Misc Flashcards
Which antipsychotics are indicated in hepatic impairment
Paliperidone (if depot required)
Amisulpride
Sulpiride
Which antidepressants are indicated in hepatic impairment
Sertraline
Citalopram
Paroxetine
Vortioxetine
Which mood stabilisers are indicated in hepatic impairment
Lithium
Which sedatives are indicated in hepatic impairment
Lorazepam
Oxazepam
Temazepam
Zopiclone 3.75mg (with care)
Which antidepressants are best avoided in hepatic impairment
TCA and MAOI
What is Modafinil
psychostimulant which enhances wakefulness, attention, and vigilance
When is dystonia most likely?
early stages of treatment or after an increase in dose
It can also occur on drug withdrawal.
Gell and Coombs classification Type I is?
(IgE-mediated) reactions: These are immediate hypersensitivity reactions mediated by the IgE antibody. They can lead to symptoms such as hives, itching, swelling, and in severe cases, anaphylaxis. They generally occurs minutes to hours after exposure.
Gell and Coombs classification Type II is?
(Cytotoxic) reactions: These involve the activation of complement proteins and destruction of cells by antibodies. Examples include drug-induced haemolytic anaemia or thrombocytopenia. The timing of these reactions is variable.
Gell and Coombs classification Type III is?
(Immune Complex) reactions: Immune complexes, which are antigen-antibody aggregates, can form and deposit in tissues, leading to inflammation. This can manifest as conditions like serum sickness or drug-induced lupus. These usually occur 1 to 3 weeks after exposure.
Gell and Coombs classification Type IV is?
(Cell-mediated) reactions: These reactions are mediated by T cells and occur over a delayed period, often days to weeks after exposure to the drug. Contact dermatitis and some forms of drug-induced hepatitis are examples.
Lithium contraindications
Addison’s disease
Brugada syndrome
Cardiac disease associated with rhythm disorders
Clinically significant renal impairment
Untreated or untreatable hypothyroidism
Low sodium levels, including people that are dehydrated and those on low-sodium diets
Lithium : long term use associated with
Hypothyroidism and hyperthyroidism
Hypercalcemia/hyperparathyroidism
Irreversible nephrogenic diabetes insipidus
CKD
Drugs to avoid in people with pseudocholinesterase deficiency include
Donepezil
Galantamine
Procaine
Succinylcholine
Pilocarpine
Serotonin syndrome is characterized by the triad of
neuromuscular abnormalities (myoclonus, and clonus), altered mental state, and autonomic dysfunction.
Neuroleptic malignant syndrome (NMS) is a
acute disorder of thermoregulation and neuromotor control
Primary investigation in NMS?
CK - at least 4 times the upper limit of normal range
Gas - Resp failure and metabolic acidosis
Leukocytosis
Altered LFTs
U + E aki elctrolyte derangement are complications
Clotting - DIC/ liver failure
urinalysis - Haemolysed blood on urinalysis suggests myoglobinuria
Risk factors for NMS
Younger age
Being male
Psychosis and mental retardation
Psychomotor agitation
Dehydration
Previous NMS
Hyperthyroidism
Alcoholism
Parkinson’s disease
Which antihistamine can cause sedation and so may affect a person’s ability to drive?
Chlorpheniramine
The prevalence of metabolic syndrome in patients in the CATIE trial was approximately
40%
mood stabiliser that has been shown to increase the risk of nephrolithiasis (kidney stones)
Topiramate
Which SSRIs is most associated with discontinuation symptoms?
Paroxetine
shorter half-life and higher potency
t/f lithium is contraindicated in severe renal impairment
true
Methylphenidate acts primarily by blocking the
Sodium dependent dopamine-transporter
Selegiline is a
monoamine oxidase inhibitor (MAOI)
Mirtazapine is an atypical antidepressant that increases the
release of norepinephrine and serotonin by antagonising certain adrenergic and serotonergic receptors
Lithium induced diabetes insipidus is thought to result from
Impaired action of ADH on principal cells
inability to concentrate urine and subsequently polyuria and polydipsia
Atomoxetine is a highly selective
norepinephrine reuptake inhibitor (SNRI)
used in adhd