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Psychiatry > Antidepressants/Mood stabilisers > Flashcards

Antidepressants/Mood stabilisers Flashcards

1
Q

Which antidepressent group in most dangerous in overdose?

A

Tricyclics

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2
Q

How long does it take for the patient to feel the improvement from an antidepressant drug?

A

2 - 3 weeks.

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3
Q

What is the general action of antidepressent medications?

A

Inhibit reuptake of norepinephrine/seratonin (5HT)

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4
Q

Briefly describe how SSRIs work

A

Reduce the reabsorption of serotonin into the presynaptic cell.
This increases the level of serotonin in the synaptic cleft available to bind to the postsynaptic receptor.
Overall there is an increase in neurotransmitter availability

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5
Q

Give an example of a tricyclic antidepressent

A

Amitryptyline

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6
Q

Give an example of an Monoamine oxidase inhibitor

A

Phenelzine

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7
Q

Give 3 examples of SSRIs

A

Fluoxetine
Citalopram
Setraline

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8
Q

What other 3 types of receptor will tricyclic antidepressents block?

A

Muscarinic receptors
Alpha adrenoreceptors
Histamine receptors

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9
Q

List some common side effects of tricyclic antidepressentss

A 
Dry mouth
Blurred vision
Constipation
Urinary retention
Tachycardia
Postural hypotension
(Sedative effect)
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10
Q

What is a contraindication to use of tricyclic antidepressents?

A

Recent MI

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11
Q

In general, what is the first line antidepressant?

A

SSRIs

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12
Q

List some common side effects of SSRI antidepressents

A

Nausea
Vomiting
Diarrhoea
Sexual dysfunction

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13
Q

How do Monoamine oxidase inhibitors work?

A

Inhibit the action of monamine oxidase

Prevents breakdown of dopamine, noradrenaline and serotonin

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14
Q

What pathway do some SSRIs (eg fluoxetine) block?

A

CYP450

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15
Q

A 26 year old man has just been started on an SSRI for depression. He has started to suffer from some sexual dysfunction. What drug would be useful?

A

Trazodone

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16
Q

What cardiac arrhythmia may arise due to tricyclic antidepressants?

A

Prolonged QT syndrome

17
Q

What drug is more often used to treat atypical depression?

A

Monoamine oxidase inhibitor

18
Q

What substance in the gut becomes inactivated by monoamine oxidase inhibitor and then acts by releasing noradrenaline?

A

Tyramine

19
Q

What does tyramine release when it is inactivated in the gut by a monoamine oxidase inhibitor?

A

Noradrenaline

20
Q

What is a patient on a Monoamine oxidase uptake inhibitor at risk of if the eat lots of tyramine containing foods?

A

Hypertensive crisis due to release of noradrenalin

21
Q

What foods should patients be told to avoid if the are tacking a MAOI?

A

cheese, yoghurt, yeast extracts, meat, alcohol, broad

beans, pickled herring

22
Q

How do you treat a hypertensive crisis die to MAOI use?

A

Alpha blockade (phentolamine

23
Q

List three anti convulsant drugs which are also used as mood stabilisers

A

Carbamazepine
Valproate
Lamotrigine

24
Q

List some atypical antipsychotics

A

Olanzapine
Risperidone
Ariprazole

25
Q

What citrate drug is used in bipolar disorder?

A

Lithium carbonate

26
Q

What calcium channel agonist is used in the treatment of bipolar disorder?

A

Nimodipine

27
Q

What receptor do true antipsychotic drugs have affinity for?

A

D2 receptor

28
Q

Which SSRI is safest if a patient has a past history of MI?

A

Sertraline

29
Q

A patient on long term aspirin is about to be started on an SSRI. What must also be presscribed?

A

PPI

30
Q

If you are prescribing an SSRI to a 17 year old, which one would be most appropriate?

A

Fluoxetine

31
Q

Which SSRI is associated with prolongation of the QT interval?

A

Citalopram

32
Q

Which drug group, most often prescribed for headaches is a contrainditicion to SSRI?

A

Triptans

Psychiatry (24 decks)

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