BNPH700 Mental health Flashcards
What are the clinical indications for benzodiazepine (anxiolytics) use
Severe anxiety, agitation, insomnia, alcohol withdrawal, muscle spasm, treatment for seizures.
Mechanism of action for anxiolytics
Act by facilitating the binding of the inhibitory neurotransmitter GABA at various GABA receptors throughout the CNS - resulting in anxiolytic, sedative, muscle relaxant and antiepileptic effects.
What are some benzodiazepine drugs called
Diazepam, Clonazepam, Midazolam, lorazepam.
Common symptoms of benzodiazepine withdrawal
Common - Anxiety, insomnia, gastric problems, tremors, agitation, fearfulness and muscle spasms
Less common - Sweating, depersonalisation, derealisation, suicidal behaviours, seizures, hypersensitivity to stimuli.
How do antipsychotics work?
Do not really know how but the main theory focuses on the neurotransmitter dopamine and blocking the D2 receptor
Name some antipsychotics
Haloperidol, Zuclopenthixol, Flupenthixol, Chlorpromazine.
Side effects of antipsychotics
Blurred vision, confusion, agitation, drowsiness, dry mouth, difficulty urinating, constipation, hallucinations
What are extrapyramidal symptoms?
Tremor, rigidity, difficulty in swallowing, sustained muscular conditions that produce abnormal postures (Dystonia) Akathisia (agitation like jogging, walking on the spot) Tardive dyskinesia (Involuntary movements of orofacial, linb and truncal regions)
Name some Atypical antipsychotics
Olanzapine, Clozapine, Risperidone, Quetiapine
Side effects of atypical antipsychotics
Weight gain, drowsiness, constipation, dizziness, hypersalivation, sexual dysfunction, postural hypotension
What medication can cause life threatening symptoms, what are those symptoms? And what must a patient have done?
Clozapine - Causes neutropenia or agranulocytosis. Low white blood cells or neutrophil count. Patient needs weekly blood tests for 18 weeks then 4 weekly there after
Symptoms - Fever, rigor, sore throat, any signs of infection or cognitive changes
What is Neuroleptic Malignant Syndrome? and what doe sit cause the body to do?
Dopamine receptor block in the corpus striatum, resulting in spasticity of skeletal muscles (leading to excessive heat generation) and impaired thermoregulation
Signs and symptoms of Neuroleptic Malignant Syndrome (NMS)? And treatment to stop it?
F - fever
E - encephalopathy
V - vitals stable
E - elevated enzymes (CPK)
R - rigidity of muscles
Stop medication, cooling, hydration, use benzodiazepines/dantrolene to relax muscles
Examples of SSRI
Citalopram, Escitalopram, Paroxetine, Fluoxetine, Sertraline
Mechanism of action for SSRI
SSRI’s block the reuptake of serotonin leading to increased neurotransmitter levels in the synaptic cleft and increased stimulation of the postsynaptic cleft
Side effects of SSRI’s
Common - Insomnia, sexual dysfunction, nausea, vomiting, headache, anxiety, diarrhea, tremor, emotional dulling,
Serotonin syndrome symptoms
Increased heart rate, fever, sweating, dilated pupils, tremor, hyperreflexia, hyperactive bowel sounds, high blood pressure, confusion, agitation, hypervigilance, temperature.
What is the mechanism of action of tricyclic antidepressants?
They block reuptake of norepinephrine and serotonin leading to increased neurotransmitter levels in the synaptic cleft and increased stimulation of the postsynaptic receptors.
Example medications for tricyclic antidepressnats
Amitriptyline, Nortriptyline, Imipramine, Clomipramine.
Side effects of tricyclic antidepressants
Dry mouth, blurred vision, constipation, urinary retention, drowsiness, weight gain, headache, nausea, palpitations, postural hypotension, sexual dysfunction, sweating
Mechanism of action for monoamine oxidase inhibators
MAOI’s inhibit MAO, an enzyme in the nerves that breaks down norepinephrine, dopamine and serotonin. Allows neurotransmitters to accumulate in the synaptic cleft, causing increased stimulation of the postsynaptic receptors
Example of MAOI medication
Tranylcypromine
What food to avoid when taking MAOI’s?
Avoid foods high in tyramine such as hard cheese, meat and fish that are not fresh, salami, dried meats, soy sauce, tofu, home brew beer, yeast extracts and fermented food, as it activates norepinephrine receptors when in excess
Example of mood stabiliser medication
Lithium
