Praveen.K.PM PharmDrug Warehouse Manager, Kerala Medical Services Corporation Ltd

Psychotic & narcotic drugs

Behavior

Body controlLeg control

smell

Psychotic & narcotic drugs

Schedule – H (psychotic drugs)Dugs that could be dispensed only on the prescription of a registered medical practitioner.

Schedule – X(Narcotic drugs)Drugs that could be dispensed only on the hand written prescription of a registeredmedical practitioner for a specific period of time and should be recorded. .

Psychotic & narcotic drugs cause addiction

Deepak

Brain & neurotransmitters

Brain & neurotransmittersExcitatory neurotransmitters Inhibitory neurotransmitters

Dopamine Serotonin(5-HT) Adrenaline

Psychotic disease & treatment

Hypnotics & anxiolytics

Mood stabilizers

a) Major depression

b) Bipolar disorder

Mental disorders(Schizophrenia)

Hypnotic & anxiolytic drugs(Central pacemaker)

NON-REM

NON-REM

NON-REMNON-REM

Growth hormone

Hypnotic & anxiolytic drugs

Transient insomnia(< 3 days), Short-term insomnia(3 days-3 weeks), Long-term insomnia(> 3 weeks).1.Zolpidem(Sove) (short-term)2.Diazepam(valium) (long term) (insomnia associated with anxiety)3.Phenobarbital (long term hypnotic)4.Alprazolam (Anxit)5.Chlordiazepoxide (Librium) (insomnia,anxiety) (long term)6.Clobazam (long term)7.Lorazepam (Larpose) (insomnia associated with anxiety)8.Pregabalin (Gabanext) (anxiety)9.Venlafaxine (Venlift) (social anxiety)10.Nitrazepam (Nitrosun) (anxiety)

Mood stabilizersMajor depression- Serotonin, Adrenaline, Dopamine

Moa inhibitors- Phenelzine, Isocarboxazid , Tranylcypromine.TCA-amtriptyline (Eliwel), Imipramine (Antidep 25), Nortriptyline.5HT & Nor-adrenaline reuptake inhibitors- Fluoxetine (Flutop), Sertraline (Zotral),Citalopram (Feliz 10), Escitalopram (Newcita 10),Venlafaxine (Venlift).Miscellance- Bupropion (bupropion), Mirtazapine(mirtaz 15)

Biplolar disorder- manic depression(episode of mania &depression)

Lithium (Licab XL400), Risperidone(Rispond ), Olanzapine (Meltolan RD),Valproic acid, Carbamazepine (Tegretal), Gabapentine (Gabapin 100).

Psychotic Drugs(schizoprenia)

Symptoms- Delusion, Hallucination, Disorganized speech, Catatonic behavior,Negative symptoms.

DrugsChlorpromazine, Trifluperazine (Espazine), Thioridazine (Thioril), Fluphenazine(Prolinate inj), Haloperidol (Hexidol)Side effectExtrapyramidal side effect(dopamine)Weight gain(serotonin)

Narcotics

1. Opoid analgesic-CNS, Opioid receptors (mu, delta, kappa receptors)2. Analgesia, Euphoria, Dependence (mu-1) (Reduces pain threshold)3. Spinal analgesia(kappa)4. Acts on cough centre

Drugs

Morphine tab(10,20,60) & injaction(15mg/ml)Buprenorphine(buprigesic injection)Papaverine hcl(papaverine inj)Fentanyl citrate(fentanyl inj)(synthetic)

Case study1. A patient came to the pharmacy & ask for medicines like diazepam(valium),

alprozolam (anxit), venlift etc(sch-H) without a prescription, how you will handle the situation?

a) Will request the patient to take two months medication.b) Will request the patient to meet the doctor c) Will tell him to get rid off the placed) Will keep silent

2.What are the precaution we need to take while dealing with schedule-X drugs?

a)Check the prescription is hand written by a registered medical practitioner for a specific period & should maintain a record.

b)Will dispense the drug as usual like an OTC productc)wouldn’t dispensed)None of the above

3)Doctor prescribed Venlift-1 OD & Sove -1 OD for an anxiety,insomnia patient, how you will dispense it?

a) Venlift 1------0-------0 Sove 0------0-------1

b) Venlift 0------1-------0 sove 1-------0-------0

c) Venlift 1-------0------0 sove 1----------0------0

d) None of above

4) A patient who is working having depression & the doctor prescribed Eliwel like 1 OD,How you will dispense?a)1---------0-------------0

b)0---------1------------0

c)0----------0--------------1(7-8pm)

d)0-----------0--------------1(12pm)

5. A patient came to the pharmacy & ask for 10 bottles of codo-q syrup ,how you will Deal the situation?

a)Yes, i can give you 20 bottle instead of 10

b)yes, I can give you 5

c) Please meet a doctor & issue a prescription for the medicine

d)Silence please