Mental health disorder Flashcards
what CD class are benzodiazepines
4 part 1
name some benzodiazepines and if they are long acting or short acting
diazepam- long acting
lorazepam-short acing
chlordiazepoxide- long acting- used in alcohol withdrawal
clozabam- indicatd as adjuct treatment in epilepsy
oxazepam- short acting
when should short acting benzos be used
Elderly patients and those with liver impairment
what is at a higher risk when using short acting benzos compared to long acting
greater risk of withdrawal
whihc drug classes are used to treat anxiety
Antidepressants antipsychotics Benzodiazepine beta blockers 5HT1 agonist
which beta block is used in anxiety for palpitations
propanolol
oxprenolol
MOA of benzodiazepines
they enhance the binding of GABA to the GABA A receptor to cause a widespread depressant effect
indication of benzos
short term relief of anxiety that is severe, disabling or causing the patinet an unacceptable amount of distress
2-4 weeks use
side effects associated with benzodiazepines
paradoxical increase in hostile aggression
overdose resulting nystamus, ataxia, drowsiness, dysarthria in severe symptoms: respiratory depression and coma
sedation- avoid alcohol, effect driving and using machinery
how long does it take for benzodiazepines withdrawal syndrome to start after starting a long acting or short acting benzodiazepines
3 days with short acting
3 weeks for long acting
what are the symptoms associated with benzodiazepines withdrawal
Insomnia, tremours, perceptual disorders, titinnus, loss or increased appetite, increased anxiety
How are benzodiazepines withdrawn
over 1 week convert the diazepam to once at night
then reduce by 1-2mg every 2-4 weeks
reduce in steps of 500mch towards the end
Drugs that interact with benzodiazepines
drugs with an increased sedation of CNS effect: alcohol, opioids, antihistamines, antidepressants, barbiturates, antipsychotics
increased plasma concentrations with enzyme inhibitors such as diltiazem, amiodarone, macrolides, fluconszole
what are the first line, second line and alternative treatments for ADHD
Methylphenidate
lisdexafetamine
atomoxetine
which CD schedule are Methylphenidate and lisdexafetamine
schedule 2
what is the MOA of Methylphenidate
it is a potent CNS stimulator- increases noradrenaline and dopamine
Meumonic to remember symptoms of antidepressant discontinuation syndrome
FINISH
Flu like sympoms e.g sweating, fatigue, headache
Insomnia e.g vivid dreams
Nausea e.g vomiting
Imbalance e.g dizziness, vertigo
Sensory disturbance e.g tingling
Hyperarousal e.g irritability, anxiety, ahitation,mania
Which antidepressant has a long half life
Fluoxetine
4-6 days
Which antidepressant has the highest risk of withdrawal effects
Paroxetine
Which anti depressants is safest to be used in under
Fluoxetine
Which antidepressant causes qt prolongation
Citalopram
Which antidepressants should you use if the pt has cardio conditions
Sertraline
