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Clinical Pharmacology > 23+24) Drugs in Psychiatric Disease > Flashcards

23+24) Drugs in Psychiatric Disease Flashcards

1
Q

What can predispose to psychiatric disorders?

A

Genetic vulnerability
Life events
Personality, coping skills
Environmental influences

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2
Q

What are the core symptoms of depression?

A

Low mood, anhedonia, decreased energy

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3
Q

Give examples of SSRIs:

A

Fluoxetine, citalopram, paroxetine, sertraline

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4
Q

What are some side effects of SSRIs?

A

Anorexia, nausea, diarrhoea, precipitation of mania, suicidal thoughts

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5
Q

What is an important side effect of citalopram?

A

Prolongs QT interval

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6
Q

Give examples of tricyclic antidepressants:

A

Amitryptyline, clomipramine

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7
Q

What are some side effects of tricyclic antidepressants?

A

Sedation, lower seizure threshold
Tachycardia, postural hypotension
Constipation, reduction in glandular secretion

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8
Q

Give examples of SNRIs:

A

Venlafaxine, duloxetine

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9
Q

What are some side effects of SNRIs?

A

Sleep disturbance, increased BP, dry mouth, hyponatremia (also SEs of SSRIs)

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10
Q

What are some symptoms of schizophrenia?

A

Hallucinations, delusions, thought disorder, behavioural changes, lack of insight

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11
Q

What is a hallucination?

A

Perception in the absence of an external stimulus

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12
Q

What is a delusion?

A

Fixed false belief out of keeping with someone’s culture or relgion

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13
Q

What are some risk factors/predispositions for schizophrenia?

A

Genetics
Environment
Cannibis

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14
Q

What is the function of the mesolimbic dopamine pathway?

A

Emotional response and behaviour

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15
Q

What is the function of the mesocortical dopamine pathway?

A

Arousal and mood

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16
Q

What is the function of the nigrostriatal dopamine pathway?

A

Production of movement

17
Q

What are the effects of antipsychotics?

A

Block D2 receptors, reducing psychotic symptoms by effects on mesolimbic pathway

18
Q

What are typical anti-psychotics?

A

Older, with increased D2 anatagonism so extra-pyramidal side effects and dyskinesia

19
Q

What are atypical anti-psychotics?

A

Modern, cause less EPSE

20
Q

What are the side effects of atypical anti-psychotics?

A

Weight gain, increase prolactin (risperidone), sedation

Neutropenia (clozapine)

21
Q

What are the side effects of typical anti-psychotics?

A

Parkinsonism, acute dystonia, akathasia, tardive dyskinesia
Postural hypotension, weight gain, prolactinemia
Neuroleptic malignant syndrome

22
Q

What is neuroleptic malignant syndrome?

A

Reaction to anti-psychotics

Severe rigidity, hyperthermia, tachycardia

23
Q

What are the symptoms of anxiety?

A

Light-headedness, shortness of breath, flushes, palpitations, nausea

24
Q

How can anxiety be treated?

A

CBT, antidepressants, anxiolytics, antipsychotics

25
Q

Describe tolerance and dependence in benzodiazepines:

A

Tolerance - need to increase the dose for the same effect

Dependence - withdrawal effects on discontinuation

26
Q

What are the side effects of benzodiazepines?

A

Drowsiness, Dizziness, psychomotor impairment, dry mouth, blurred vision

27
Q

Describe potential toxicity caused by benzodiazepines:

A

Cleft lip and palate in pregnancy

If late in pregnancy - resp depression and feeding difficulties in baby

28
Q

What can overdose on benzodiazepines cause?

A

Respiratory depression

29
Q

How can benzodiazepine overdose be reversed?

A

IV flumazenil

30
Q

What are the symptoms of bipolar disorder?

A

Overactive, poor concentration, poor sleep, poor judgement, increased interest in sex, psychosis

31
Q

Give examples of mood stabilisers:

A 
Lithium
Sodium valproate
Carbamazepine
Lamotrigine
Anti-psychotics
32
Q

Describe lithium’s mechanism of action:

A

Increases serotonin

Attentuate effects of certain neurotransmitters on their receptors

33
Q

How should lithium be monitored?

A

Renal and thyroid function every 6 months

Lithium blood levels weekly until stable conc. then 3 monthly (12 hours after dose)

34
Q

What are the indications for starting a patient on lithium?

A

Prophylaxis of mania and depression

Reduces suicidality

35
Q

What are the side effects of lithium?

A

Memory problems, thirst, tremor, weight gain, hypothyroidism, hair loss

36
Q

What medications can be used in dementia?

A

ACh-esterase inhibitors

NMDA agonist

37
Q

What are some side effects of ACh-esterase inhibitors?

A

N&V, fatigue, insomnia, bradycardia, worsening COPD, gastric ulcers

38
Q

What are some side effects of memantine?

A

Hypertension, dyspnoea, headache, dizziness, drowsiness

Clinical Pharmacology (24 decks)

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