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ART_MRCPSYCH_B_MENTOR > Meds_guidlines_5 > Flashcards

Meds_guidlines_5 Flashcards

1
Q

Percentage of patients who will experience relapse if stopped antidepressants within 6 months after recovery

A

50%

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2
Q

In refractory depression what medication is recommended for augmentation by NICE?

A

Quetiapine
Lithium

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3
Q

Why is it so important to manage recurrent depression for long time?

A

Chances for 3rd and 4th episode increase up to 70%

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4
Q

What antidepressants used in post CVA depression?

A

SSRI (not if there is risk of GI bleeding)
Nortriptyline

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5
Q

Post CVA antidepressant of choice in a case who is on warfarin

A

Citalopram and escitalopram

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6
Q

NICE recommendation for 1st line medical treatment of depression in young people?

A

Fluoxetine

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7
Q

Starting dose for Fluoxetine in a 10 year old patient with moderate depression

A

10 mg

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8
Q

1st line of treatment in moderate depression in adolescents

A

individual CBT

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9
Q

1st line treatment for adolescent with mild depression

A

group CBT

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10
Q

What medication can cause impulsive behavoiurs?

A

Ropinirole (DAs)

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11
Q

Effects of magic mushrooms are similar to that of…

A

LSD

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12
Q

Medical treatment for children above 7 with enuresis who did not respond to reward system and alarms

A

200mcg Desmopressin

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13
Q

A dug that should be avoided in breasfeeding moms

A

Doxepin(induces resp. depression and sedation in the baby)

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14
Q

An antipsychotic that has antidepressant effect at low dose

A

Flupentixol

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15
Q

the ssri that suits patients with low mood and liver disease

A

paroxetine

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16
Q

preferred drug in manic patient with liver impairment

A

lithium

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17
Q

preferred drug for anxious patient with insomnia and liver impairment

A

alprazolam, lorazepam, oxazepam and temazepam

ALOT

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18
Q

what is a known side effect of st john’s wort

A

Potential to cause significant photosensitivity or phototoxicity

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19
Q

St john’s wort and cyp450 system

A

Causes induction cyp3a4

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20
Q

Another name for st john’s wort

A

Hypericum perforatum

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21
Q

Herbal remedy with evidence to be helpful in treating depression

A

St john

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22
Q

Herbal remedy with evidence to be helpful in treating anxiety

A

Piper methysticum (KAVA)

23
Q

risk of KAVA

A

hepatotoxicity (hence not recommended)

24
Q

Antipsychotic of choice in schizo +HIV

A

Risperidone

then olan, aripiprazole and quetiapine

25
Q

Medication that is used in HIV but xan cause depression and mania and fatal suicide

A

Efavirenz

26
Q

In a patient with schizophrenia in whom osteoporosis is suspected, what is preferred antipsychotic?

A

Aripiprazole (no effect on prolactine)

27
Q

A schizophrenia patient on risperidone develope gynecomastia or signs of hyperprolactemia ,what is alternative antipsychotic

A

Aripirazole

28
Q

In patients with sexual dysfunction as a result of risperidone, what is alternative if aripiprazole is not available

A

Quetiapine

29
Q

A depressed patient on venlafaxine or sertraline stops lactating, what is alternative?

A

Mirtazapine (NaSSA)

specific serotonergic antidepressant

30
Q

What else is serious consequence of hyperprolactemia induced by psychotropics that you should let patients know about?

A

Breast cancer

31
Q

Anti psychotic choices in parkinson’s

A

1st clozapine
2nd quetiapine

(low affinity for d2 receptors, hence no blockinh of nigrostriatal pathway)

32
Q

a benzodiazepine Drug with high chance of interdose withdrawal symptoms

A

Oxazepam

33
Q

Artefact for low calcium in elderly

A

Low albumin

34
Q

What if hypnotics did not solve insomina in patients who failed to respond to sleep hygiene too?

A

Stop hypnotics (zoplicone 7.5 mg daily) and do not prescribe anything from that class due to dependency

35
Q

Who are at more risk of developing benzo dependency?

A

Patient with history of anxiety

36
Q

Telorance to hypnotic effects of benzodiazepine?

A

May happen within days

37
Q

1st line treatment for insomnia less than 4 weeks

A

Zopiclone (NICE)
Promethazine (high next day drowsiness)

38
Q

recommended Rx for insomnia 2 months duration or more

A

CBT-I

39
Q

when should prolonged melotonin be given in cases of insomnia

A

1-2 hrs before bed

40
Q

Mention a recognised medication for insomnia with minimun next-day sedation effect…

A

Darido-rexant

Dual Orexin Receptor Agonist (DORA)

41
Q

Optimal therapeutic range for lithium

A

0.8-1 mmol/L

42
Q

Ideal range for lithoum (plasma level) as prophylaxis of bipolar

A

0.6-0.75

43
Q

Lithium monitoring in >65 y.o after plamsa level and mood stabilized?

A

Every 3 months

44
Q

In adults, how often lithium level is checked after stabilising and abscent of drug interaction??

A

Every 6 month

45
Q

In adults, how often lithium level is checked after stabilising and precence of drug interaction??

A

Every 3 month

46
Q

Effective mood stabilizer in steroid induced psychosis

A

Lithium

47
Q

Sign of toxicity on AMDISEN for lithiun

A

Myoclonus

48
Q

Mania can be induced by which Parkinson medication

A

Levadopa
Selegiline

49
Q

A drug that is very effective but poorly tolerated in acute mania

A

Haloperidol

50
Q

A drug that is effective and well tolerated in acute mania

A

Olanzapine

51
Q

Not recommended for acute mania

A

Topiramate

52
Q

Not recommended for acute mania

A

Topiramatw

53
Q

1st line of treatment for depression in Multiple Sclerosis

A

Sertraline

ART_MRCPSYCH_B_MENTOR (38 decks)

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