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AB 3rd Year Psychiatry > Drugs > Flashcards

Drugs Flashcards

1
Q

how long should antidepressants be trialed for?

A

4-6wks

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2
Q

how do benzodiazepines work?

A

enhance the effect of GABA

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3
Q

what do benzodiazepines cause?

A

sedation
anticonvulsant
anterograde amnesia

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4
Q

are benzos safe in pregnancy? what risks?

A

no, cleft palate

floppy baby when breastfeeding

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5
Q

examples of typical antipsychotics?

A

haloperidol

chlorpromazine

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6
Q

how do typical antipsychotics work?

A

inhibit dopamine 2 receptors

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7
Q

side effects of antipsychotics?

A 
parkinsonism
akathisia
metabolic syndrome
sedation
increased PRL
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8
Q

treatment for acute dystonia?

A

prochlorperazine

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9
Q

eg of atypical antipsychotics?

A 
clozapine
olanzapine
risperidone
aripiprazole
amisulapride
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10
Q

what antipsychotic is less likely to cause extrapyramidal side effects?

A

atypical

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11
Q

what antipsychotic has a higher risk of metabolic syndrome?

A

atypical (particularly clozapine)

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12
Q

what other risks does clozapine have?

A

agranulocytosis
FBC measured regularly
myocarditis (taper off)

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13
Q

what two atypical antipsychotics should be avoided in pregnancy?

A

clozapine

olanzapine

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14
Q

what can anticonvulsants be used in?

A

bipolar

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15
Q

what is valporate good for?

A

mania/hypomania

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16
Q

what is lamotrigine good for?

A

bipolar depression

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17
Q

side effects of lithium?

A 
dry mouth
strange taste
polydipsia/uria
hypothyroid
reduced renal function
wt gain
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18
Q

complication of lithium?

A

nephrogenic diabetes insipidus

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19
Q

monitoring for lithium?

A

U+Es, ECG, TFTs at start
3 months - U+Es, Li level
6 months - TFTs

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20
Q

is lithium safe in pregnancy?

A

no

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21
Q

features of Li toxicity?

A 
vomiting 
diarrhoea
ataxia
drowsy
convulsions
coma
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22
Q

first line in depression? egs?

A 
SSRIs
fluoxetine
citalopram
sertraline
paroxetine
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23
Q

mechanism of SSRIs?

A

selectivity inhibits reuptake of 5-HT

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24
Q

major complication of SSRIs?

A

increase in self harm/suicide in under 25yrs

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25
Q

when should SSRIs be taken?

A

morning

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26
Q

are SSRIs safe in overdose?

A

yes

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27
Q

which SSRIs safe in pregnancy?

A

fluoxetine

sertraline

28
Q

egs of tricyclic antidepressants?

A

imipramine
amitriptyline
dosulepin

29
Q

mechanism of tricyclic?

A

blocks reuptake of NA and 5-HT into presynaptic terminals

30
Q

side effects of tricyclics?

A 
sedation
wt gain 
arrythmia/tachydardia/PHT
blurred vision
dry mouth
urinary retention
31
Q

when should tricyclics be taken?

A

night

32
Q

what antidepressants should be avoided in those with a Hx of overdose?

A

tricyclics

33
Q

what antidepressants are safe in those with a Hx of overdose?

A

SSRIs

34
Q

what is used in Tx resistant depression? egs?

A

MOAIs
moclobemide
phenelzine
isocarboxazid

35
Q

side effects of MOAIs?

A 
insomnia
PHt
oedema
jaundice
makes other drugs more potent
36
Q

major complication of MOAIs?

A

hypertensive crisis

37
Q

how to avoid and Tx HT crisis?

A

avoid tyramine meals - cheese, alcohol, caffeine

Tx - phentolamine infusion

38
Q

what are another use of antidepressants? egs?

A

neuropathic pain
duloxetine (SNRI)
amitriptyline (tricyclic)

39
Q

egs of SNRIs?

A

venflaxine

duloxetine

40
Q

when should SNRIs be taken?

A

morning

41
Q

eg of NaSSA?

A

mirtazapine

42
Q

when should NaSSA be taken?

A

night

43
Q

side effects of NaSSA?

A 
weight gain (due to appetite increase)
sedation
44
Q

what can occur when alcohol and NaSSA are mixed?

A

GI upset

45
Q

eg of SARI?

A

trazodone

46
Q

when should SARI be taken?

A

night

47
Q

features of a hypertensive crisis?

A

headache
SOB
nosebleeds
anxiety

48
Q

side effects of SSRIs?

A 
nauseau
headache
sweating
vivid dreams
sexual dysfunction
49
Q

what anti depressants have discontinuation side effects?

A

SSRIs

50
Q

what fetal abnormality can lithium caused if used while pregnant?

A

ebstein’s (heart defect)

51
Q

if used during pregnancy, what can olanzapine cause?

A

gestational diabetes

52
Q

how do atypical antipsychotics work?

A

dopamine and 5-HT antagonism

53
Q

how do MOAis work?

A

inhibitor MAO-A and B enzymes

54
Q

what antidepressant is best in CVS problems?

A

sertraline

55
Q

what antidepressant is best in epilepsy?

A

citalopram

56
Q

what is a cardiac side effect of one SSRI?

A

long QT with citalopram

57
Q

mechanism of SNRI?

A

block reuptake of NA and 5-HT into presynaptic terminals

58
Q

what is the only licensed antidepressant for under 18s?

A

fluoxetine

59
Q

if on an SSRI and NSAID, what must be given?

A

PPI

60
Q

if on SSRI, what drug should be avoided?

A

triptans

61
Q

if on warfarin/heparin, what drug should be recommended?

A

mirtazipine (NaSSA)

62
Q

what is Tx for neuroleptic malignant syndrome?

A

bromocriptine

63
Q

what is neuroleptic malignant syndrome?

A

reaction to antipsychotics

64
Q

who is good to use mirtazipine in?

A

lack of appetite

wt loss

65
Q

how do NaSSAs work?

A

Blocks a2, 5-HT2 & 5-HT3

AB 3rd Year Psychiatry (13 decks)

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