Jumat, 11 November 2011

 Penggolongan Obat Psikofarmaka (Psikotropik)
Menurut Depkes (2000), jenis obat psikofarmaka adalah :
1) Clorpromazine (CPZ, Largactile)
2) Haloperidol (Haldol, Serenace)
3) Trihexiphenidyl (THP, Artane, Tremin)
Berdasarkan Konvensi Perserikatan Bangsa Bangsa tentang pemberantasan peredaran narkotika dan psikotropika, tahun 1988 tersebut maka psikotropika dapat digolongkan sebagai berikut : (didahului dengan nama International dan nama kimia diletakkan dalam tanda kurung)
Psikotropika golongan I
* Broloamfetamine atau DOB ((±)-4-bromo-2,5-dimethoxy-alpha-methylphenethylamine)
* Cathinone ((x)-(S)-2-aminopropiophenone)
* DET (3-[2-(diethylamino)ethyl]indole)
* DMA ( (±)-2,5-dimethoxy-alpha-methylphenethylamine )
* DMHP ( 3-(1,2-dimethylheptyl)-7,8,9,10-tetrahydro-6,6,9-trimethyl-6H- dibenzo[b,d]pyran-1-olo )
* DMT ( 3-[2-(dimethylamino)ethyl]indole)
* DOET ( (±)-4-ethyl-2,5-dimethoxy-alpha-phenethylamine)
* Eticyclidine – PCE ( N-ethyl-1-phenylcyclohexylamine )
* Etrytamine ( 3-(2-aminobutyl)indole )
* Lysergide – LSD, LSD-25 (9,10-didehydro-N,N-diethyl-6-methylergoline-8beta-carboxamide)
* MDMA ((±)-N,alpha-dimethyl-3,4-(methylene-dioxy)phenethylamine)
* Mescaline (3,4,5-trimethoxyphenethylamine)
* Methcathinone ( 2-(methylamino)-1-phenylpropan-1-one )
* 4-methylaminorex ( (±)-cis-2-amino-4-methyl-5-phenyl-2-oxazoline )
* MMDA (2-methoxy-alpha-methyl-4,5-(methylenedioxy)phenethylamine)
* N-ethyl MDA ((±)-N-ethyl-alpha-methyl-3,4-(methylenedioxy)phenethylamine)
* N-hydroxy MDA ((±)-N-[alpha-methyl-3,4-(methylenedioxy)phenethyl]hydroxylamine)
* Parahexyl (3-hexyl-7,8,9,10-tetrahydro-6,6,9-trimethyl-6H-dibenzo[b,d]pyran-1-ol)
* PMA (p-methoxy-alpha-methylphenethylamine)
* Psilocine, psilotsin (3-[2-(dimethylamino)ethyl] indol-4-ol)
* Psilocybine (3-[2-(dimethylamino)ethyl]indol-4-yl dihydrogen phosphate)
* Rolicyclidine – PHP,PCPY ( 1-(1-phenylcyclohexyl)pyrrolidine )
* STP, DOM (2,5-dimethoxy-alpha,4-dimethylphenethylamine)
* Tenamfetamine – MDA (alpha-methyl-3,4-(methylenedioxy)phenethylamine)
* Tenocyclidine – TCP (1-[1-(2-thienyl)cyclohexyl]piperidine)
* Tetrahydrocannabinol
* TMA ((±)-3,4,5-trimethoxy-alpha-methylphenethylamine)

Psikotropika golongan II
* Amphetamine ((±)-alpha-methylphenethylamine)
* Dexamphetamine ((+)-alpha-methylphenethylamine)
* Fenetylline (7-[2-[(alpha-methylphenethyl)amino] ethyl]theophylline)
* Levamphetamine ((x)-(R)-alpha-methylphenethylamine)
* Levomethampheta-mine ((x)-N,alpha-dimethylphenethylamine)
* Mecloqualone (3-(o-chlorophenyl)-2-methyl-4(3H)- quinazolinone)
* Methamphetamine ((+)-(S)-N,alpha-dimethylphenethylamine)
* Methamphetamineracemate ((±)-N,alpha-dimethylphenethylamine)
* Methaqualone (2-methyl-3-o-tolyl-4(3H)-quinazolinone)
* Methylphenidate (Methyl alpha-phenyl-2-piperidineacetate)
* Phencyclidine – PCP (1-(1-phenylcyclohexyl)piperidine)
* Phenmetrazine (3-methyl-2-phenylmorpholine)
* Secobarbital (5-allyl-5-(1-methylbutyl)barbituric acid)
* Dronabinol atau delta-9-tetrahydro-cannabinol ((6aR,10aR)-6a,7,8,10a-tetrahydro-6,6,9-trimethyl-3-pentyl-6H- dibenzo[b,d]pyran-1-ol)
* Zipeprol (alpha-(alpha-methoxybenzyl)-4-(beta-methoxyphenethyl)-1-piperazineethanol)

