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An Approach to Drug Classification in Psychopharmacology

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An Approach to Drug Classification in Psychopharmacology Issues in Religion and Psychotherapy Volume 8 Number 2 Article 4 4-1-1982 An Approach to Drug Classification in Psychopharmacology Bruce H. Woolley Follow this and additional works at: https://scholarsarchive.byu.edu/irp Recommended Citation Woolley, Bruce H. (1982) "An Approach to Drug Classification in Psychopharmacology," Issues in Religion and Psychotherapy: Vol. 8 : No. 2 , Article 4. Available at: https://scholarsarchive.byu.edu/irp/vol8/iss2/4 This Article or Essay is brought to you for free and open access by the Journals at BYU ScholarsArchive. It has been accepted for inclusion in Issues in Religion and Psychotherapy by an authorized editor of BYU ScholarsArchive. For more information, please contact [email protected], [email protected]. AN APPROACH TO DRUG CLASSIFICATION IN PSYCHOPHARMACOLOGY Bruce H. Woolley,* Pharm.D. Presented at the AMCAP Convention 2 October 1981 In our fast-paced society, numerous .emotional and c. Oxymorphone (Numorphan) physiological factors often produce stress, anxiety, d. Methyldihydromorphinone (Metopon) depression, and other dysfunctional behavior. One of e. Codeine the significant stressors that appear regularly where f. Hydrocodone (Dicodidl there are family and/or emotional problems is the use g. Oxycodone (Percodan) and abuse of drugs and substances which affect the 2. Phenylheptylamines a. Methadone (Dolophine) central nervous system (brain and spinal cord). These b. Propoxyphene (Darvon) agents can include prescribed drugs improperly taken, 3. Phenylpiperidines over-the-counter drugs purchased at local pharmacies a. Meperidine (Demerol) or grocery stores, or illicit substances ingested for the b. Alphaprodine (Nisentil) "high" they seem to provide. However, when utilized c. Anileridine (Lentine) and administered bycompetent medical personnel, these d. Piminodine (Alvodinel agents offer excellent palliation for psychopathology. e. Diphenoxylate (in Lomotil) The therapeutic use of pharmacologically active drugs 4. Morphinans for behavioral dysfunctions requires competent a. Levorphanol (Levo-Dromoranl diagnostic skills, expertise in clinical pharmacology, and b. Methorphan c. Levallorphan (Lorfan) proper monitoring techniques. Each involves years of 5. Benzomorphans preparation and training and are far beyond the scope of a. Phenazoci'"e (Prinadol) this paper. Within this context the author seeks to b. Pentazocine (Talwip) provide the reader with a survey of the major B. HYPNOTIC·SEDATIVES classifications of frequently prescribed and/or abused 1. Barbiturates drugs only as a reference. a. Ultra short acting There have been many attempts in the literature to Thiopental (Pentothal Sodium) categorize and segment psychoactive agents. These b. Short acting attempts have varied, depending upon the reason for Pentobarbital (Nembutal) classification, from pharmacological approaches to Secobarbital (Seconal) c. Intermediate acting pathological approaches to therapeutic approaches. All Amobarbital (Amytal) have merit and clearly show that any attempt at drug d. Long acting classification is, at best, superficial. Add to these Phenobarbital attempts the ever-increasing abuse problem with Mephobarbital (Mebaral) psychoactive agents, and the problem of categorizing Metharbital (Gemonil) these agents becomes even more formidable. 2. Non-barbiturates For this paper the agents are classified into three a. Tertiary carbinols categories (Table 1) utilizing a pharmacological approach Ethchlorvynol (Placidyl) and taking the chemical structure into consideration. Ethinamiate (Valmid) b. Piperidinediones Major drugs of abuse have been included to show action Glutethimide (Doriden) correlation. It must be kept in mind, however, that Methyprylon (Noludarl I agents placed in one category can and do therapeutically c. Chloral derivatives 1 and pathologically fall into other categories. Chloral hydrate (Noctecl 1--, Chloral betane (Beta-Chlor) TABLE 1 Traclo!os (Triclos) Outline of Draa Cbssiflalion d. Quinazolones Methaqualone (Qualude) e. Monoureides I. CNS DEPRESSANTS Paraldehyde (Paral) A. NARCOTIC ANALGESICS Acetylcarbromal (Paxarel, Sedamyl) 1. Natural and semisynthetic opiate alkaloids 3. Phencyclidine a. Morphine . 11-(Phenylcyclohexyl) piperidineI b. Hydromorphone (Dilaudid) C. TRANQUILIZERS 1. Neuroleptics (antipsychotics or major tranquilizers) *Brother Woolley is Director of the BrighilDl Young a. Phenothiazines University Health Center. 