailment or pathology, for which given medicine provides relief. • Pharmaceuticals – prescribed medicinal drugs that are neuroleptics – substances or medications that “seizes hold” of the central nervous system in order to treat the patient o Neuroleptics reduce anxiety or depression by inducing a more “normal” state of mind:o 1. Calming agents: Sedatives – A category of drugs that produce a calming, soothing effect and Tranquilizers – A term that is sometimes used to describe sedatives; formerly, it applied to the benzodiazepines and benzodiazepine-type drugs such as Valiumo 2. Sleep-inducing agents: Hypnotics – An agent that potentiates sleepo 3. Antipsychotics – Substances used to treat mental disorders; they include the phenothiazines, haloperidol (Haldol), and risperidone (Risperdal). They do not produce a pleasure sensation and are not used recreationally (usually for schizophrenia or bipolar)o 4. Antidepressants – Mood elevators; a category of substances used to combat clinical depression; including Prozac, Xanax, Paxil, and Zoloft. They do not produce pleasurable intoxication in nondepressed individuals and are not used recreationally. They alleviate feelings of dejection, sadness and gloom, and dysphoria• All four substances are pharmacologically miscellaneous, but the users share a common thread: they are suffering from an undesirable mental condition are taking medication to relieve suffering, except for maybe sedatives which can be used for recreational purposes. • Depression carries two entirely different meanings: 1) a mood of gloominess and despair, and 2) a mechanism of reducing the body’s organic functioning. The Top 200 Prescription Drugs• In 2009, there was a 5% increase in prescription drugs, but revenues have flattened in spite of substantial increases in prescription filled, largely because of increases in the use of generics, which are cheaper than the brand-name drugs. o In 2009, generics accounted for 75 of prescriptions dispensed, up from 57% in 2004• Most pharmaceutical drugs – roughly 8/10 – have no psychoactive effects and are prescribed to treat bodily ailments such as heartburn, asthma, etc… (Focus is on the body, not the mind).• A few popular psychoactive drugs are top-selling pharmaceuticals (i.e. Ambien and Lunesta – popular sleeping aids), but they are usually not taken recreationally (not pleasurable). • The most popular drug category among the pharmaceuticals was made up of antipsychotics; used to combat schizophrenia (Seroquel, Abilify, and Zyprexa).• Antipsychotics accounted for $14.6 billion of the total pharmaceutical pie. • Antidepressants, the 4th largest selling type of pharmaceutical drugs, are also not used for recreational purposes but racked up $9.9 billion in sales in 2009 (Lexapro, Zoloft, Cymbalta)• Antidepressants stand in 5th place with respect to causing overdose deaths; according to the DAWN most of them were suicides. • A number of narcotics – a popular recreational drug – did rank among the top 200 prescription drugs in 2009 (hydrocodone is ranked 1st, Oxycodone, OxyContin, and Endocet are ranked high)o They are more popular than illegal opiates and heroin• According to DAWN, narcotics are the top drug type in causing overdose deaths, but most of these deaths are not caused by heroin, but by the artificial opiates, including oxycodone and hydrocodone. A substantial proportion of these suicides are caused by a lethal drug normally prescribed and administered for a legitimate purpose.• Sedative-hypnotics tranquilizer, the benzodiazepines – are taken as anti-anxiety agents and stand in good stead on the 200 prescription drugs list (diazepam, the generic for Valium, probably the all-time best-selling prescription drug is now ranked 111th, clonazepam, lorazepam)• Anxiety is a big business and Benodiazepines are not only used therapeutically but it attracts a fairly substantial amount of recreational users (According to DAWN, it’s 2nd overdoses)• All brand-name drugs decline in sales after their peak in popularity:o 1.) The patent held by the pharmaceutical company that initially markets a prescription drug is valid for only 20 years from the time of filing, and it may take as many as 10 years for the drug to reach the market. Therefore, popularity declines after patent After the drug falls into the public domain, another company can sell the generic brand that is also more cost affective If a drug is successful, a company will try to prevent it from entering the public domain by blocking its generic sales through a variety of legal maneuvers (filing new patents), but eventually the patent will run out. Among the top 200 drugs, all the benzodiazepines and all but one of the narcotics (OxyContin) are generics.o 2.)Physicians become aware of some undesirable side effects and search for less toxic substances Pharmaceutical corporations have to submit initial reports on a drug’s safety and effectiveness to the Food and Drug Administration and they may understate the drug’s side effects, but overstate the therapeutic effectiveness due to profit When a drug becomes widely use, more types of patients take it than initial tests and side effects may reach mass media (i.e. Prozac, Halcion) Hence, the total volume of prescriptions that are written for a given drug category may remain stable or even rise, while the number of particular drug products (whether brand named or generic) will rise and fall precipitously For major categories such as narcotics, sedatives, hypnotics, tranquilizers, antipsychotics, and antidepressants, the trend line will not change a great deal from one decade to anotherSedative-Hypnotics: An Introduction • The story behind sedative drugs start with the human central nervous system (CNS): too anxious to properly function, too troubled to fall asleep, etc…• Sedatives (sedative-hypnotics) – category of drugs that produce a calming/soothing effecto They are downers or general depressants that retard signals passing
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