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FINALS > CNS - Prescribing > Flashcards

CNS - Prescribing Flashcards

1
Q

What drug class is diazepam?

A

Benzodiazepine

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2
Q

How do benzodiazepines work?

A

Increase the affinity for inhibitory neurotransmitter TA BA

opens chloride iron channels

hyper polarisation of the neuron membrane preventing further excitation

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3
Q

When is diazepam indicated?

A

Short-term treatment of severe anxiety

short-term treatment of insomnia

muscle spasms

status epilepticus

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4
Q

What are common side effects of benzodiazepines?

A 
Amnesia
confusion
dependence
drowsiness
hangover effect the next day
psychomotor impairment
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5
Q

What are severe side effects of benzodiazepines?

A

A taxi leading to increased risk of falls in elderly
dependence
respiratory depression
tolerance

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6
Q

When is benzodiazepine contraindicated?

A 
Elderly
respiratory disease
muscle weakness
my senior Gravis
history of drug or alcohol abuse
sleep apnoea
pregnancy breastfeeding
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7
Q

What do benzodiazepines interact with?

A

Antihypertensives – increase hypotensive effect

clozapine has serious adverse effects with Lorazepam

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8
Q

What should be communicated to patients when taking benzodiazepines?

A

May impair their ability to perform skilled tasks such as drivingA whole starting this

should not be taken for longer than four weeks

alcohol increases their effect

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9
Q

How do you treat benzodiazepine overdose?

A

IV flumazenil

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10
Q

What are examples of typical antipsychotics?

A

Haloperidol
chlorpromazine
prochlorperazine

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11
Q

What are examples of atypical antipsychotics?

A

Risperidone
quetiapine
clozapine

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12
Q

When would you prescribe antipsychotics?

A

Schizophrenia and other psychoses
mania

if needing to sedate someone who is elderly use haloperidol

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13
Q

What are side effects of antipsychotics?

A

Drowsiness
agitation
extrapyramidal symptoms (postural hypotension positive dyskinesia neuroleptic malignant syndrome)

agranulosatosis in clozapine only

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14
Q

What drugs do antipsychotics interact with?

A

Antihypertensives – increased hypertension

drugs which prolonged QT intervals

anti-epileptics – lower seizure threshold

opioids and alcohol– increased sedation

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15
Q

What should be monitored with clozapine?

A

SBC

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16
Q

What class is lithium?

A

A mood stabiliser

17
Q

What are side effects of lithium?

A

Fine tremor
weight gain

hypothyroidism
hyperparathyroidism - hypercalcaemia

lithium toxicity

18
Q

What are symptoms of lithium toxicity?

A 
blurred vision
muscle cramps
drowsiness
course tremor
slurred speech
ataxia
confusion
convulsions
nausea
vomiting
ECG changes
19
Q

What drugs does lithium interact with?

A 
Increase conc:
NSAIDS
ACEi
ARB
diuretics

decrease conc:
caffieie
sodium salts
-phallines

amiodarone - increase risk of ventricular tachycardias

20
Q

When should lithium be checked?

A

Every three months

check baseline (U+E, eGFR, T4, TSH, FBC, ECG) every six months

BMI every 12 months

21
Q

What drug class is amitriptyline?

A

Tricyclic antidepressant

22
Q

How you try psychics work?

A

Rent reuptake and degradation of serotonin and noradrenaline

23
Q

When would you prescribe tricyclic antidepressants?

A

Depression
neuralgia
nocturnal enuresis in children
sedatives

24
Q

What are side effects of amitriptyline?

A

Can cause anti-muscarinic facts
anxiety, dizziness, agitation in the elderly

can cause overdose and recall you toxic
hyponatraemia

25
Q

What drug names of SSRIs?

A

Fluoxetine
sertraline
citalopram

26
Q

Why would you use SSRIs

A

Depressive illness
Panic disorder
Obsessive compulsive disorder

27
Q

What are side effects of SSRIs

A 
GI upset
the increased risk of bleeding
hypersensitivity reactions
risk of withdrawal
convulsions
neuroleptic malignant syndrome
28
Q

what drugs interact with SSRIs?

A

Alcohol increase edited

NSAIDs increased risk of bleeding

antiepileptic’s lower threshold for seizures

MAOIs do not start SSRI until two weeks of stopping MAOIs and vice versa

29
Q

What drugs are there in the class of SNRI?

A

venlafaxine

duloxetine

30
Q

When all SNRIs indicated?

A

Major depressive disorder
Generalised anxiety disorder
Duloxetine is also used for stress incontinence

31
Q

What are important side-effects of SNRIS

A

SIADH; Rhabdomyolysis

Neuroleptic malignant syndrome

Withdrawal (particularly with venlafaxine)

GI disturbance,

anxiety, dizziness, paraesthesia, tremor, sleep disturbance, sweating

FINALS (24 decks)

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