1) Aliphatics (Aminoalkyls) 13 AMCAP JOURNAl/APRIL 1982 Promazine (Sparine) 1. Amphetamines Chlorpromazine (Thorazine) 2. Other Triflupromazine (Vesprin) J1J, MOOD MODIFIERS 2) Piperidines A. ANTIDEPRESSANTS Thioridazine (Mellaril) 1. Monoamine oxidase (MAO) inhibitors Mesoridazine (Serentil) a) Hydrazines Piperacetazine (Quide) Iproniazid (Marsilid) 3) Piperazines b) Nonhydrazines Prochlorperazine (Compazine) Tranylcypromine (Parnate) Trifluoperazine (Stelazine) 2. Tricyclic antidepressants Butaperazine (Repoise) a. Dibenzazepine derivatives Acetophenazine (Tindal) Imipramine (Trofranil) Fluphenazine (Prolixin) T rimipramine (Surmontil) Perphenazine (Trilafon) Desipramine (Norpramin, Pertrofrane) Carphenazine (Proketazine) b. Dibenzocycloheptadiene derivatives b. Thioxanthenes Amitryptyline (EIavil) Thiothixene (Navane) Nortriptylene (Avenlyl) Chlorprothixene (Taractan) Protriptylene (Vivactil) c. Butyrophenones Doxepin (Adapin,Sinequan) Haloperidol (Haldol) 3. Tetracyclics d. Dibenzoxapines Maprotiline (Ludiomil) Loxapine (loxitane) 4. Miscellaneous e. Indoles Amoxapine (Asendin) Molindone (Lidone, Moban) B. LITHIUM f. Rauwolfia alkaloids C. PSYCHOTOMIMETICS 2. Anxiolytics (minor tranquilizers) (HALLUCINOGENS, PSYCHODYSLEPTICS) a. Diphenylmethane antihistamines 1. Mescaline Diphenhydramine (Benadryl) 2. Psylocibin Hydroxyzine (Vistaril. Atarax) 3. Lysergic acid derivatives b. Propanediol carbamates 4. Tryptamines Meprobamate (Equanil. Miltown) 5. Cannabis (marihuana) Tybamate (Solacen) Central Nervous System Depressants (psycholeptics) c. Benzodiazepines Chlordiazepoxide (Librium) Generally, excluding the anesthetics, the CNS Diazepam (Valium) depresssant substances can be divided into five divisions: Prazepam (Centrax) the narcotic analgesics and antagonists, the sedative­ Chlorazepate Monopotassium (Azene) hypnotics, the tranquilizers, the antiparkinson agents, Chlorazepate Dipotassium (Tranxene) and alcohol. Alprazolam (Xanax) Clonazepam (Clonopin) Narcotics Flurazepam <Dalmane) These drugs (Table 2) depress the centers in the brain Lorazepam (Ativan) and spinal cord and are used medically as analgesics D. ANTIPARKINSONIAN AGENTS (agents to relieve pain) as well as for their antitussive 1. Anticholinergics (cough relief) properties. They have a high potential for Ben~otropine (Cogentin) producing physiological and psychological dependence. Trihexyphenidyl (Artane) Tolerance' develops quite rapidly with these agents, and Procyclidine (Kemadrin) 2 Cycrimine (Pagitane) cross-tolerance exists in this category. The narcotics Biperiden (Akineton) are divided into the natural and semisynthetic opiate Ethopropazine (Parsidol) alkaloids. 2. Antihistamines The opium alkaloids are contained in a white milky Diphenhydramine (Benadryl) substance obtained from the unripe bulb of the poppy Chlorphenoxamine (Phenoxene) (Papaver somniferum). The milky substance expelled Orphenadrine (Disipal) contains many drugs, including morphine, codeine, 3. Miscellaneous ethylmorphine, apomorphine, and papaverine. Amantadine (Symmetrel) Morphine is the most important alkaloid; however, . E. ALCOHOL codeine is the most widely used. II. CNS STIMULANTS (THYMOLEPTICS) A. XANTHENE ALKALOIDS (PURINES) 1. Theophylline 1. Tolerance is a resistance and/or accommodation that is developed 2. Theobromine to the effects of the drug as that drug is chronically ingested. As • 3. Calfeine result of tolerance, over a prolonged period of time, more of the B. ECGONINE DERIVATIVES drug is needed to get the same effect one experienced with the 1. Cocaine initial dose. 2. Misc. atropine-like compounds 2. CrQss-tolerance refers to a condition in which tolerance toone kind C. PHENYLETHYLAMINES of drug builds up and is carried over to other drugs. Drugs in many (SYMPATHOMEMETIC AMINES) categories exhibit this property within their particulardrug family. AMCAP JOURNAL/APRIL 1982 14 TABLE 1 development of dependence. They are classified by their Commonly Us~ NarcotiC'S chemical structure and include the tertiary carbinols • (Placidyl, Valmid), the piperidinediones (Doriden, Usu,l Sinsle Dur.tion Noludar), chloral derivatives (chloral hydrate), the Proprietuy NU''le Generic N.me Aduh Dou~e of Action quinazolones (Quaaludel, and the monoureides (Paral, Opium S hrs_ Paxarel). They are used in medical practice to induce Morphine Morphine Sulf,te ISmS 4 hrs. sleep. Codrine Codeine Phosph,te 30-6sm. 4 hrs. TABLE 4 Heroin 2-3 hrs. Nonbubitur..tes Dilfudide Hydromorphine 2m, 4 hrs. Perroc"n- Oxycodone HCI I t.blel '" hrs. Demer~e Meperidine SO-100m. 4 hrs. Usu.. 1SinKle Dur.. tion OoIophine- Meth,done 5-10 m, 4 hrs. Adult Dose of Action Many.other agents have been developed to produce Doridens Gh.tethimide 0500 ma "blels .5hrs analgesic and antitussive properties similar to the opiate .nd upsules PbodylS Ethchlorvynol sao ma t.blets alkaloids without the problem of dependency. However, Quuludea Meeth,qu.. lone 1.50·)00 ma dependency has proven to be a problem with all of these upsules agents. Noclec· Chlor..1hydr.. te leo m~ upsules S hrs. Usual short-term effects include sedation, analgesia, Nolud.
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