All Drugs

Question 1

Paroxetine

Answer 1

SSRI - see class

BAD:
SEDATING
SEXUAL DYSFUNCTION
DISCONTINUATION

Question 2

Sertraline

Answer 2

SSRI - see class

BAD:
SEVERE GI DRUG INTERACTIONS
SEXUAL DYSFUNCTION
DISCONTINUATION

Question 3

Fluoxetine (Prozac)

Answer 3

SSRI - see class

GOOD:
minimal discontinuation
good for non-compliance

BAD:
ACTIVATION

Question 4

Citalopram

Answer 4

SSRI - see class

BAD:
DOSE DEPENDANT LONG QT
SEXUAL DYSFUNCTION
DISCONTINUATION

Question 5

Escitalopram

Answer 5

SSRI - see class

GOOD:
better acutely and for remission than Citalopram

BAD:
LONG QT
SEXUAL DYSFUNCTION

Question 6

Fluvoxamine

Answer 6

SSRI - see class

BAD:
GI UPSET
WEAKNESS
SEXUAL DYSFUNCTION

Question 7

Amitriptyline

Answer 7

Tertiary TCA - see class

GOOD:
very effective

BAD:
LETHAL IN OD
V HIGH SEs

Question 8

Doxepin

Answer 8

Tertiary TCA - see class

GOOD:
very effective

BAD:
LETHAL IN OD
V HIGH SEs

Question 9

Clomipramine

Answer 9

Tertiary TCA - see class

GOOD:
very effective

BAD:
LETHAL IN OD
V HIGH SEs

Question 10

Desipramine

Answer 10

Secondary TCA - see class

GOOD:
very effective

BAD:
LETHAL IN OD
HIGH SEs

Question 11

Nortriptyline

Answer 11

Secondary TCA - see class

GOOD:
very effective

BAD:
LETHAL IN OD
HIGH SEs

Question 12

Venlafaxine

Answer 12

SNRI - see class

GOOD: in elderly as fast renal clearance

BAD:
BP RAISE
DISCONTINUATION
SEXUAL
LONG QT

Question 13

Duloxetine

Answer 13

SNRI - see class

GOOD:
less increase in BP than Venlaflaxine

BAD:
BP STILL RISES
DRUG-DRUG INTERACTIONS

Question 14

Mirtazapine

Answer 14

Novel - see class

GOOD:
augmentation with SSRI

BAD:
CHOLESTEROL INCREASE
VERY SEDATING
WEIGHT GAIN

Question 15

Buproprion

Answer 15

Novel - see class

GOOD:
augmentation with SSRI
no weight gain
no sexual dysfunction
no sedation

BAD:
SEIZURE RISK
ANXIETY !!

Question 16

Lithium

Answer 16

Mood Stabiliser

GOOD:
long term prophylaxis of mania and depression, especially bipolar
ONLY MEDICATION THAT REDUCES RISK OF SUICIDE

BAD:
TOXICITY!!!
GI
THYROID
TERATOGENIC

NEED TO DO:
U&E
TSH
PREG TEST
CREATININE

TARGET LEVEL 0.6-1.2

> 2.5 = SEVERE TOXICITY

Question 17

Fluphenazine

Answer 17

High Potency Typical Antipsychotic - see class

BAD:
EXTRAPYRAMIDAL SIDE EFFECTS

Question 18

Haloperidol

Answer 18

High Potency Typical Antipsychotic - see class

BAD: EXTRAPYRAMIDAL SIDE EFFECTS

Question 19

Pimozide

Answer 19

High Potency Typical Antipsychotic - see class

BAD:
EXTRAPYRAMIDAL SIDE EFFECTS

Question 20

Chlorpromazine

Answer 20

Low Potency Typical Antipsychotic - see class

BAD:
CARDIOTOXIC
SEDATION
HYPOTENSION

Question 21

Thioridazine

Answer 21

Low Potency Typical Antipsychotic - see class

BAD:
CARDIOTOXIC
SEDATION
HYPOTENSION

Question 22

Risperidone

Answer 22

Atypical Antipsychotic - see class

BAD:
HYPERPROLACTINAEMIA
WEIGHT GAIN
SEDATION

Question 23

Olanzapine

Answer 23

Atypical Antipsychotic - see class

BAD: WEIGHT GAIN +++
LFTs

Question 24

Quetiapine

Answer 24

Atypical Antipsychotic - see class

BAD:
LFTs
ORTHOSTATIC HYPOTENSION

Question 25

Aripiprazole

Answer 25

Atypical Antipsychotic - see class

GOOD:
MINIMAL SEs

Question 26

Clozapine

Answer 26

Atypical Antipsychotic - see class

GOOD:
IT WORKS! _ RESERVED FOR TREATMENT RESISTANT PATIENTS

BAD:
LOADS OF SEs - AGRANULOCYTOSIS
SEIZURES

Question 27

Valproic Acid (DEPAKOTE)

Answer 27

Anticonvulsant - see class

GOOD:
COMORBID SUBSTANCE ABUSE
RAPID CYCLERS
BETTER TOLERATED THAN LITHIUM
AS EFFECTIVE AS LITHIUM FOR DEPRESSION

BAD:
NOT AS EFFECTIVE AS LITHIUM FOR MANIA
THROMBOCYTOPAENIA
PLATELET DYSFUNCTION
TERATOGENIC

NEED TO DO:
LFTs
FBC
PREG TEST

TARGET LEVEL: 50-125

Question 28

Carbamazepine (Tegretol)

Answer 28

Anticonvulsant - see class

GOOD:
1st line for acute mania and mania psychosis
RAPID CYCLERS
MIXED PATIENTS

BAD: RASH+++
AV CONDUCTION DELAY
DRUG-DRUG

NEED TO DO:
LFTs
FBC
ECG

TARGET LEVEL: 4-12

Question 29

Lamotrigine (Lamictal)

Answer 29

Anticonvulsant - see class

GOOD:
also for chronic/neuropathic pain

BAD:
RARE BUT VERY SEVERE SKIN REACTIONS - TOXIC EPIDERMAL NECROSIS, STEVEN’S JOHNSON SYNDROME - THEREFORE WITHDRAW IMMEDIATELY IF ANY SIGN OF A RASH

NEED TO DO:
LFTs

Question 30

Chlordiazepoxide

Answer 30

Benzodiazepine

GOOD:
for withdrawal state

BAD:
ADDICTIVE +++!!!

Question 31

Thiamine

Answer 31

Treatment for Wernicke’s Encephalopathy and Korsakoff Psychosis

Question 32

Naloxone

Answer 32

Specific opiate antagonist, used for the treatment of opioid toxicity, reverses resp. depression etc