Mental Health

Question 1

Antipsychotic agents can cause dry mouth, blurred vision, constipation and urinary retention. These are due to their ______ effectd

Answer 1

The adverse effects described are due to their anticholinergic effects, blockade of muscarinic receptors by antipsychotic agents.

Question 2

Benzodiazepines facilitate the action of which of the following neurotransmitters?

Answer 2

Benzodiazepines facilitate the action of the inhibitory CNS neurotransmitter, GABA.

Question 3

Compared to other neuroleptics, clozapine has less affinity for which type of dopamine receptors?

Answer 3

Clozapine has less affinity for D2 compared to the conventional neuroleptics, so it is less likely to induce extrapyramidal effects.

Question 4

Schizophrenia is thought to be due to the:

Answer 4

due to the overactivity of dopaminergic pathways.

Question 5

Which of the following benzodiazepines has the longest duration of action?

Answer 5

Diazepam

Question 6

Which of the following benzodiazepines has the shortest duration of action?

Answer 6

Alprazolam

Question 7

Which drugs can evoke depression?

Answer 7

beta-blockers, corticosteroids and oral contraceptives

Question 8

Hyperprolactinaemia, resulting in swelling of the breast and milk secretion, is one adverse effect of antidepressive agents. t/f?

Answer 8

false. Hyperprolactinaemia is due to the antagonism of dopamine receptors.

Question 9

Lithium may increase the bone density or bone formation in children. t/f?

Answer 9

true - Lithium may decrease bone density or bone formation in children.

Question 10

Regular and nightly use of a hypnotic agent is effective in preventing insomnia in the elderly.

Answer 10

false. When possible, prescribers often suggest that the elderly limit their intake of hypnotic drugs to three or four times a week to decrease the potential for inducing drug tolerance.

Question 11

How antipsychotics work?

Answer 11

theories focus on neurotransmitter doapmine (DA) and blokcing the D2 receptor.
seotonin also thought to modulate activity of dopamine.

Question 12

Antipsychotic benefits

Answer 12

effective in reducing symptoms of psychosis.
more relapses the pt has the less likely they will respond
2-4 weeks for full effect except clozapine which is 12 months
reduces risk of suicide

Question 13

What part of brain controles release of prolaction?

Answer 13

Hypothalamus

Question 14

Atypical antipsychotics were made to

Answer 14

reduce the level of EPSEs (extra-pyramidal side effects), especially tardive dyskinesia

Question 15

Name some extra-pyramidal side effects

Answer 15

Parkinsonian symptoms - tremor, rigidity
Dystonia - abnormal postures, difficultry swallowing
Akathisia - rocking from foot to foot, walking on the spot
Tardive dyskinesia - late onset, involuntary movements of limbs

Question 16

Which drugs have higher propensity to cause extra-pyramidal side effects ?

Answer 16

Typical antipsychotics

Question 17

Atypical Antipsychotics less likely to cause EPSE’s however more likely to cause

Answer 17

metabolic syndrome.

Question 18

Examples of Atypical Antipsychotics

Answer 18

Olanzapine, colazpine, quetiapine [PINES]

Question 19

Metabolic syndrome symptoms include

Answer 19

Weight gain, elevated Hba1c, hypertension, decreased cholestrol

Question 20

Metabolic syndrome is a serious health risk especially when people with _____ and ______ already have a genetic predisposition to developing diabetes

Answer 20

schizophrenia and BPAD

Question 21

Rare but life threatening - clozapine:

Answer 21

Agranulocytosis or Neutropenia:
low white blood cell or neutrophil count
Weekly blood tests for first 18 weeks of treatment, then 4 weekly thereafter

Symptoms of concern - fever, rigor, sore throat, any signs of infection and cognitive changes.

Question 22

Neuroleptic Malignant Syndrome (NMS) (antipsychotic medication)
- describe how this forms and signs and symptoms?

Answer 22

Dopamine receptor block in the corpus striatum, resulting in spasticity of skeletal muscles (leading to excessive heat generation) and impaired hypothalamic thermoregulation.

Signs and symptoms:
F - fever 
E - encephalopathy 
V - vitals unstable 
E - elevated enzymes (elevated CPK) 
R - rigidity of muscles

Question 23

Antidepressants
The biomedical explanation suggests that depression is related to deficiencies of serotonin, noradrenaline and possibly dopamine, or serotonin
Antidepressant medications have been developed to address these deficiencies, they do this in three ways.

Answer 23

Inhibiting the effects of monoamine oxidase, thus increasing the levels ofserotonin and norepinephrinein the synaptic cleft.

By blocking the reuptake ofspecific neurotransmitters leading to increased neurotransmitter levelsin the synaptic cleft.

Are involved in the regulation of receptor sites and breakdown of neurotransmitters, leading to an accumulation of neurotransmitter in the synaptic cleft

Question 24

3 categories of antidepressants - name.

