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ESA 5 > Pharma 12 Psychiatric Drugs > Flashcards

Pharma 12 Psychiatric Drugs Flashcards

1
Q

What are the 3 core symptoms of depression and associated symptoms?

A

2/3 needed for diagnosis

Low mood

Anhedonia (No pleasure)

Decreased Energy

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2
Q

What are some secondary symtoms of depression

A

Decrease appetite

Sleep Disturbance

Hopelessness

Reduced Concentration

Iritatability

Self Harm

Reduced Libido

psychotic symptoms

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3
Q

What are the 2 theories behind the development of depression?

A

1) Monoamine neurotransmittters deficiency
2) Monoamine receptors are deficiency

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4
Q

What are the 4 classes of antidepressants and how do they work

A
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Tricyclic antidepressant (TCAs)
  • Serotonin-noradrnaline reuptake inhibitors (SNRIs)
  • Monoamine oxidase inhibitors (MAOIs)
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5
Q

Why are MAOIs rarely used?

A

Serious ADRs and DDIs

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6
Q

give 2 examples SSRI drugs

A

Fluoxetine (Prozac), citalopram, paroxetine, sertraline

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7
Q

Give SSRI ADRs

A

GI abnormalities

Headache

SSRI Serotonin syndrome (Mania)

Stimulate CNS

Reproductive dysfunction in males

Insomnia

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8
Q

Give the MoA of TCAs

A

Block reuptake of serotonin and noradrenaline at presynaptic membrane

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9
Q

Give 3 examples of TCAs

A

imipramine

lofepramine

amitriptiline

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10
Q

Give ADRs of TCAs

A

CNS - sedation and impairment of psychomotor performance, lowering of seizure threshold

Autonomic nervous system - reduction in glandular secretions, eye accommodation block

CVS - tachycardia, postural hypotension, impair myocardial contractility

GI - constipation

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11
Q

Give ADRs of SNRIs

A

Same as SSRIs + some additional actions due to noradrenaline uptake inhibition

Sleep disturbance,

Increased BP

Dry mouth

Hyponatraemia

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12
Q

Give 2 examples of SNRIs

A

Venlafaxine

Duloxetine

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13
Q

What is psychosis

A

Lossing contact with reality.

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14
Q

Give the positive symptoms of schizophrenia

A

Hallucinations

Disturbances of thinking

Delusions

Behavioural change

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15
Q

Give the cognitive symptoms of schizophrenia

A

Selective attention

Poor memory

Reduced astract thought

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16
Q

What is the main theory behind development of schizophrenia?

A

Oversecretion of dopamine

17
Q

How do typical anti-psychotics work in schizophrenia? Name 2 examples

A

Dopamine (D2) antagonists.

Haloperidal, Chloropromazine

18
Q

What makes an atypical antipsychotic atypical?

A

Less likely to cause extrapyramidal signs

19
Q

How do atypical anti-psychotics work in schizophrenia? Give 4 example drugs. Why are they preferred?

A

D2 antagonists but only selective pathways meaning less parkinson like symptoms, lactation and sexual dysfunction

Risperidone, olanzipine, clozapine, quetiapine

20
Q

Give the ADRs of antipsychotics

A

Weight gain (esp olanzipine)

Hyperprolactinemia

Extra-pyramidal side effects (Parkinson like symptoms)

Cardiac toxicity

21
Q

Clozapine ADRs

A

Agranulocytosis due to sever leukopenia

Secere Constipation

Hypersalivation

Weight Gain (25Kg)

22
Q

What is Neuroleptic Malignant Syndrome and what are it’s symptoms

A

Neuroleptic malignant syndrome is a life-threatening, neurological disorder caused by an adverse reaction to antipsychotic drugs.

Symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction.

23
Q

Define anxiety (pathological)

A

Fear out of proportion of the situation so that individuals undergo avoidance or physical symptoms e.g. light headedness, SOB

24
Q

How do you treat anxiety disorders?

A

Cognative Behavioural Therapy (CBT) first line, then pharmacological.

Anti-depressents then Benzodiazepines (Very addictive)

25
Q

What MoA of Benzodiazepines

How would you treat an overdose?

ADRs?

A

GABARs agonist

ADRs - dependence, drowsiness, dizziness, psychomotor impairment, dry mouth, hypotension

Overdose treated with flumazenil - BZD antagonist

26
Q

Define bipolar disorder (Manic Depression)

A

episodes of mania and depression with poor concentration, sleep, rapid speech, poor judgement

Mania - Unusually excited/ happy/ optimistic/ overactive, poor concentration/ judgement, increased libido, grandiose psychotic episodes

27
Q

How do you treat bipolar disorder?

A

Mood Stabalizers

Lithium, Sodium valproate, Carbamazepine

28
Q

What are the ADRs of Lithium

How do you treat toxicity/overdose

A

Nephrotoxic, thyrotoxic, memory problems, thirst, polyuria, tremor, hair loss

Supportive measures, Anticonvulsants, IV Fluids, Haemodialysis

29
Q

What medications do you use to treat Alzheimers dementia

A
  • Acetyl Cholinesterase Inhibitors
    • Donepezil, Galantamine, Rivastigmine
    • Early stage
  • NMDAr antagonist
    • Memantine
    • Late Stage
30
Q

MoA of Acetyl Cholinesterase Inhibitors

ADRs

A

GI upset, insomnia, bradycardia

ESA 5 (43 decks)

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