Anti-psychotics (Mood stabilizers)

Question 1

name 4 APs used for mood stabilisers?

Answer 1

aripiprazole, risperidone, quetiapine, olanzapine

Question 2

when are APs particularly useful?

Answer 2

acute mania - when pt presents as very mentally unwell

Question 3

2 classes of APs?

Answer 3

typical and atypical

Question 4

name 3 typical APs?

Answer 4

fluphenazine, haloperidol, pimozide

Question 5

name 4 atypical APs?

Answer 5

clozapine, risperidone, olanzapine, quetiapine

Question 6

action of typical APs?

Answer 6

D2 antagonists

Question 7

action of atypical APs?

Answer 7

serotonin-dopamine 2 antagonists

Question 8

aripiprazole - 2 advantages?

Answer 8

low sedation and low EPS

Question 9

aripiprazole - indications?

Answer 9

mania, mixed, maintenance

Question 10

aripiprazole - action?

Answer 10

D2 PARTIAL agonist

Question 11

risperidone - indications?

Answer 11

mixed, mania

Question 12

risperidone - 3 side effects?

Answer 12

weight gain, hyperprolactinaemia, sedation

Question 13

quetiapine - indications?

Answer 13

mania, depression, maintenance

Question 14

quetiapine - major SE?

Answer 14

orthostatic hypotension

Question 15

quetiapine - other SEs?

Answer 15

weight gain, abnormal LFTs

Question 16

olanzapine - indications?

Answer 16

mania, mixed, maintenance

Question 17

olanzapine - SEs?

Answer 17

hyperprolactinaemia, abnormal LFTs, weight gain

Question 18

young woman presents with 1st case of mania - no hx of note. Most appropriate treatment and measures taken?

Answer 18

pure mania - 800mg lithium - check pregnancy, serum creatinine, TSH

Question 19

young woman presents as aggressive, overactive and abusive etc. She needs restrained - tx?

Answer 19

olanzapine and benzodiazapine

Question 20

how long should prophylaxis be for mania?

Answer 20

life-long

Question 21

name 5 indications for APs?

Answer 21

schizophrenia, BAD, Schizoaffective disorder, psychotic depression, treatment resistant depression/ anxiety

Question 22

action of APs?

Answer 22

dopamine antagonists - therefore decrease dopamine pathways

Question 23

which pathway is associated with -ve sx of schizophrenia?

Answer 23

mesocortical

Question 24

which pathway is associated with +ve sx of schizophrenia?

Answer 24

mesolimbic

Question 25

which pathway is associated with Parkinsonain sx - i.e. rigidity/bradykinesia/ tremors etc.?

Answer 25

nigrostriatal

Question 26

which pathway is associated with hyperprolactinaemia?

Answer 26

tuberoinfundibular

Question 27

effect of dopamine on prolactin?

Answer 27

dopamine inhibits the release of prolactin

Question 28

name 3 sx of hyperprolactinaemia?

Answer 28

galactorrhoea, gynaecomastia, decreased libido

Question 29

how can we treat the EPS SEs of APs?

Answer 29

anticholinergics, dopamine facilitators, B-blockers

Question 30

what is neuroleptic syndrome?

Answer 30

severe muscle rigidity, fever, altered mental state, increased WBC, CPK and LFTs

Question 31

clozapine - indication?

Answer 31

treatment resistance schizophrenia/ schizoaffective disorder

Question 32

clozapine - name 4 SEs?

Answer 32

abnormal LFTs, weight gain, seizures, agranulocytosis

Question 33

clozapine - why do we need to do weekly bloods for 6 months?

Answer 33

in case of agranulocytosis

Question 34

name 4 general tests which should be undertaken before starting AP?

Answer 34

fasting lipid, fasting blood sugar, LFTs, FBC

Question 35

give an example of an anxiolytic?

Answer 35

busprione

Question 36

action of anxiolytic?

Answer 36

5HT1A agonist

Question 37

name 3 SEs of benzodiazepines?

Answer 37

somnolence, dependence, amnesia

Question 38

name 3 indications for benzodiazepines?

Answer 38

GAD, substance withdrawal, insomnia