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ART_MRCPSYCH_B_MENTOR > Misc. - 2 > Flashcards

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
Q

Rx for efavirenz induced affective disorder?

A

fluoxetine and paroxetine (RCT -backed)

26
Q

what is HAND?

A

HIV-associated NeuroCognitive Disorder

27
Q

sympotms of HAND

A
  • psychomotor function impairment (slow movement.. impaired coordination…)
    -Abnormal attention & concentration
  • Mental agility
    -Mental inflexibility
    -Personality change
    -Apathy
    -social withdrawal
28
Q

what function is perserved in HANDS

A

language

29
Q

suggested Rx in HIV for

psychosis

A

atypical antipsychotic (less EPSE)
Que (750-800)
Ris 16
Ari (aro30)

30
Q

when benzodiazepine can be used in delirium in HIV patients

A

when alcohol or benzodiazepine with drawal is the precipitating factor

31
Q

suggested Rx in HIV for
Delirium

A

Atypical preferred (Risperidone [16 max])
Avoid benzodiazepine

32
Q

suggested Rx in HIV for
Depression

A

1st line SSRI =Citalopram /Escitalopram
SNRI
Mirtazapine
Bupropion

33
Q

which antidepressant have to avoided in HIV depression?

A

MAOIs

34
Q

suggested Rx in HIV for
Anxiety

A

SSRI

35
Q

suggested Rx in HIV for
Bipolar

A

valproate
lithium with caution

36
Q

which mood stabilizer should be avoided in bipolar HIV

A

carbamazepine

37
Q

is hyperprolactinaemia dose related in antipsychotic use?

A

yesss

38
Q

Long term risk fith antipsychotic - induced hyperprolactinaemia?

A

Osteoporosis
Breast Cancer (theoretical concern)

39
Q

antipsychotics with high risk of hyperprolactinaemia

A

Almost all typical antipsychotics
SPAR

Sulpride
Paliperidone
AMulspirde
Risperidone

40
Q

mnemonic for high risk hyperprolactinaemia antipsychotics

A

SPAR

41
Q

prolactive meaurement as per maudsley

A

before
3 months
1 year

42
Q

SPAR should be avoided in which patients

A
  • under 25
  • with osteoporosis
  • hx of hormone-dependent cancer
    -Young women
43
Q

when should prolactine be measured?

A

1 hr after dose taking or waking

44
Q

normal range of prolactine

A

Women 0-25 ng/ml
Men 0-20 ng/ml

45
Q

abonormality of prolactine range

A

Elevated= 25-118 ng/ml
Highly elevated= >118 nm/ml

46
Q

in highly elevated prolactine what should you rule out?

A

prolactinoma

47
Q

what if prolactin is raised

A

if symptomatic = consider to switch (non SPAR)
if non-symptomatic = joint decision after discussion of risk (Breast cancer and Oesteoporosis

48
Q

what drug can help if switching is not an option in antipsychotic induced hyperprolactin

A

add aripirazole (aro30)

49
Q

other options if swtching is not an option in antipsychotic induced hyperprolactin?

A
  • DA agonist (amantadine or bromocriptine= might worsen psychosis)
  • High doses (2.5-3 mg)metformin
50
Q

if antidepressant induce hyperprolactinemia

A

switch to mirtazapine

ART_MRCPSYCH_B_MENTOR (38 decks)

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