Meds_Guidlines Flashcards
First line treatment in adults adhd
Lisdexamfetamine or methylphenidate
2nd line treatment in adults adhd
Atomoxetine
3rd line treatment in adult adhd
Guanfacine
Alternative Rx to methylphenidate/lisdexamfetamine induced tics in adult adhd?
Atomoxetine
Alternative Rx for methyl/disdexamfetamine resistance attention deficiet in adult adhd
Atomoxetine
SSRI S.E in baby when taken after 20 weeks of pregnancy
Persistent pulmonary hypertension
What needs monitoring in children treated with methylphenidate?
Height and weight
Lenght of therapeutic trial of methylphenidate /lisdexamfetamine in children
6 weeks
The only antipsychotic licensed in the UK to treat behavioural and psychological symptoms of dementia???
Risperidone
NICE guidline: Fist line treatment for adhd in children(pre school)?
pArEntal training PrOgrAmmes
When would you prefer atomoxetine to methylphenidate in adhd+conduct disorder in children?
When there is a chance of misuse or diversion
Very common s.e of stimulants in adhd
Appetite suppression
Stimulant associated with liver toxicity
Pemoline
The stimulant that is controlled drug due to abuse and addiction?
Methylphenidate
For hallucination associated with delirium tremens(alcohol withdrawal), what psychotropics are preferred?
first oral lorazepam, if not applicable or not worked then parenteral lorazepam and Haluperidol
First line opiod detoxifixation drug (NICE)
buprenorphine (partial opiod agonist)
What drug that is used to help alcohol abstinence can cause dizziness and abduminal pain?
Disulfiram
Mechanism of acamprosate
Glutamatergic NMDA antagonist
NICE 1st line treatment to prevent replase in alcohol dependence
Naltrexone
NICE recommends it to use to support prevention of replase in alcoholism!!!
Nalmefene
Contradicted to be used in myocardial disease or psychosis + alcoholism
Disulfiram
Interferes with conversion of aldehyde to acetic acid in alcoholism
Disulfiram
Not to be used with patients who could be having alcohol withdrawals
IV glucose (may precipitate wernickโs encephalopathy)!
a hypnotic that is generally avoided in alcohol withdrawal
Clomethiazole ( may cause respiratory depression)
First line treatment for alcohol withdrawal
Chlordiazepoxide
Should be offered to pts with alcohol withdrawal
Thiamine parenteral
First line treatment for depression
SSRI
NNT for for SSRI in moderate depression
5
Assoc. with liver injury when used as antidepressant in elderly
Agomelatine
SSRI in elderly increase risk ofโฆ
Falls
Continue antidepressants in elderly after remission for how long?
12 months (higher chance of relapse)
Increases the level of theophylline
Fluvoxamine
How long should antidepressant trial last to decide its effectiveness?
4 weeks
Causes steven johnson syndrome
Carbamazepine
Causes visual impairment
Vigabatrin (assess visual every 3 months)
Increases lamotrigine 2 folds
Valproate
Causes angle closure glucoma
Topiramate (red, painful eye with vision loss)
Causes aggression when used in epilepsy
Levetiracetam
Perampanel
Can cause cleft palate and floppy baby syndrome in baby
Benzodiazepines
Very rare occasion in which bezodiazepine can be used in pregnancy
Extreme anxiety and agitation (when benefits outweigh risks)
Contraindicated in patients with uncontrolled epilepsy
Clozapine
Most associated with increase in hypertention, hence needs regular monitoring
Clozapine
Indicated in schizophrenia +diabetes
Amisulpride ๐
Most likely to cause dyslipidemia
Olan
What percentage of non compliance is due to forgeting it
10%
What scales are used to check compliance
DAI - Drug Attitude Inventory
MARS - Medication Adherence Rating scale
% of patients with schizo who become non-compliance after 24 months
75%
1st line treatment of body dysmorphic disorder
Fluoxetin
How long to continue ssri in body dismorphic sybdrome after symtoms reduced
12 month
1st line of medical treatment for OCD
ssri (like citalopram)
First line treatment for OCD in children
CBT including exposure response prevension
How long antidepressant therapy should continue in child ocd
6 months after remission
Rx licenced for OCD in young people in UK
fluvoxamine
which one is faster in detox buprenorphine or methadone?
buprenorphine