Psikotropika golongan III
* Amobarbital (5-ethyl-5-isopentylbarbituric acid)
* Buprenorphine (2l-cyclopropyl-7-alpha-[(S)-1-hydroxy-1,2,2-trimethylpropyl]-6,14- endo-ethano-6,7,8,14-tetrahydrooripavine)
* Butalbital (5-allyl-5-isobutylbarbituric acid)
* Cathine / norpseudo-ephedrine ((+)-(R)-alpha-[(R)-1-aminoethyl]benzyl alcohol)
* Cyclobarbital (5-(1-cyclohexen-1-yl)-5-ethylbarbituric acid)
* Flunitrazepam (5-(o-fluorophenyl)-1,3-dihydro-1-methyl-7-nitro-2H-1,4-benzodiazepin-2-one)
* Glutethimide (2-ethyl-2-phenylglutarimide)
* Pentazocine ((2R*,6R*,11R*)-1,2,3,4,5,6-hexahydro-6,11-dimethyl-3-(3-methyl-2-butenyl)-2,6-methano-3-benzazocin-8-ol)
* Pentobarbital (5-ethyl-5-(1-methylbutyl)barbituric acid)

Psikotropika golongan IV
* Allobarbital (5,5-diallylbarbituric acid)
* Alprazolam (8-chloro-1-methyl-6-phenyl-4H-s-triazolo[4,3-a][1,4]benzodiazepine)
* Amfepramone (diethylpropion 2-(diethylamino)propiophenone)
* Aminorex (2-amino-5-phenyl-2-oxazoline)
* Barbital (5,5-diethylbarbituric acid)
* Benzfetamine (N-benzyl-N,alpha-dimethylphenethylamine)
* Bromazepam (7-bromo-1,3-dihydro-5-(2-pyridyl)-2H-1,4-benzodiazepin-2-one)
* Butobarbital (5-butyl-5-ethylbarbituric acid)
* Brotizolam (2-bromo-4-(o-chlorophenyl)-9-methyl-6H-thieno[3,2-f]-s-triazolo[4,3-a][1,4]diazepine)
* Camazepam (7-chloro-1,3-dihydro-3-hydroxy-1-methyl-5-phenyl-2H-1,4 benzodiazepin-2-one dimethylcarbamate (ester))
* Chlordiazepoxide (7-chloro-2-(methylamino)-5-phenyl-3H-1,4-benzodiazepine-4-oxide)
* Clobazam (7-chloro-1-methyl-5-phenyl-1H-1,5-benzodiazepine-2,4(3H,5H)-dione)
* Clonazepam (5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one)
* Clorazepate (7-chloro-2,3-dihydro-2-oxo-5-phenyl-1H-1,4-benzodiazepine-3-carboxylic acid)
* Clotiazepam (5-(o-chlorophenyl)-7-ethyl-1,3-dihydro-1-methyl-2H-thieno [2,3-e] -1,4-diazepin-2-one)
* Cloxazolam (10-chloro-11o-chlorophenyl)-2,3,7,11b-tetrahydro-oxazolo- [3,2-d][1,4]benzodiazepin-6(5H)-one)
* Delorazepam (7-chloro-5-(o-chlorophenyl)-1,3-dihydro-2H-1,4-benzodiazepin-2-one)
* Diazepam (7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one)
* Estazolam (8-chloro-6-phenyl-4H-s-triazolo[4,3-a][1,4]benzodiazepine)
* Ethchlorvynol (1-chloro-3-ethyl-1-penten-4-yn-3-ol)
* Ethinamate (1-ethynylcyclohexanolcarbamate)
* Ethyl loflazepate (ethyl 7-chloro-5-(o-fluorophenyl)-2,3-dihydro-2-oxo-1H-1,4-benzodiazepine-3-carboxylate)
* Etil Amfetamine / N-ethylampetamine (N-ethyl-alpha-methylphenethylamine)
* Fencamfamin (N-ethyl-3-phenyl-2-norborananamine)
* Fenproporex ((±)-3-[(alpha-methylphenylethyl)amino]propionitrile)
* Fludiazepam (7-chloro-5-(o-fluorophenyl)-1,3-dihydro-1-methyl-2H-1,4-benzodiazepin-2-one)
* Flurazepam (7-chloro-1-[2-(diethylamino)ethyl]-5-(o-fluorophenyl)-1,3-dihydro-2H-1,4-benzodiazepin-2-one)
* Halazepam (7-chloro-1,3-dihydro-5-phenyl-1-(2,2,2-trifluoroethyl)-2H-1,4-benzodiazepin-2-one)
* Haloxazolam (10-bromo-11o-fluorophenyl)-2,3,7,11b-tetrahydrooxazolo [3,2-d][1,4]benzodiazepin-6(5H)-one)
* Ketazolam (11-chloro-8,12b-dihydro-2,8-dimethyl-12b-phenyl-4H-[1,3]oxazino[3,2-d][1,4]benzodiazepine-4,7(6H)-dione)
* Lefetamine – SPA ((x)-N,N-dimethyl-1,2-diphenylethylamine)
Penggolongan berdasarkan rumus kimiawi:
