Drugs and Side effects

Question 1

TCA

• SE mnemonic
• management of OD

Answer 1

TCAS
Thrombocytopenia
Cardiac - arrythmias, long QT, wide QRS
Anticholinergic - constipation, urinary retention, dry mouth, dilated pupils, blurred vision, drowsy
Seizures - coma, agitation, metabolic acidosis

Management IV bicarbonate

Question 2

SSRI SE

-mnemonic

Answer 2

4Ss
Sexual dysfunction
Stomach upset and bleeds
-N+V
-appetite, weight change
Seretonergic syndrome
Suicidal thoughts and worsening of symptoms
-anxiety, agitation => headache, sweating, tremor, dizzy, blurry vision
-insomnia

Question 3

Typical antipsychotics

-SE and management

Answer 3

Extrapyramidal SE

• acute dystonia, oculogyric crisis, Parkinsonism => procyclidine
• tardive dyskinesia, akithisia => stop antipsychotic

Question 4

Atypical antipsychotics

Answer 4

Weight gain
Agranulocytosis and myocarditis for clozapine
T2DM
Sedation
Galactorrhea
Low Na

Question 5

Lithium

• SE
• management

Answer 5

LITHIUM

• lethargy, leukocytosis
• Insipidus
• tremor, teratogenic
• hypothyroidism
• intention tremor
• urinary excess
• metallic taste

IV saline
Hemodialysis

Question 6

Paracetamol OD

-management

Answer 6

Often asymptomatic
N+V

If within 1hr of ingestion => activated charcoal
If not or unknown => NAC
-monitor ptt, creatinine, LFTs

Question 7

Opioids OD

• presentation
• management

Answer 7

Coma, resp depression, pinpoint pupils

Antidote - IV naloxone
Management of opioid dependence - methadone, buprenorphine