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Pre-reg > Nervous System > Flashcards

Nervous System Flashcards

1
Q

What anti-cholinergic has a high risk of SJS?

A

Galantamine

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2
Q

What is used in severe Alzheimers and what is the drug class?

A

Memantine

NMDA

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3
Q

What anti-cholinergic can imcrease the risk of neuroleptic malignant syndrome with concomitant use with antipsychotics?

A

Donepezil

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4
Q

What are the anticholinergic S/E?

A 
Constipation
Dizziness
Drowsiness
Urinary retention 
Dry mouth 
Tachycardia
Blurred vision
Confusion (more common in elderly)
Nausea and vomitting
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5
Q

What is the MHRA warning about elderly patient with dementia who are on antipsychotics?

A

Increased risk of stroke/TIA

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6
Q

What is used to treat anxiety that works on 5HT1

A

Buspirone

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7
Q

When to measure lithium?

A

12 hours post dose

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8
Q

What electrolyte can precipitate lithium toxicity?

A

Hyponatremia

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9
Q

Lithium toxic S/E

A 
Fine tremor 
Confusion 
Hypotension
Tachycardia 
Polyuria
Visual disturbances
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10
Q

Least sedating TCA’s?

A

Imipramine and nortriptyline

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11
Q

Max dose of citalopram in the elderly ?

A

20mg

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12
Q

How long do anti-depressants take to work?

A

2 weeks

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13
Q

Is St John’s wort an enzyme inducer or inhibitor?

A

Enzyme inducer

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14
Q

How long should anti-depressant treatment be tried before it is switched of deemed ineffective?

A

4 weeks

6 weeks elderly

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15
Q

What are the effects of Serotonin syndrome?

A

Neuromuscular (tremor and rigidity), autonomic (Tachycardia, hyperthermia, shivering)
Altered mental state (confusion,mania and agitation)

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16
Q

What class is moclobemide?

A

MAOI

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17
Q

Wash out period compared to MAOIs?

A

MAOI-MAOI 2 weeks
TCA-MAOI 1-2 weeks (3 weeks for clomipramime and imipramine)
SSRI- MAOI 1 week (flouxetine 5 weeks)

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18
Q

How long should anti-depressants be continues after remision?

A

6 months
1 year elderly
2 years recurrent depression

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19
Q

How long should an antipsychotic be tried before it is deemed to be ineffective or switched?

A

4-6 weeks

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20
Q

What is the treatment for the 1st episode of psychosis?

A

CBT and anti-psychotics

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21
Q

What are antipsychotics better and relieving positive or negative symptoms?

A

Positive symptoms

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22
Q

What are the positive symptoms of schizophrenia?

A

Hallucinations and delusions

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23
Q

What are the negative symptoms of schizophrenia?

A

Emotional apathy

Social withdrawal

24
Q

When can clozapine be used for schizophrenia?

A

After 2 antipsychotics have been tried (one of them being a second generation)

25
Q

What are the general s/e of most 1st generation anti-psychotics?

A

EPSE symptoms
•Parkinsonism symptoms such as tremor, bradykinesia
•Dystonia (uncontrolled muscle spasm)
•Akathisia (restlessness)
•Tardive dyskinesia (uncontrollable muscle movements of face e.g.lips, jaw, tounge)
Hypetprolactinaemia

26
Q

What are the 1st generation anti-psychotics?

A 
Phenothiazines (chlorpromazine, promazine, prochlorperazine etc)
Butyphenones (Haloperidol)
Thioxanthenes (flupentixol)
Pimozide 
Sulpride
27
Q

What are some 2nd generation anti-psychotics?

A 
Quetiapine
Clozapine
Aripiprazole
Risperidone
Olanzipine
Amisulpride
Asenapine 
Paliperidone
28
Q

What anti-psychotic does not increase prolactin concentration?

A

Aripiprazole

29
Q

Which anti-psychotics increase the concentration of prolactin?

A

1st generation
Riperidone
Amisulpride

30
Q

Which anti-psychotics cause an increase in sexual dysfunction?

A

Risperidone
Haloperidol
Olanzapine

31
Q

Which anti-psychotics are low risk at causing sexual dysfunction?

A

Aripiprazole

Quetiapine

32
Q

What anti-psychotics have an increased risk of CV effects?

A

IV anti-psychotics

Pimozide

33
Q

What is used to treat NMS?

A

Dantrolene

Bromocriptine

34
Q

What should be monitored with anti-psychotics?

A 
Weight 
HbA1C
Lipids 
Prolactin (before starting)
BP
ECG
FBC
Urea and electrolytes
Liver
35
Q

What is the MHRA warning about Anti-epileptics?

A

Small risk of suicide

36
Q

What antiepileptics cause antiepileptic hypersensitivity syndrome?

A

CPPP3L2R

Carbamazepine, primidome, phenytoin, phenobarbital, lacodamide, lamatrogine and rufinamide

37
Q

If you’ve had your 1st seizure and a specialist says you are fit to drive how long should you wait?

A

6 months

38
Q

If you have been diagnosed with epilepsy how long would you need to be seizure free for if you are not a danger to the public?

A

1 year

39
Q

How long can you license be revoked for if you’ve had a prescribed change to your antiepileptic or withdraw?

A

1 year

40
Q

What anti-epileptic can cause SJS?

A

Lamatrogine

41
Q

What antiepileptics can cause blood dycrasias?

A 
Carbamazapine
Phenytoin 
Lamatrogine
Valproate 
Ethosuxamide
42
Q

What are the toxic side effects of phenytoin?

A 
Slurred speech 
Nyastagmus
Ataxia
Confusion
Hyperglycaemia
Diplopia
43
Q

How is narcolepsy managed?

A

1st good sleep hygiene

Drugs such as methylphenidate,modafinil and dexamphetamine

44
Q

What is used 1st line for PD for patients whose motor symptoms effect their quality of life?

A

Levodopa

Co-bendelopa or co-careldopa

45
Q

What is 1st line for PD patients whose motor symptoms do not effect their quality of life?

A 
Levodopa/dopamine agonists or MAOI
Adjunct to levodopa can be dopamine agonist/COMT/MAOI
Then non ergot
Then ergot
Amantadine last line
46
Q

What is the treatment for excessive day time sleepiness in PD?

A

Excessive modafinil (not for pregnancy)

47
Q

What is used to treat hallucinations/delusions in PD patients?

A

Quetiapine or clozapine

48
Q

What are the dopamine receptor agonists?

A

Pramipexole, rotigotine, ropinorole

49
Q

What colour does entacapone colour your urine?

A

Red/brown

50
Q

What corticosteroid can be used as an anti-emetic for cancer chemotherapy?

A

Dexamethasone

51
Q

What are neurokinin 1 receptor antagonist?

A

E.g. aprepitant used for moderate and severe nausea and vomitting

52
Q

What anti-emetic is licenced for pregnancy ?

A

Metoclopramide/prochlorperazine/promethazine

53
Q

What supplement should be given to pregnant women who have severe vomitting ?

A

Thiamine to prevent wernickes encephalopayhy

54
Q

What is used to treat nausea and vomitting with migraine?

A

Cinnarazine/prochlorperazine (use for acute)

55
Q

How long does chronic pain last for?

A

3 months

Pre-reg (4 decks)

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