Med_Guidlines_7 Flashcards
Treatment option for post stroke pathological emotional liability (crying)
Amitriptyline
Rx of psychotic depression (NICE and Maudsley)
A TCA (amitriptiline) and antipsychotic (Olan or quetiapine)
TCA resistant (not tolerated) psychotic depression [NICE]
SSRI WITH antipsychotics
the antipsychotic most associated with high THS levels?
Quetiapine
An antipsychotic that may disturbe liver enzymes
Olanzapine
Clozapine causes which enzyme to raise?
ALP
Does clozapine induced high ALP require dose adjustment?
Not often
Only if there are sympoms like Nausea, weakness and abd discomfort
Mood stabilizer mostly associated with liver toxicity
Valproate
A psychotropic that causes a drop in ALT and AST enzymes
Vigabatrin
Antidepressant that should be avoided in depression + epilepsy
Bupropion
Amitriptyline
Most appropreiate antidepressant for depression in epilepsy
SSRIs like Citalopram and sertralin
Mirtazapine
Highly pro convulsive antidepressant
TCAs
Antipsychotic with highest impact on siezure
Clozapine
Antipsychotic with low impact on siezure
Haloperidol
Used to manage dementia in Parkinson’s
Ache I: donepezil, rivastigmine galantamine (supported by RCT and metaanalysisi
Drug used to treat hypersalivation from clozapine
Hyoscin hydrobromide
Antipsychotic that elevates risk of cardiac arrest?
Thoridazine & droperidol
SSRI most likey to cause QTc prolongation
Citalopram
QT prolongation induced drugs
Erythromycin
Antimalaria
Citalopram
holoperidol
Mental or electrolye condition that are associated with QTc prolongation
Anorexia nervosa
hypokalaemia
hypomagnesaemia
hypocalcemia
Tachy or brady cardia increases risk of qtc prolongation
Brady
What to do if quetiapine caused QTc prolongation
Stop the Que
switch to Aripiprazole
refer to cardiologist
an antipsychotic with minimal effect on QTc
Aripiprazole
In a non_pharma resisted Restless leg syndrome which treatment can help
Gabapentin (1st line NICE)
Low potency opiod like codeine
Approve antipsychotic for adolescent schizophrenia
Risperidone or aripiprazole (2mg) (+ family intervention with individual CBT)
daily max dose of olan in 12-17 (BNF) in schizophrenia
20 mg
Is rapid neuroleptisation allowed in children with schizophrenia?
Nope! (NICE)
no loading dose
1 most affective antipsychotic for prominent negative symptoms schizo
Amisulpride
In PTSD when patient did not respond to SSRI, what is the next solution?
Venlafaxine (NICE)
recommended antidepressant in elderly patient depressed with broken hip on beta blockers for AF and inuprofen for osteoarthritis
Mirtazapine
Good for sleep regulation, appetite boost and cardio safe
1st line treatment for post MI depression
SSRI like sertraline
Non-addictive choise for opiod detox
Lofexidine
2nd line of treatment after ssri in ptsd
Venlafaxine
Med indicated to reduce nightmares in PTSD if other approaches failed
prozasin (blocks a1 adrenergics and reduce hyperarousal)
Not recommended in PTSD
amitriptyline
Antidepressant for a patient on tamoxifen
Venlafaxine and Citalopram (NO CYP2D6 Inhibitor like fluoxetine)
Medication that causes swallowing difficult in learning disability
Clonazepam
Drug licenced for tardive dyskinesia
Tetrabenzine
Alternative to haloperidol when patien develops Tardive dyskinesia
Quetiapine
TARDIVE d. is due to
Hypersensitiviy of D2
epilepsy med that is associated with weight loss
topiramate
most appr. Rx for 10 y.o with tourette’s who did not respond to to comprehensive behavioural intervention for Tics (CBIT)
Clonidine (alpha 2 adrenergic agonist
Drug licenced for acute psychmotor agitation in psychosis
Oral olan 10 mg
Rapid tranquilisation
Inhaled loxapine
Contraind. for loxapine
Asthma & COPD
combined with IM haloperidol for rapid tranquilisation
promethazine
Conventional antipsychotic licensed for depression (BNF)
Flupentixol
Mechanism of action flupentixol
Strong D1 and D2 antagonist
weak 5-HT2A antagonist
Dose of Flupentixol as antidepressant
0.5-3 mg/day
When IM Flupentixol is an option for depression? (Maudsley)
if the alternative to the oral route is needed
