Misc. - 2 Flashcards

1
Q

History of Psychotropics and Intervention
Insulin shock therapy

A

Sakel 1933

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2
Q

History of Psychotropics and Intervention

Frontal leucotomy for psychosiss

A

Moniz 1935

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3
Q

Metrazol therapy

A

Meduna1934

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4
Q

cerletti (and bini)

A

ECT 1938

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5
Q

Cade

A

Discovered lithium benefit in mania 1949

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6
Q

Chlorpromazine synth

A

Charpentier 1950

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7
Q

Iproniazid (MAOI) discovery

A

Kline 1951

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8
Q

Delay and Deniker

A

Used Chlorpromazine for schizo 1952

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9
Q

Coined ‘Neuroleptic’

A

Delay and Deniker

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10
Q

Antidepressant of imipramine

A

Kuhn 1957

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11
Q

Described the cheese effect in MAOI use

A

Blackwell

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12
Q

Lurie

A

coined the term antidepressants 1960

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13
Q

Carlsson

A

Developed the first SSRI 1992 (zimelidine)

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14
Q

Reintroduced clozapine into clinical practice

A

Kane 1988 (happy birthday)

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15
Q

what was clozapine made from?

A

imipramine 1958

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16
Q

first antidepressant to be made?

A

Iproniazid MAOI

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17
Q

First ssri to be made

A

Zimeldine (CALRSSON 1992)

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18
Q

first antipsychotic

A

chlorpromazine

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19
Q

who used chlorpromazine for anesthetics before it being used as antipsychotic later?

A

Laborit and huguenard 1951

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20
Q

what antituberculosis were thought to have antidepressant effects

A

isoniazid (lurie)
iproniazid

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21
Q

what was imipramine made from

A

promethazine

22
Q

what lymphocyte HIV reduces

A

CD4 T cells

23
Q

the most prevalent mental health issue in HIV patients?

A
  • first depression 35%
    then
    Substance misuse
    anxiety
    psychosis
    adjustment disorder
    bipolar
24
Q

which HIV Rx causes depression

A

efavirenz (mania and suicide)

25
Rx for efavirenz induced affective disorder?
fluoxetine and paroxetine (RCT -backed)
26
what is HAND?
HIV-associated NeuroCognitive Disorder
27
sympotms of HAND
- psychomotor function impairment (slow movement.. impaired coordination...) -Abnormal attention & concentration - Mental agility -Mental inflexibility -Personality change -Apathy -social withdrawal
28
what function is perserved in HANDS
language
29
suggested Rx in HIV for psychosis
atypical antipsychotic (less EPSE) Que (750-800) Ris 16 Ari (aro30)
30
when benzodiazepine can be used in delirium in HIV patients
when alcohol or benzodiazepine with drawal is the precipitating factor
31
suggested Rx in HIV for Delirium
Atypical preferred (Risperidone [16 max]) Avoid benzodiazepine
32
suggested Rx in HIV for Depression
1st line SSRI =Citalopram /Escitalopram SNRI Mirtazapine Bupropion
33
which antidepressant have to avoided in HIV depression?
MAOIs
34
suggested Rx in HIV for Anxiety
SSRI
35
suggested Rx in HIV for Bipolar
valproate lithium with caution
36
which mood stabilizer should be avoided in bipolar HIV
carbamazepine
37
is hyperprolactinaemia dose related in antipsychotic use?
yesss
38
Long term risk fith antipsychotic - induced hyperprolactinaemia?
Osteoporosis Breast Cancer (theoretical concern)
39
antipsychotics with high risk of hyperprolactinaemia
Almost all typical antipsychotics SPAR Sulpride Paliperidone AMulspirde Risperidone
40
mnemonic for high risk hyperprolactinaemia antipsychotics
SPAR
41
prolactive meaurement as per maudsley
before 3 months 1 year
42
SPAR should be avoided in which patients
- under 25 - with osteoporosis - hx of hormone-dependent cancer -Young women
43
when should prolactine be measured?
1 hr after dose taking or waking
44
normal range of prolactine
Women 0-25 ng/ml Men 0-20 ng/ml
45
abonormality of prolactine range
Elevated= 25-118 ng/ml Highly elevated= >118 nm/ml
46
in highly elevated prolactine what should you rule out?
prolactinoma
47
what if prolactin is raised
if symptomatic = consider to switch (non SPAR) if non-symptomatic = joint decision after discussion of risk (Breast cancer and Oesteoporosis
48
what antipsychotic can help if switching is not an option in antipsychotic induced hyperprolactin
add aripirazole (aro30)
49
other options if swtching is not an option in antipsychotic induced hyperprolactin?
- DA agonist (amantadine or bromocriptine= might worsen psychosis) - High doses (2.5-3 mg)metformin
50
if antidepressant induce hyperprolactinemia
switch to mirtazapine