Mental Health Flashcards
What drug class is Amitriptyline?
Tricyclic Antidepressant (TCAs)
What are TCAs indicated for?
Moderate to severe depression (second line) Neuropathic pain (not licensed)
How do TCAs work?
Inhibit neuronal reuptake of serotonin and noradrenaline from synaptic cleft
Increase availability for neurotransmission
Block a wide array of receptors (muscarinic, histamine, adrenergic and dopamine) - wide range of side effects
What are the side effects of TCAs?
Sedation Hypotension Arrhythmias ECG changes Convulsions Hallucinations Mania Breast changes Extrapyramidal symptoms (rare)
What are the contraindications of TCAs?
Elderly CVD Epilepsy BPH Raised Intraocular pressure
Important drug interactions of TCAs?
Monoamine oxidase inhibitors - do same thing - can cause hypertension and hyperthermia or serotonin
What drug class is Citalopram?
SSRI
What are SSRIs indicated for?
First line for moderate to sever depression
Can be for mild as well
Panic disorder
OCD
How do SSRIs work?
Inhibit neuronal reuptake of serotonin
What are the side effects of SSRIs?
GI Appetite loss Weight disturbance (loss or gain) Hyponatraemia Suicidal thoughts and behaviour can increase Lower seizure threshold Prolong QT interval Can get withdrawal symptoms if sudden removal
What are the contraindications of SSRIs?
Epilepsy
Peptic Ulcer Disease
Young people
Important drug interactions of SSRIs?
Monoamine oxidase inhibitors
Antipsychotics that increase the QT interval
What drug class is Diazepam?
Benzodiazepine
What are Benzodiazepines indicated for?
Management of seizures and status epilepticus (1st line) Alcohol withdrawal reactions (1st line) Sedation for interventional procedures Short term for severe anxiety Short term for severe insomnia
How do Benzodiazepines work?
Targets GABA
Benzos facilitate and enhance binding of GABA to receptor
This depresses synpatic transmission
What are the side effects of Benzodiazepines?
Drowsiness Sedation Loss of airway reflexes in overdose Can become dependant Abrupt cessation of treatment (alcohol withdrawal esque symptoms)
What are the contraindications of Benzodiazepines?
Elderly
Respiratory impairment
Neuromuscular disease
Liver failure
Important drug interactions of Benzodiazepines?
P450 inhibitors stop elimination
Benzo have additive effects to other sedating drugs - opiods and alcohol
What drug class is Donepezil?
Acetylcholinesterase Inhibitor
What are Acetylcholinesterase Inhibitors indicated for?
Treating dementia symptoms in mild to moderate Alzheimers
memory loss and behavioural changes
How do Acetylcholinesterase Inhibitors work?
Increase levels of ACh in brain
Slows destruction of ACh
By blocking cholinesterase
What are the side effects of Acetylcholinesterase Inhibitors?
Hallucinations Insomnia Muscle cramps Urinary incontinence Rash Peptic Ulcer Disease
What are the contraindications of Acetylcholinesterase Inhibitors?
Peptic Ulcer disease
Asthma, COPD
Antipsychotic treatment
SVT conductions abnormalities
Important drug interactions of Acetylcholinesterase Inhibitors?
Interferes with non-depolarising muscle relaxants
