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Mental Health (Junior Block) > 11) Psychopharmacology > Flashcards

11) Psychopharmacology Flashcards

1
Q

Describe neuroleptic malignant syndrome.

A

Adverse reaction to antipsychotic drug where there is muscle rigidity, fever, autonomic instability and cognitive changes such as delirium.

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2
Q

Which enzyme is raised in neuroleptic malignant syndrome?

A

Creatinine phosphokinase

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3
Q

Suggest some of the features of neuroleptic malignant syndrome.

A
  • Muscle rigidity
  • Hyperpyrexia
  • Tachycardia
  • Sweating
  • Flucuating blood pressure
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4
Q

Describe serotonin syndrome.

A

Excess serotonin on the CNS and/or peripheral nervous system due to a drug reaction.

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5
Q

Suggest some possible ADRs of mirtazapine.

A
  • Weight gain
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6
Q

Suggest some possible ADRs of lithium.

A
  • Polydypsia and polyuria
  • Nausea
  • Diarrhoea
  • Weight gain
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7
Q

Describe tardive dyskinesia and explain why it occurs.

A

Tardive dyskinesia is the choreo-athetoid movements of lips, tongue and mouth (and sometimes hands) caused by dopamine blockade such as performed by antipsychotics.

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8
Q

Suggest THREE neurological or psychiatric conditions in which sodium valproate may be used.

A
  • Epilepsy
  • Bipolar affective disorder
  • Acute mania
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9
Q

How can antipsychotics raise plasma prolactin?

A

Blockade of the tubero-infundibular dopaminergic system reduces the inhibition on prolactin.

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10
Q

Suggest how a patient with lithium toxicity may present.

A
  • Coarse tremor
  • Reduced conciousness
  • Convulsions
  • Renal failure
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11
Q

Suggest how a patient with benzodiazepine toxicity may present.

A
  • Drowsy

- Respiratory depression

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12
Q

Suggest some possible ADRs of SSRIs.

A
  • GI (nausea, diarrhoea, dyspepsia, bloating)
  • Weight loss
  • Sexual dysfunction
  • Headaches
  • Fatigue
  • Hyponatraemia
  • Increased risk of bleeding (especially when given with NSAIDs)
  • Discontinuation symptoms
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13
Q

After the first episode of depression, how long should patients continue on antidepressants after recovery?

A

6 months

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14
Q

Suggest TWO pharmacological interventions that may help a patient suffering from obsessive-compulsive disorder.

A
  • SSRI’s

- TCAs (commonly Clomipramine)

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15
Q

What is the first line medication for most/all anxiety disorders?

A

SSRIs

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16
Q

Which benzodiazepine is commonly used in the treatment of alcohol withdrawal?

A

Chlordiazepoxide

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17
Q

Suggest some drugs which can cause serotonin syndrome.

A
  • Antidepressants
  • Opioids
  • CNS stimulants
18
Q

Suggest some of the features of serotonin syndrome.

A
  • Hypotension and tachycardia
  • Shivering
  • Sweating
  • Dilated pupils
  • Myoclonus (intermittent jerking or twitching)
  • Hypereflexia
  • Hypervigilance, anxiety
19
Q

Compare and contrast serotonin syndrome and neuroleptic malignant syndrome.

A
  • Serotonin syndrome is caused by excessive serotonin, NMS is caused by a dopamine blockade
  • Serotonin toxicity has a rapid onset after the administration of a serotonergic drug, NMS has a slow onset and typically evolves over several days after administration of a neuroleptic drug
  • Serotonin syndrome responds to serotonin blockade via drugs like chlorpromazine/cyproheptadine, whereas NMS responds to dopamine agonists such as bromocriptine
20
Q

Described how serotonin syndrome may be managed.

A
  • Serotonin antagonists such as cyproheptadine/chlorpromazine
  • Activated charcoal if there is serotonin still being digested
  • BZDs for the myoclonus
  • Supportive measures for hyperthermia
21
Q

What is the first line treatment for Alzheimer’s disease?

A

Acetylcholinesterase inhibitors (ACHEIs)

22
Q

Suggest TWO ways in which adverse drug reactions from acetylcholinesterase inhibitors (ACHEIs) can be made less likely.

A
  • Take with food

- Titrate them up slowly

23
Q

Give TWO examples of acetylcholinesterase inhibitors. (ACHEIs)

A
  • Donepezil

- Rivastigmine

24
Q

Suggest a mechanism for how acetylcholinesterase inhibitors (ACHEIs) may improve memory in patients with dementia.

A

As acetylcholine is reduced in dementia and plays a significant role in memory/attention/mood the prevention of its degradation leads to an improvement in this dimensions.

25
Q

Suggest some ADRs of acetylcholinesterase inhibitors. (ACHEIs)

A
  • Nausea and vomiting
  • Fatigue and insomnia
  • Worsen COPD
  • Bradycardia
26
Q

What is memantine? How does it work?

A

Memantine is the main drug in the group of NMDA antagonists. They work by preventing too much glutamate leaking out of cells and interfering with learning/memory.

27
Q

Suggest some ADRs of NMDA antagonists.

A

Most of the ADRs of memantine and other NMDA antagonists are mild, however, some include:

  • Nausea
  • Restlessness
  • Hypertension
  • Dyspnoea
28
Q

Which SSRI is most effective in the treating of eating disorders?

A

Fluoxetine

29
Q

Suggest some possible ADRs of TCAs.

A
  • H1 receptor block leads to sedation (tired, drowsy)
  • Anticholinergic leads to blurred vision, urinary retention, xerostomia
  • Sympatholytic leads to postural hypotension and reflex tachycardia
30
Q

Which antipsychotic is considered first line for delirium?

A

Haloperidol

31
Q

Suggest TWO uses for pregablin.

A
  • Generalised anxiety disorder

- Neuropathic pain

32
Q

Compare and contrast lorazepam and diazepam.

A
  • Diazepam is slow onset, lorazepam is rapid in its onset

- Diazepam is long acting, lorazepam is short acting

33
Q

Suggest some ADRs of the main AEDs. (valproate, lamotrigine, carbamezepine)

A
  • GI disturbances (V&N)
  • CNS problems like dizziness, drowsiness, ataxia
  • Steven-Johnson syndrome
34
Q

Which TWO SSRIs are generally accepted to be first line in the treatment of mild/moderate depression.

A
  • Citalopram

- Fluoxetine

35
Q

Suggest THREE possible discontinuation symptoms observed when stopping an SSRI abruptly.

A
  • Increased mood change
  • Restlessness/difficulty sleeping
  • Unsteadiness
  • GI symptoms
36
Q

A patient asks to stop taking their SSRI. Over what period should you slowly wean them off their SSRI?

A

6 months

37
Q

Describe the mechanism of action of TCAs.

A
  • Inhibit reuptake of 5-HT in the synaptic cleft
  • Inhibit reuptake of noradrenaline in the synaptic cleft
  • Bind to:
    + mACh receptors
    + Histamine receptors
    + 5-HT2 receptors
38
Q

Which class of drugs does Venlafaxine belong to? Name THREE ADRs of this class of drugs.

A

SNRIs:

  • Headache
  • Insomnia
  • Sexual dysfunction
  • Dry mouth
  • Dizziness
  • Hypotension (also occasionally hypertension)
39
Q

Why should cheese lovers beware MAOis?

A

Cheese reaction! MAOis prevent breakdown of dietary tyramine, cheese and steak produce lots of it.

40
Q

What class of drugs does Mirtzapine belong to?

A

NASSA

Mental Health (Junior Block) (13 decks)

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