  1. kelompok fenotiazine
  2. kelompok buspiron
  3. kelompok trisiklik/tetrasiklik/SSRI
Penggolongan berdasarkan efek yang diharapkan
  1. anti psikotik
·  Konvensional (lama): fenotiazine (chlorpromazine), piperazine (trifluoperazine), definibutylpiperidine (pimezode), piperidine (thioridazine), butyrophenone (haloperidol).
·  Novel (modern): benzisoxadole (resperidone), dibenzodiazepine (clozapine), dibenzothiazepine (quetiapine) dan thienobenzodiazepine (olanzapine).
·  Antipsikosis Tipikal (FGA): low potency > klorpromazine, tioridazine, mesoridazine, high potency > perfenazine, thiotixene, loxapin, molindon, haloperidol, flufenazine, trifuloperazine.
·  Antipsikosis Atipikal (SGA), antagonis reseptor 5-HT, blokade dopamine rendah: klozapin, olanzapin, quetiapine, ziprasidon, aripiprazol, risperidon.
·  Fenotiazine: Klorpromazine, trifulopromazine, tioridazine, flufenazine, plokroperazine, trifuoloperazine.
·  Thioxantine: Klorprotiksen, thiotiksen.
·  Dihidroindolon: Molindon
·  Dibenzoksazepin: loksapin (loxitane).
·  Dibenzodiazepine: Klozapin (Clozaril).
·  Butirofenon: Haloperidol (Haldol).
·  Difenibutilfiferidin: Pimozid (orap)
  1. anti cemas (anti ansietas dan hipnotik)
    1. barbiturat: fenobarbital, alprazolam
    2. benzodiazepine: klordiazepoksid, oksazepam, diazepam, untuk hipnotik (lorazepam dan temazepam).
    3. Non benzodiazepine: meprobomate, buspirone.
    4. Beta adrenergic blocker: propanolol dan atenolol.
    5. anti depresi
      1. Antidepresi trisiklik: imipramin, amitripilin, doksepin, klmipramin, desipramin, nortriptilin, amoksapin, proptriptilin, klomipramin.
      2. Antidepresi Tetrasiklik: maproptiline, mianserin, amozapine.
      3. Antidepresi generasi II: desimipramin, trazodone, bupropion, amoksapin, maprotilin
      4. Antidepresi generasi III: venlafaxine, nefazodone (duloxetine, mirtazepine
      5. Selective Serotonin Reuptake Inhibitor (SSRIs): fluoksetin, fluvoksamin, paroksetin, sertralin.
      6. MAOI: Moklobamid.
      7. Penghambat Monoamin Oksidase dan anti depresan lain: tranilisipromin, feneizin, isokarboksazid, selegilin. Lain-lain: mianserin, maproptilin, alprazolam, dan bupropion.
      8. Anti depresi Atypical: trazodone.
      9. anti obsesi
      10. anti panik
      11. anti mania:
Mania akut: haloperidol (haldol, serenace), carbamazepin (tegretol)
Profilaksis mania: lithium carbonate (teralithe)
  1. anti insomnia:
benzodiazepine: nitrazepam, flurazepam, triazolam, estazolam
Non benzodiazepine: chloral hydrate, phenobarbital
Penggolongan berdasarkan diagnostik
  1. obat untuk delirium
  2. obat untuk demensia
  3. obat untuk skizofrenia
  4. Obat untuk Gangguan Bipolar: Litium, olanzepine, karbamazepine, valproal
  5. obat untuk gangguan cemas menyeluruh
  6. obat untuk obsesi kompulsi
  7. obat untuk gangguan somatoform
  8. obat untuk gangguan insomnia
Penggolongan berdasarkan kategori lama/baru
  1. kelompok konvensional (lama)
Contoh: chlorpromazine, trifluoperazine, amitrypiline, maproptilin, diazepam, dan clonazepam
  1. kelompok novel (baru)
Contoh: risperidone, quetiapine, kelompok selective cerotonin inhibitor, dan sertralin.

2 komentar: