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Year 4: Psychiatry > Mood Stabilising Drugs > Flashcards

Mood Stabilising Drugs Flashcards

1
Q

what is lithium used in

A

bipolar disorder to prevent replapses

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2
Q

what needs to be monitored on a patient on lithium

A

U+Es every month
Thyroid function every 6-12 months
creatine clearance every 12 months

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3
Q

mneumonic for remembering lithium side effects

A

LITHIVM

Leukocytosis 
diabetes insipidus 
Tremor
Hypothyroidism 
Increased weight 
Vomiting
Miscellaneous (dry mouth/polyuria)
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4
Q

toxic side effects of lithium

A 
confusion 
drowsiness
convulsions 
slurred speech
ataxia 
vomiting + diarrhoea
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5
Q

ECG changes in lithium toxicity

A

T wave flattening or inversion

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6
Q

what drugs should be avoided with lithium

A

NSAIDs
ACEI
Diuretics

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7
Q

contraindications of lithium

A 
pregnancy 
breast feeding 
impaired renal function 
thyroid disease
cardiac conditions 
neurological conditions (such as Parkinson's)
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8
Q

examples of anti-convulsants

A

sodium valproate
lamotrigine
carbamazepine

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9
Q

what is sodium valproate often used to treat

A

mania

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10
Q

mechanism of action of sodium valproate

A

increases GABA

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11
Q

side effect of sodium valproate use in pregnancy

A

neural tube defects

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12
Q

side effects of sodium valproate

A

VALPROATE

Vomiting 
Alopecia / Ataxia 
Liver toxicity 
Pancreatitis / Pancytopenia 
Retain fat (increase weight)
Odema
Appetite increase
Tremor 
Encephalopathy
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13
Q

what is lamotrigine used for

A

bipolar depression

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14
Q

mechanism of action of lamotrigine

A

blocks sodium channels- decreases glutamate release

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15
Q

side effects of lamotrigine

A

GI upset, insomnia, dizziness, diplopia, ataxia, steven Jonson syndrome

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16
Q

what do you need to be careful of with carbamazepine

A

AGRANULOCYTOSIS

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17
Q

side effects of carbamazepine

A

N+V
ataxia, dizziness, slurred speech, diplopia
raised liver enzymes – hepatic toxicity.
P450 inhibitor
hyponatremia – fluid retention. SIADH
AGRANULOCYTOSIS

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18
Q

Mode of action of anti-psychotics

A

block dopamine receptors

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19
Q

what are the 1st generation anti-psychotics

A

typical anti-psychotics

- haloperidol, chlorpromazine

20
Q

what are 2nd generation anti-psychotics

A

atypical anti-psychotics

- olanzapine, risperidone, clozapine

21
Q

contraindications to anti-psychotics

A 
epilepsy 
cardiac disease
parkinsons 
phaechromocytoma
reduced conscious level
22
Q

which type of anti-psychotics has higher risk of extra-pyramidal side effects

A

typical antipsychotics

e.g. haloperidol, chlorpromazine

23
Q

what causes extra pyramidal side effects

A

excessive acetylcholine and relative dopamine deficiency

24
Q

what are some extra pyramidal side effects

A

acute dystonic reaction
Parkinsonism
akathisia
tardive dyskinesia

25
Q

what is an acute dystonic reaction

A

muscle spasms e.g torticollis, oculogyric crisis

26
Q

how do you treat acute dystonic reaction

A

acetylcholine antagonists

27
Q

what causes Parkinsonism

A

blockage of D2 receptors in the substantia nigra

28
Q

what is akathisia

A

internal restlessness

29
Q

what drug is most associated with akathisia

A

haloperidol

30
Q

what is tardive dyskinesia

A

repetitive involuntary purposeless movements e.g. sticking out tongue, lip smacking

31
Q

treatment of akathisia

A

propanolol or short term benzodiazepines

32
Q

treatment of extrapyramidal side effects

A

procyclidine

33
Q

what is neuroleptic syndrome

A

increased temperature, fluctuating consciousness, muscle rigidity, autonomic dysfunction
creatine and phosphokinase will be raised

34
Q

when is clozapine given

A

treatment resistant schizophrenia

35
Q

what receptor does clozapine block

36
Q

main risk of clozapine

A

AGRANULOCYTOSIS

37
Q

general side effects of clozapine

A

drooling, sedation, weight gain

38
Q

which atypical antipsychotic is given as first line

A

olanzapine

39
Q

main side effect of atypical anti psychotics

A

metabolic syndrome - obesity, hypertension, high cholesterol, diabetes

40
Q

odd side effect of chlorpromazine

A

blue grey discolouration in the sun

41
Q

general side effects of antipsychotics

A 
prolonged QT interval
arrhythmia
skin rash 
hepatotoxic 
pancytopenia 
drowsiness
42
Q

which atypical antipsychotic does not cause drowsiness

A

ariprizole

43
Q

antipsychotics can increase risk of what in elderly patients

44
Q

treatment of tardive dyskinesia

A

tetrabenazine

45
Q

treatment of akathisia

46
Q

treatment of dystonia

A

procyclidine

Year 4: Psychiatry (22 decks)

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