3A Psych Flashcards
Mental state exam word
ASEPTIC
A septic
Appearance and behaviour
(hygiene, clothes, weight, posture)
(fidgeting, shy, agitated, eye contact)
a S eptic
Speech
(rate, rhythm, tone, volume)
as E ptic
Emotion
(Mood)
(Affect observable emotion over a chat)
ase P tic
Perception
(hallucination, illusions, paranoia, depersonalisation, derealisation)
asep T ic
Thoughts
(Form, content, possession)
asept I c
Insight
(are they aware they have a problem, do they think it needs treating)
asepti C
Cognition
(Orientation to time, place, person)
Organic vs non organic
Organic = observable on a scan e.g. on a CT seeing a tumour or dementia
Non organic = not observable
How do SSRIs work
Inhibit the reuptake of serotonin from
presynaptic serotonin pumps
2 SSRIs
sertraline
Fluoxetine for under 18s
SSRIs used for
Depression, anxiety, OCD
side effects SSRIs
GI symptoms, anxiety/agitation, insomnia,
sweating, sex (anorgasmia)
suicide
withdrawal SSRI symptoms
dizziness, headache, tremor, agitation, GI issues
SNRI mechanism
Presynaptic blockade of both noradrenaline and serotonin reuptake pumps
(in high doses also blocks dopamine reuptake);
low effects on muscarinic,
histaminergic and alpha-adrenergic receptors.
2 SNRIs
Venlafaxine, duloxetine
SNRI conditions
depression + anxiety
Side effects SNRI
Dizziness, dry mouth, constipation, hot flushes
Tricyclic Antidepressants
example
Amitriptyline
tricyclic used for
depression, anxiety, OCD, (chronic pain)
Tricyclic mechanism
Blockade of both noradrenaline and serotonin reuptake pumps (also dopamine to a small extent). Muscarinic, histaminergic, alpha-adrenergic.
Tricyclic side effects
Anticholinergic effects (muscarinic receptor block): dry mouth, constipation,
blurred vision, urinary retention
Antiadrenergic effects: postural hypotension (dizziness and syncope)
Antihistaminergic effects: sedation and weight gain
Overdose
NaSSAs example
(Noradrenergic and Specific Serotonergic Antidepressants)
Mirtazapine
NaSSAs mechanism
(Noradrenergic and Specific Serotonergic Antidepressants)
Presynaptic alpha2 blockage -> increased noradrenaline and
serotonin from presynaptic neurons; histamine antagonist
NaSSAs used for
(Noradrenergic and Specific Serotonergic Antidepressants)
depression, anxiety
NaSSAs
(Noradrenergic and Specific Serotonergic Antidepressants)
sedation and weight gain
MAOI mechanism
(Monoamine Oxidase Inhibitors)
Inhibit enzyme Monoamine oxidase A & B
MAOI side effects
(Monoamine Oxidase Inhibitors)
overdose risk
tyramine cheese reaction (hypertensive crisis)
MAOI used for
(Monoamine Oxidase Inhibitors)
depression
For depression drug order
SSRI
different SSRI
SNRI
Lithium used for
Mania
Mood stabiliser
Who can you not give lithium
Preggo women as TERATOGENIC
What do you need to do for people on lithium
Monitoring
Baselines
weekly then every 3 months
Lithium side effects
polyuria, polydipsia, weight gain, oedema, fine tremor
coarse tremor, ECG changes (QT), arrhythmias, nystagmus
dysarthria, brisk reflexes, impaired consciousness
Serotonin syndrome
Neuromuscular abnormalities
Altered mental state
Autonomic dysfunction
Sodium valproate used for
mood stabiliser, anticonvulsant
Who cant you give Sodium valproate to
women of childbearing age as highly TERATOGENIC
Sodium Valproate side effects
weight gain, dizziness, hair loss, n+v, tremor, deranged LFT
Benzodiazepines 2 examples
lorazepam (short acting), diazepam (longer acting)
What are benzodiazepines used for
anxiety (short term in extreme cases only), mania, psychosis,
alcohol withdrawal, acute agitation/aggression
Benzodiazepines mechanism
Bind to GABA receptor -> neuronal inhibition
side effects Benzodiazepines
addictive, resp and CNS depressant effects (so avoid in certain cases)
Z drugs used for and examples
zopiclone
insomnia / inducing sleep
Stimulate GABA receptor
