Mental Health Flashcards
what type of drug is amitriptyline?
tricyclic antidepressant
how do tricyclic antidepressants work?
inhibit neuronal reuptake of serotonin and noradrenaline thereby increasing
their availability for neurotransmission
(Also block receptors including muscarinics, histamine, alpha-adrenergic, dopamine)
what are the indications to take tricyclic antidepressants?
Depressive illness, neuropathic pain
what are the contraindications to taking tricyclic antidepressants?
MI, arrhythmia, epilepsy, raised IOP, prostatic hypertrophy
what are the side effects of amitriptyline?
Dry mouth, constipation, urinary retention, blurred vision, sedation, hypotension, arrhythmias, ECG changes, convulsions, hallucinations, mania, breast changes, sexual dysfunction, extrapyramidal symptoms
what are the interactions with amitriptyline?
Monoamine oxidase inhibitors (together cause hypertension, hyperthermia or serotonin syndrome)
what type of drug is citalopram?
SSRI
how do SSRIs work?
(SSRIs) preferentially inhibit
neuronal reuptake of serotonin (5-HT) from the synaptic cleft, thereby
increasing its availability for neurotransmission
what are the indications to take SSRIs?
Moderate-to-severe depression, panic disorder, obsessive compulsive disorder
what are the contraindications to taking SSRIs?
Epilepsy, peptic ulcer disease, young people, self-harm/suicidal thought, reduce dose in hepatic impairment
what are the side effects of SSRIs?
GI upset, appetite and weight disturbance, hyponatraemia (esp in elderly), suicidal thoughts and behaviours increased, lower seizure threshold, prolong QT interval, increase risk of bleeding
what are the interactions with SSRIs?
Monoamine oxidase inhibitors (both increase serotonin levels and precipitate serotonin syndrome); aspirin/NSAIDS (increased risk of GI bleed – provide gastroprotection); anticoagulants (increased risk of bleeding)
What class of drug is diazepam?
benzodiazepine
how do benzodiazepines work?
Target GABAa receptor (chloride channel which opens when bound to GABA – main inhibitory neurotransmitter in brain) – facilitate and enhance binding of GABA to GABAa receptor, has widespread depressant effect on synaptic transmission
what are the indications to take benzodiazepines?
Seizures and status epilepticus, alcohol withdrawal symptoms, sedation for interventional procedures (when general anaesthesia unneccesary/undesirable), short term treatment of extreme anxiety and insomnia
what are the contraindications to taking benzodiazepines?
Avoid in significant respiratory impairment or neuromuscular disease (myasthenia gravis), avoid in liver failure (cause hepatic encephalopathy
what are the side effects of benzodiazepines?
Dose-dependant drowsiness, sedation and coma, loss of airway reflexes can lead to airway obstruction, can develop dependance
what are the interactions with benzodiazepines?
Opioids and other sedatives (additive effect)
cytochrome P450
inhibitors (e.g. amiodarone, diltiazem, macrolides, fluconazole, protease
inhibitors) may increase their effects.
what type of drug is Donepezil?
Acetylcholinesterase inhibitor
how does donepezil work?
Acetylcholinesterase inhibitor leading to increased concentration of acetylcholine at cholinergic synapses (relatively specific for brain)
what are the indications to take donepezil?
Mild-to-moderate dementia in Alzheimer’s disease
what are the contraindications to taking donepezil?
Sick sinus syndrome or other supraventricular conduction abnormalities; susceptibility to peptic ulcers; asthma, COPD, concomitanat antipsychotic treatment
what are the side effects of donezepil?
Nausea, vomiting, anorexia, diarrhoea, fatigue, insomnia, headache, dizziness syncope, abnormal dreams, hallucinations, agitation, aggression, muscle cramps, urinary incontinence, rash, pruritis
