Anti-psychotics Flashcards
When are Selective serotonin reuptake inhibitors used?
Used in moderate to severe depression wit CBT
What is the most important SSRI?
Citalopram
What are the ADRs of SSRIs?
Anorexia
Nausea
Diarrhoea
What is an example of a tricyclic antidepressant?
Amitryptilline
What are effects of TCAs?
Inhibition of noradrenaline uptake
Muscarinic cholinoceptor blockage (reduces Cholinergic neurotransmission)
Alpha-1 Adrenoceptors blockade (suppression of noradrenergic neurotransmitter)
What is the problem with TCA overdose?
Become extremely toxic
What are the ADRs of TCAs?
Sedation
Lower seizure threshold
Tachycardia
Constipation
What are examples of non-selective monoamine uptake inhibitors?
Venlafaxine
What are the ADRs of non-selective monoamine uptake inhibitors?
Sleep disturbance
Increased BP
Dry mouth
What are some symptoms of paranoid schizophrenia?
Basically a lack of contact with reality
- disturbances of thinking
- hallucinations
- behavioural changes
What are some precipitating factors for schizophrenia?
Genetic
Biological
Upbringing
What neurotransmitter seems to be increased in most cases of schizophrenia?
Dopamine
What is Chlorpromazine?
Dopamine antagonist
Typical antipsychotic
What is the problem with giving dopamine antagonists?
Over time, will lead to Parkinsonism
What pathways are affected when you block D2 receptors?
- nigrostriatal: tardive dyskinesia
- mesocortical: enhanced negative psychotic symptoms
- Mesolimbic: therapeutic action on positive schiz symptoms
- tuberojnfundibular: hyperprolactinaemia
What are ADRs of antipsychotics?
Extra pyramidal side effects
Sedation
Hypotension
Tachycardia
How is clozapine different to chlorpromazine?
It is an atypical antipsychotic
Good activity with less extrapyramidal side effects
Reduces negative symptoms
What are ADRs of atypical antipsychotics?
Leukopenia
Excess salivation
Excessive weight gain
Sedation
Why is it important to reduce ADRs in antipsychotics?
If you don’t, patients will stop taking meds and they will relapse
What is anxiety?
Fear out of proportion to a situation Physical symptoms include: - light headedness - shortness of breath - flushes - nausea - palpitations
What is the first line treatment for anxiety?
CBT
How do Benzodiazepines work?
Binds to BDZ receptors and enhance GABA action
They are highly lipid soluble and so CNS diffusion is rapid
What are the ADRs of BZ’s?
Drowsiness Dizziness Dry mouth GI upset Headaches
What problems are caused by taking BZs during pregnancy?
Cleft lip and palate of the child
Can cause resp depression and feeding difficulties in the baby
What can be used to treat BZ overdose?
Flumazenil
What is bipolar disorder?
Depression and hypomania
Over active
Poor concentration
Poor sleep
How do you treat Bipolar disorder?
Lithium
Anti-epileptics
What are the ADRs of lithium?
Memory problems
Thirst
Polyuria
Tremor
What does Lithium toxicity cause?
Vomiting
Diarrhoea
Coarse tremor
Dysarthria
How do you treat Lithium toxicity?
Anticonvulsants
Increased fluid intake and IV fluids
Haemodialysis if necessary
What are the defensive factors of the stomach?
Epithelial integrity
Cell replication
Mucous membrane barrier
Vascular supply
What is the monoamine hypothesis?
Deficiency of monoamine neurotransmitters lead to depression
