CNS Flashcards
What is first line treatment for ADHD (any age)
Methylphenidate
What CD schedule is methyphenidate and what are prescribing legalities?
Schedule 2 CD
Needs to be rxd by brand if modified release
What parameters are monitored with methylphenidate?
pulse, BP, appetite, weight and height
psychiatric symptoms e.g. depression, psychosis, suicidal ideation
What are the side effects of methylphenidate
increased HR and BP
loss apetite and weight loss
psychaitric symptoms
tics/tourettes
Why would you withdraw methylphenidate grudually
abrupt withdrawal causes psychosis, depression, renewed hyperactivity
What are 3 side effects of atomoxetine
suicidal ideation
hepatotoxicity
qt prolongation
What are 3 side effects of atomoxetine
suicidal ideation
hepatotoxicity
qt prolongation
In what situations would you not use antidepressants in bipolar disorder
Rapid cycling BD Recent hypomania manic episode mood fluctuations - antidepressants elevate low mood
what treatment is used in acute episodes of mania/hypomania
Benzodiazepines e.g. lorazepam
antipsychotics QOR- quetiapine, olanzapine, risperidone
What is the therapeutic range for lithium in:
- older adults and prophyaxis
- acute episodes or recurrent relapse
elderly/proph= 0.4-1mmol/L
Acute or recurrent = 0.8-1mmol/L
When is lithium monitored
Weekly at start and after dose changes then every 3 months when stable, increasing to 6 months
When is lithium sampled
12 hours post dose
What are 7 side effects of lithium
thyroid disorders weight gain renal impairment reduced seizure threshold benign intracranial hypertension QT prolongation
What are signs of lithium toxicity
renal e.g. polyuria, incontinenc EPS e.g. myoclonus, nystagmus, tremor visual disturbances confusion, drowsy, Diarrhoea and vomiting
What can predispose to lithium toxicity
dehydration/loss of water
changes in salt intake e.g. high salt intake
