Drugs Used in Psychiatric Disorders Flashcards

1
Q

How do psychiatric drugs work, generally speaking?

A

Agonists or antagonists of neurotransmitter receptors, or as an inhibitor of a regulatory enzyme

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2
Q

What are the 3 core symptoms of depression, and how many do you need to diagnose depression?

A

Low mood
Decreased energy
Anhedonia

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3
Q

What are the secondary symptoms of depression?

A

Decreased appetite, sleep disturbance, physical aches, irritability, self harm, suicidal thoughts, reduced concentration, as well as psychotic symptoms if severe, and reduced libido.

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4
Q

What class of neurotransmitter are NA and serotonin?

A

Monoamine neurotransmitters

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5
Q

What is the theory of pathophsiology of depression?

A

Deficiency of neurotransmitters such as NA and serotonin, or receptor abnormality. Depletion causes compensatory upregulation of post-synaptic receptors.

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6
Q

What are the classes of antidepressants?

A
TCAs
SNRIs
SSRIs
MAOIs
NARIs
Other including mirtazepine
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7
Q

What is the indication for SSRIs?

A

moderate to severe depression, alongside CBT

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8
Q

Which SSRI is the most selective?

A

Citalopram

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9
Q

Which is the most potent SSRI?

A

Paroxetine

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10
Q

Tell me about the pharmacokinetics of SSRIs.

A

Almost complete absorption in the gut
Long half life (once daily dose)
Metabolised in the liver

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11
Q

Are SSRIs generally well tolerated?

A

Yes

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12
Q

What are the most common side effects of SSRIs?

A

Loss of appetite, nausea, and diarrhoea

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13
Q

What are some of the rarer side effects of SSRIs?

A

Precipitation of mania
Possible increased suicidal ideation
Neurological side effects

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14
Q

What neurological side effects do you get with SSRIs?

A

Extra-pyramidal i.e. parkinsonian

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15
Q

What is the risk of taking an overdose of SSRIs?

A

Not much of a risk, as long as taken alone

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16
Q

Which SSRIs cause QT prolongation?

A

Citalopram

17
Q

What are the main TCAs?

A

Amitryptiline
Imipramine
Clomipramine
Lofepramine

18
Q

How do SSRIs work?

A

Selective serotonin reuptake inhibitor - prevent serotonin reuptake so more is available in the synapse to keep receptors saturated.

19
Q

How to TCAs work?

A

Inhibit NA reuptake, block muscarinic cholinergic receptors, and alpha 1 adrenoceptor blockage.

20
Q

Tell me about the pharmacokinetics of TCAs.

A

Lipid soluble
Aborbed in the gut and metabolised by liver
Long half lives

21
Q

What are the CNS side effects of TCAs?

A

Sedation
Impaired psychomotor skills
Seizure threshold lowered

22
Q

What is the ANS and GI side effect of TCAs?

A

Reduced glandular secretions

Constipation

23
Q

What are the CVS side effects of TCAs?

A

Tachycardia
Postural hypotension
Impaired myocardial contractility

24
Q

If a pt already on NSAIDs is given an SSRI, what else should they be given, and why?

A

PPI as they are at an increased risk of developing a GI bleed