Medications Flashcards
What effect does Lithium have on white blood cells?
Neutrophil levels are increased
SSRIs can cause which electrolyte abnormality?
Hyponatreamia
MAOIs are contraindicated in patients suffering from what physical condition?
Phaeochromocytoma
(Phaeochromocytoma are catecholamine secreting tumours, as MAOIs inhibit catecholamine breakdown they could cause a hypertensive crisis which may cause brain damage or death)
Increased bleeding risk is associated with what medication group?
Anti-depressants. SSRIs inhibit platelet aggregation but the mechanism for other anti-depressants is unclear.
Which is the best medication for paraphilia (intense sexual arousal to inappropriate things) and hyper-sexuality?
Sertraline and other SSRIs as their side effects include reduced libido and delayed orgasm.
What is Cyproterone acetate?
Anti-androgen which can be used to treat hyper-sexuality
What are the side effects of Lurasidone?
Lurasidone is an atypical anti-psychotic which commonly causes akathisia and sedation as side effects. It has a neutral metabolic profile. Minimum effective dose is 37mg
Which anti-depressant is most suitable for a depressed patient with ischaemic heart disease?
Sertraline
The SADHART study demonstrated that sertraline is safe in patients with IHD. Other anti-depressants have not been evidenced as safe. Mirtazapine is the safest second line alternative however can cause weight gain
30-50% of patients with long term exposure to Vigabatrin experience what visual change?
Irreversible concentric visual field loss
What are the side effects of Lithium?
Thyroid disorders such as hypothyroidism, hyperthyroidism and thyroiditis. These can present with lethargy, weight gain and hypothermia
Who wrote The Divided Self?
R D Laing - an important figure in the anti-psychiatry movement so said that schizophrenia was a theory not a fact
Who wrote Psychiatry in Dissent?
Anthony Clare
Who wrote The Red Book?
Carl Jung
Who wrote The Road Less Travelled?
Scott Peck
Who wrote The Myth of Mental Illness?
Thomas Szasz
What are the symptoms of discontinuation syndrome?
Flu-like symptoms Insomnia Nausea Imbalance Sensory disturbance Hyperarousal
Discontinuation is most likely with antidepressants with a short half life such as venlafaxine or paroxetine
In which stages of pregnancy should Lithium be avoided?
First trimester - causes atrialisation of the right ventricle
Breast-feeding - it is excreted in breast milk and toxic lithium levels can develop rapidly in the infant if they become dehydrated
Lithium can be used in the second and third trimesters but dose requirements are increased
Which anti-depressant causes the least sexual dysfunction?
Agomelatine
Which anti-depressant is best for atypical depression?
Phenelzine
What is the long term effect of Lithium on kidney function?
Nephrogenic diabetes insipidus
First sign is often nocturia
Occurs in 20-40% of patients on long term lithium
Causes a progressive decline in eGFR (but creatinine is usually normal)
Which anti-convulsant is contraindicated with Clozapine?
Carbamazepine due to risk of agranulocytosis
What are the side effects of Sodium Valproate?
Hyperammonaemia Gastric irritation Nausea Lethargy Confusion Weight gain Hair loss Peripheral oedema Hepatic failure Thrombocytopenia PCOS Pancreatitis
What are the side effects of Lamotrigine?
Dizziness Headache Sedation Tremor Nausea Ataxia
What is the mode of action of Disulfiram?
Inhibits acetaldehyde dehydrogenase (metabolises alcohol)so that drinking alcohol causes a build up of acetaldehyde which is unpleasant and possibly fatal