Answer 24

SSRI’s, TCA’s and MAOI’s

Question 25

Example of SSRI’s and actions

Answer 25

prams and ine’s.
Citalopram, fluoxetine, sertraline

Action - SSRI’s block reuptake of serotonin.

Question 26

Side effects of SSRI’s

Answer 26

Insomnia, sexual dysfunction, nausea and vomiting.

Rare - serotinin syndrome. increased HR, fever, sweating.

Question 27

TCA’s examples and actions and side effects

Answer 27

INE’s. Amitriptyline, Nortiptyline. Block reuptake of norepinephrne and serotonin.
Dry mouth, blurred vision, constipation, weight gain.

Question 28

MAOI’s example and action

Answer 28

Tranylycpromine. Inhibit MAO, an enzyme in the nerves that breaks down norepinephrine, dopamine and serotonin.

Question 29

Anxiolytic (Anti-anxiety) Benzo’s - short treatment only. examples of anxiolytics and hypnotics

Answer 29

Anxiolytics
diazepam, clonazepam, lorazepam

Hypnotics
Temazepam, Triazolam, Zoplicone

Question 30

What is the one thing to look out for when it comes to anxiolytics?

Answer 30

They are metabolised extensively in the liver, therefore need to be used very cautiously with people with liver disease

Question 31

Benzodiazepines are ______ and _______ develops quickly

Answer 31

Benzodiazepines are addictive and tolerance develops quickly

Question 32

Benzodiazepines are sometimes used for their:

Answer 32

muscle relaxant effects

Question 33

In addition to its use in schizophrenia, chlorpromazine is also used to treat:

Answer 33

Chlorpromazine is useful in the treatment of intractable hiccup.

Question 34

Overdose of which of the following antidepressants is most likely to result in cardiac arrhythmias?

Answer 34

Overdose of TCAs can be life-threatening, resulting in serious adverse reactions such as cardiac arrhythmias.

Question 35

Tricyclic antidepressants act mainly by inhibiting the reuptake of:

Answer 35

TCAs act by inhibiting the reuptake of noradrenaline or 5-HT (serotonin).

Question 36

Which antipsychotic agents has the potential for causing agranulocytosis?

Answer 36

clozapine

Question 37

Which of the following drugs is used to manage benzodiazepine overdose?

Answer 37

flumazenil - This is a specific benzodiazepine-receptor antagonist.

Question 38

Which class of drugs increases the risk of falls in the elderly?

Answer 38

Psychotropics, antidepressants and benzodiazepine dosage are associated with increased risk of falls in the elderly.

Question 39

Antihistamines may be used as a sedative in young children.

Answer 39

This is preferred to benzodiazepines in children. However, antihistamines may sometimes cause paradoxical reactions, which include increased excitability, hostility and increased body temperature.

Question 40

Antipsychotics are particularly effective against the positive symptoms of schizophrenia, which are disordered thinking or hyper-behaviours commonly associated with schizophrenia. T/F

Answer 40

True

Question 41

Electroconvulsive therapy (ECT) is a safe and highly effective treatment for schizophrenia. T/F

Answer 41

False Although ECT was originally introduced to treat schizophrenia, it is now used to treat severe depression. ECT is thought to act by causing consistent readjustment in monoamine levels in the brain.

Question 42

Anixolytics/benzodiazepines(diazepam-longest duration of action) MOA EFFECT INDIC AR

Answer 42

MOA inc GABA to inhibit nerve trans in CNS
Effect drowsiness, confusion, dizziness, slurred speech
Indic acute stress, anxiety
AR addictive

Question 43

Antipsychotic MOA EFFECT INDIC AR

Answer 43

MOA block dopamiergic receptor sites which reduce + symptoms that we observe w psychosis
SEffect constipation, weight gain, sexual dys
Indic mgmt of shizoph, mania, reduces risk of suicide, psychosis
AR NMS[neuroleptic malignant syndrome]-FEVER mnemonic S+S

Question 44

Antidepressant (SSRI’s, TCA’s, MAOI’s) MOA EFFECT INDIC AR

Answer 44

MOA inhibit effects of monoamine oxidase,
SEffect anxiety, GI upset, diarrhoea, n+v
Indic depression, anxiety disorders
AR Serotonin syndrome

Question 45

Antimania/Lithium MOA effect indic pt ed, S+S toxicity

Answer 45

MOA mimics the effects of sodium, absorbed from GI tract. excreted from kidneys although 80% absorped, if low Na2+ levels is dehydr
SEffect tremor, gi upset, polyuria/in children can inc bone density and formation
Indic bipolar affective and schizo affective, and manic episodes.
Pt ed take with food, increase fluids, 3m tests to determine lithium levels
S+S of toxicity - blurred vision, confusion, slurred speech, n+v