Medication Flashcards

Question

How does serotonin syndrome present?

Answer 1

1. cognitive - altered mental state, headache, agitation, hallucinations 2. somatic- myoclonus, tremor, hyperreflexia 3. autonomic - sweating, tachycardia, hypertension. nausea, hyperthermia

Answer 2

1. remove cause 2. IV fluids and benzodiazepines 3. cyproheptadine = serotonin antagonist

Answer 3

chlordiazepoxide diazepam lorazepam

Answer 4

sedation anxiolytic anti convulsant

Answer 5

enhance effect of GABA by increasing frequency of chloride channels

Answer 6

``` high risk of dependence confusion drowsiness hypotension/ dizziness nausea ```

Answer 7

``` anxiety insomnia tremor loss of appetite seizures ```

Answer 8

olanzapine clozapine risperidone quetiapine (worse metabolic syndrome SE)

Answer 9

haloperidol laxapine pimozide (worse EPS symptoms)

Answer 10

block D2 dopamine receptors in the brain

Answer 11

``` extra pyramidal anti muscarinic e.g. dry mouth, blurred vision, urinary retention, constipation raised prolactin hypercholesterolaemia reduced seizure threshold impaired glucose tolerance (diabetes) prolonged QT interval weight gain adrenergic - sedation, postural hypotension, inhibition of ejaculation ```

Answer 12

Acute dystonia = first few days akathisia (restlessness, muscle pains)= first month parkinsonism = few months tardive dyskinesia = years

Answer 13

``` FBC UandE LFTs blood lipids weight ECG ```

Answer 14

occurs after taking anti psychotics for a long period of time

Answer 15

``` chewing jaw movements chorea irreversible lip smacking ```

Answer 16

tetrabenazine = treatment for hyperkinetic movement disorders (e.g. Huntington's also)

Answer 17

zuclopenthixol | flupentixol decanoate

Answer 18

anti psychotic monthly depot injections!

Answer 19

occurs most commonly in first 10 days of starting anti psychotic treatment (commonly in males) OR when anti psychotic medication stopped/ reduced

Answer 20

``` rigidity hyperthermia/ fever sweating tachycardia raised CK confusion ```

Answer 21

1. stop anti psychotic 2. IV fluids 3. bromocriptine or dantrolene (dopamine agonist)

Answer 22

``` facial grimacing oculogyric crisis torticollis dystonia of laryngeal muscles opisthotonus ```

Answer 23

1. stop anti psychotic | 2. anti cholinergic drugs e.g. procyclidine IM/IV , IM benzotopine

Answer 24

lithium is a mood stabiliser 1st line for bipolar disorder, cyclothymia reduces suicidal ideation

Answer 25

NARROW= 0.4-1.0 mmol/L

Answer 26

checked weekly when starting lithium until stable then checked every 3 months (12 hours post dose)

Answer 27

``` weight TFTs renal function (creatinine and eGFR) ECG FBC ```

Answer 28

``` L - leucocytosis I - impaired renal function T- tremor (fine) H - hypothyroidism I - increased weight gain U - urine increase (oliguria) M - metallic taste ``` + nausea/ vomiting. diabetes insipidus, idiopathic intracranial hypertension

Answer 29

1. 6-2.0 = mild 2. 1-2.5 = moderate >2.5 = severe

Answer 30

fine tremor nausea and vomiting poor concentration

Answer 31

``` coarse tremor slurred speech disorientation nystagmus hyperreflexia ```

Answer 32

inverted T wave/ flat T wave

Answer 33

``` muscle twitches parkinsonism incontinence renal failure seizures confusion ```

Answer 34

``` severe hypotension convulsions arrythymias coma anti cholinergic - dry mouth, dilated pupils ```

Answer 35

ACE-I pregnancy diuretics NSAIDs

Answer 36

agranulocytosis neutropenia constipation NEED 1 MONTHLY FBC used if fail to respond to 2 other drugs and good for comorbid movement disorders

Answer 37

sexual dysfunction breast enlargement gallactorhoea

Answer 38

prolonged QT interval

Answer 39

1. IV bicarbonate | 2. IV lipid emulsion

Answer 40

serotonin dopamine D2 receptor antagonist

Answer 41

1. mesolimbic: +VE symptoms 2. mesocortical: -ve symptoms 3. nigrostriatal: extra pyramidal symptoms 4. tuberoinfundibular: Hyperprolactinaemia in schizophrenia, there is overactivity of mesolimbic pathway and under activity of mesocortical so drugs block these and help +ve symptoms but worsen -ve symptoms

Answer 42

1. benzodiazepines e.g. diazepam 2. Z drugs e.g. zopiclone 3. melatonin - only used over >55 y/o

Answer 43

lithium anti convulsants e.g. valproate, lamotrigine anti psychotic e.g. olanzapine

Answer 44

PRIMARY CARE/ VOLUNTARY SECTOR: counselling psychoeducation CBT ``` SECONDARY CARE / SPECIALIST: DBT psychoanalytic psychotherapy group therapy family therapy ```

Answer 45

detention in hospital for assessment of your mental health and potentially get treatment

Answer 46

nurses holding power, 6 hours, needs to be followed by MHA

Answer 47

police removal from public place to designated place of safety for MHA assessment

Answer 48

police removal from home to designated place of safety for MHA assessment

Answer 49

2 doctors (one must be section 12 approved, other must be registered doctor) + approved mental health professional

Answer 50

mental health disorder nature or degree to warrant detention in hospital risk to self others or health

Answer 51

RMO - registered mental officer | family - nearer relative