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Misc > Nerv > Flashcards

Nerv Flashcards

1
Q

3 ACHs used in Mild- Moderate Alzheimers

And what do you need to look out for with them?

A

Donepezil- NMS
Galantamine-SJS
Rivastigmine- GI distrubance- hold until resolves, can switch to a patch

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2
Q

Whilst most AEDs are given BD Which ones are given OD?

A 
LP3-
Lamotrigine
Phenytoin
Phenobarbital 
Primidone
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3
Q

Focal Partial Seizures?

A

Lamotrigine/Carbamazepine

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4
Q

Tonic-Clonic(Generalised)

A

Valproate/Carbamazepine

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5
Q

Absence(Generalised)

A

Ethosuximide/Valproate

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6
Q

Myoclonic
Atonic/tonic
(Generalised)

A

Valproate

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7
Q

Carmbamazepine is used in which seizures?

A

Focal and Tonic/Clonic

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8
Q

What is the Therapeutic Range for Carbamazepine?

What are the signs of tox?

A

4-12mg/L
iHANDBAG
Incoordination, Hyponatraemia, Ataxia, Nystagmus, Drowsiness, Blurred vision, Arrhythmias, and GI dist

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9
Q

Side effects of carbamazepine?

Is it an enzyme inducer or inhibitor?

A

BHHR HD
Blood dyscrasias, Hepatotoxicity, Hypersensitivity, Rash, Hyponatraemia, Dose dependent s/e

Its an inducer

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10
Q

Whats the range for Phenytoin?

Signs and symptoms of toxicity?

A

10-20mg/L
SNAtCHeD
Slurred speech , Nyastagmus,Ataxia, Confusion, Hyperglycaemia, Diplopia

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11
Q

Side effects of phenytoin?

And is Phenytoin an inhibitor or an inducer?

A

BHHR CLS
Blood dyscrasias, Hypersensitivity, Hepatoxicity, Rash, Changes in appearance, Low vitamin D (Osteomalacia/rickets), Suicidal ideation
Its an inducer

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12
Q

Side effects of SV?

A

BHP

Blood dyscrasias, Hepatoxicity, Pancreatitiis

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13
Q

How long should sodium valproate be reduced over?

A

gradually over 4 weeks

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14
Q

Tell me about category 1 and 2 AEDs and brands?

A

Category 1) CP3 -Carbamazepine, Phenytoin, Primidone, Phenobarb MUST BE ON SAME BRAND

Category 2)VLCT- Clinical judgment

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15
Q

Which AEDs Has highest and then high risk in pregnancy?

A

Highest-SV- Must not be used in women of child bearing age unless conditions of PPP are met

High-CP3L. Carbamaz, Phenytoin, Phenobarb, Primidone, and Lamotrigine

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16
Q

Which AED causes cleft pallete in first trimester?

A

Topirimate

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17
Q

Which AEDs can cause drowsiness in infants breast feeding?

A

Primidone, phenobarbital, and the benzodiazepines

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18
Q

With the AEDs Withdrawal effects can occur in babies breast feeding if the mother suddenly stops which drugs?

A

phenobarbital, primidone, or lamotrigine

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19
Q

Which AED can cause a rash?

A

Lamotrigine

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20
Q

Which AEDs cause eye problems , and what are they?

A

Vigabatrin-Visual Field Defects

Topimirate-Glaucoma

21
Q

What drugs are used in ADHD?

A

1) Methylphenidate(CD2)-6wk trial
2) Lisdexamphetamine(CD2)-6wk trial
alt: atomoxetine OR guanfacine

22
Q

Monitoring for methylphenidate & lisdexamphetamine

A

pulse, BP, psychiatric symptoms, appetite, weight and height at initiation, following dose adjustment, and at least every 6 months thereafter
Seizures
Also cause Tics and Tourettes syndrome

23
Q

Drug used in acute episodes of mania?

A

1)Benzos(eg.Lorazepam)- Short term use only
2)QOR(Quetiapine, Olanzapine, Risperidone)
If inadeaute add- lithium or valproate

24
Q

Whats the lithium range?

And acute epidoes of mania?

A
  1. 4-1mmol/L

0. 8-1mmol/L

25
Q

When do you do lithium monitoring?

A

You do it 12 hours after the dose thats why patient has dose at night time.

When initiating- Monitor weekly after initiation until stable then every 3 months for a year then every 6months there after
Before treatment you also measure- renal, cardiac, and thyroid function
Body weight/BMI, serum electrolytes and FBC

26
Q

Lithium symptoms of toxicity?

A

REVeNGe

Renal disturbance, EPS, Visual Disturbance(blurred vision), e, Nystagmus, GI disturbance(D/V)

27
Q

Side effects of lithium

ps. Hyponatraemia pre-disposes to lithium tox

A 
TRBQL
Thyroid dysfunction(hypo/hyper), Renal impairment, Benign intracranial hypertension, QT prolongation, Lowers seizure threshold
28
Q

Which Anti-depressant is given to children

A

Fluoxetine

29
Q

Which SSRI is safe to use after MI/UA

A

Sertraline

30
Q

SSRIs cause which main electrolyte disturbance?

A

Hyponatraemia, but can also occur to others

31
Q

Symptoms of serotonin syndrome?

A

NAA
Neuromuscular hyperactivity-Tremors, rigidity
Altered mental state-confusion and mania
Autonomic Dysfunction-diarrhoea, hyperthermia, tachycardia, sweating, shivering

32
Q

Switching between AD drugs.

MAOIs?

A

Wait 2 Weeks, moclobemide does NOT need a washout period!!!

33
Q

Switching between AD drugs

SSRI

A

1 week

Fluoxetine - 5 weeks

34
Q

Switching between AD drugs.

TCAs

A

1-2 weeks

clomiprime/imiprimine- 3 weeks

35
Q

Which antidepressants -have the highest risk of Withdrawal reactions?

A

Paroxetine and venlafaxine

36
Q

Least seadting TCAs?

A

NIL

Nortrptyline, Impiramine, Lofepramine

37
Q

Which MAOi are hepatotoxic?

A

pheelazine and isocarboxazid

38
Q

Which MAOis have the greatest risk of hypertensive crises? ps it also has the greatest stimulat action

A

Tranylcypromine

39
Q

Which antipsychotic has the most hyperprolactinemia?

A

Amisulpride, and Risperidone

40
Q

Clozapine S/E?

A

AMG,

Agranulocytosis, Myocarditis & Cardiomyopathy, GI obstruction(pt to report constipation)

41
Q

Which APS cause most EPS?

A

GP 3 Phenothiazine( end with perazine and phenazine)

Butyrophenones(haloperidol and Benperidol)

42
Q

APS With most Hyperprolactinaemia?

A

Amisulpride and Risperidone

43
Q

APS which cause Hyperglycaemia and diabetes?

A

CiROQ

Clozapine, Risperidone, Olanzapine, Quetiapine

44
Q

APS which cause weight gain?

A

COW, Clozapine, Olanzapine

45
Q

APS WIth sexual dysfunction ?

A

Haloperidol and Risperidone

46
Q

APS With QT Prolongation?

A

Pimozide & Haloperidol

47
Q

Anti-emetic used in PD?

A

Domperidone which also has Cardio s/e

48
Q

Antiemetic used in pregnancy?

A

Promethazine, Prochloroperazine, metoclopramide

Misc (5 decks)

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