mental health

Question 1

tricyclic antidepressants

method of action:
uses:
side effects:
contraindications:
example:

Answer 1

Method of Action: Inhibit the reuptake of amines such as serotonin and noradrenaline in the brain, enhancing inhibition from the brainstem to the spinal cord

Uses: Depression, bipolar disorder, chronic pain and insomnia

Side effect: Cardiac arrhythmia, xerostomia, postural hypotension

Contraindications: Hypersensitivity, cardiac arrhythmia, severe liver disease and mania

Example: Amitriptyline (Ends in -Triptyline)

Question 2

MAO inhibitors

method of action:
uses:
side effects:
contraindications:
example:

Answer 2

Method of Action: Inhibits the enzyme monoamine oxidase in the brain leading to reduced breakdown of amines such as serotonin and dopamine

Uses: Depression, anxiety – only used as a last resort for symptomatic treatment

Side effect: Xerostomia, headache, drowsiness, the CHEESE REACTION (cheese contains tyramine, a monoamine. IF you are taking this drug and eat cheese tyramine enters the blood, is not broken down by the enzyme leading to malignant hypertension)

Contraindications: Hypersensitivity, uncontrolled hypertension, hepatic or renal impairment

Example: Rasagiline (ends in –Giline)

Question 3

SSRIS

method of action:
uses:
side effects:
contraindications:
example:

Answer 3

Method of Action: Inhibits cellular reuptake or serotonin so more is available intercellularly at synapses

Uses: Depression, generalised anxiety disorder, severe phobia anxiety and PTSD

Side effect: Headache, nausea, vomiting, insomnia, erectile dysfunction or loss of libido

Contraindications: Bipolar disorder, bleeding disorders and diabetes

Example: Fluoxetine

Question 4

typical antipsychotics

method of action:
uses:
side effects:
contraindications:
example:

Answer 4

Method of Action: Bind to dopamine receptors (can be adrenergic, muscarinic or histamine), good for positive symptoms but poor for negative symptoms

Uses: Schizophrenia (specifically psychosis)

Side effect: High incidence of Parkinsonism (symptoms of parkinsons disease) and other extrapyramidal symptoms

Contraindications: No longer the first line due to the poor treatment of negative symptoms and high incidence of parkinsonism

Example: Phenothiazines

Question 5

atypical antipsychotics

method of action:
uses:
side effects:
contraindications:
examples:

Answer 5

Method of Action: Bind to dopamine2 receptors and serotonin2a receptors, good for positive and negative symptoms

Uses: Schizophrenia (specifically psychosis)

Side effect: Low incidence of parkinsonism, xerostomia, blurred vision and weight gain

Contraindications: Bone marrow suppression, reduced hepatic function, parkinsons syndrome and hypotension

Example: Clozapine and Aripiprazole

Question 6

lithium prophylaxis

method of action:
uses:
side effects:
contraindications:

Answer 6

Method of Action: Unknown

Uses: Periods of mania during bipolar

Side effect: Fatigue, hypokalaemia and memory impairment

Contraindications: NSAIDs and diuretics

Question 7

benzodiazepines

method of action:
uses:
side effects:
contraindications:
examples:

Answer 7

Method of Action: Increases amount of GABA in the brain

Uses: Status epilepticus and anxiety

Side effect: Drowsiness, excess sedation and in children paradoxical hyperactivity

Contraindications: Alcohol, opiates and any antidepressant

Example: Midazolam

Question 8

miconazole

method of action:
uses:
side effects:
contraindications:

Answer 8

Method of Action: Inhibits formation of fungal cell membranes (topical)

Uses: Oral Candidiasis

Side effect: Burning, stinging, sensitivity, tenderness and flaking/sloughing

Contraindications: Hypersensitivity, interactions with statins, increases effect of warfarin