Group C: Psychopharmacology

Question 1

List at least two classes of antidepressants and provide one example for each class (2 marks)

Answer 1

• TCAs -Amitriptyline, Nortriptyline, Imipramine
• SSRIs - Citalopram, Fluoxetine, Sertraline

Question 2

Describe two common contraindications for the use of Tricyclic Antidepressants (TCAs) (2 marks)

Answer 2

• Suicidal ideation due to the risk of cardiac toxicity in overdose.
• Recent myocardial infarction due to the risk of arrhythmias.

Question 3

What is the minimum number of symptoms required to diagnose a Major Depressive Episode (MDE) according to DSM-5? (1 mark)

Answer 3

5

Question 4

Name four symptom symptom of Major Depressive Episode as per DSM-5 criteria (0.5x4 = 2 marks)

Answer 4

Worthlessness, Loss of interest, Fatigue, Suicidal ideation

M SIGE CAPS
* mood (deprseed mood )
* sleep ( insomnia or hypomania )
* interest (decreased)
* Guilt , feeling of worthlessness
* Energy (decreased )
* concentration (decreased )
* Attention (decreased )
* psychomotor activation /retardation
suicidal ideation

Question 5

Mood stabilizers questions

A 35-year-old male patient with a history of bipolar mood disorder type 1 is currently prescribed lithium as a mood stabilizer. He presents to the clinic complaining of nausea, tremors, and confusion. On further questioning, he mentions that he recently started taking ibuprofen regularly for joint pain.

Explain the possible cause of the patient’s symptoms (2 marks).

Answer 5

1. The patient’s symptoms could be due to lithium toxicity. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can reduce the clearance of lithium by affecting kidney function, leading to increased lithium levels and potential toxicity.

Question 6

Mood stabilizers questions (7 marks)

A 35-year-old male patient with a history of bipolar mood disorder type 1 is currently prescribed lithium as a mood stabilizer. He presents to the clinic complaining of nausea, tremors, and confusion. On further questioning, he mentions that he recently started taking ibuprofen regularly for joint pain.

What are the clinical signs and symptoms of lithium toxicity? (2 marks)

Answer 6

2. Clinical signs and symptoms of lithium toxicity: nausea, vomiting, diarrhea, tremors, confusion, ataxia, and in severe cases, seizures, arrhythmias, or coma.

Question 7

Name one natural mineral used as a mood stabilizer (1mark)

Answer 7

Lithium

Question 8

Give two examples of an anticonvulsant used as a mood stabilizer (0.5x2 = 1 mark)
Answer

Answer 8

Lamotrigene
Sodium valproate

Question 9

.Name two psychiatric disorder for which mood stabilizers are indicated (0.5 x2 = 1 mark)

Answer 9

• Bipolar type 1 or type 2
• Schizoaffective
• Borderline personality disorder

Question 10

Antipsychotic questions (6 marks)

What extrapyramidal signs should you be aware of when using neuroleptics? [1½ marks]

Answer 10

Akathisia, Dystonia & Parkinsonism

Question 11

Antipsychotic questions

Name 2 side effects of using atypical antipsychotics [1 mark]

Answer 11

• Impaired glucose tolerance
• Dyslipidemia
• Prolonged QT interval
• Sexual Dysfunction
• Sedation
• Agranulocytosis (clozapine)

Question 12

Antipsychotic questions

An adult patient was on Haloperidol but has experienced EPSEs, as the doctor on duty you are required to change the patient to another medication.
Name the medication and your stat dose [1½ marks]

Answer 12

• If extrapyramidal side effects: switch to risperidone rather than adding an anticholinergic medicine:

Risperidone, oral (Doctor prescribed).
o Initial dose: 2 mg daily.
o Increase to 4 mg daily, if poor response after 4 weeks.

Question 13

Antipsychotic questions

4.Name the two main categories of antipsychotic drugs (0.5 x2 = 1 mark)

Answer 13

• Typical antipsychotics (first generation)
• Atypical antipsychotics (second generation)

Question 14

Antipsychotic questions

What is one benefit of atypical antipsychotics over typical antipsychotics? ( 1 mark)

Answer 14

Decreasing chances of EPSE (extrapyramidal side effects)