Pharma 12 Psychiatric Drugs Flashcards
What are the 3 core symptoms of depression and associated symptoms?
2/3 needed for diagnosis
Low mood
Anhedonia (No pleasure)
Decreased Energy
What are some secondary symtoms of depression
Decrease appetite
Sleep Disturbance
Hopelessness
Reduced Concentration
Iritatability
Self Harm
Reduced Libido
psychotic symptoms
What are the 2 theories behind the development of depression?
1) Monoamine neurotransmittters deficiency
2) Monoamine receptors are deficiency
What are the 4 classes of antidepressants and how do they work
- Selective serotonin reuptake inhibitors (SSRIs)
- Tricyclic antidepressant (TCAs)
- Serotonin-noradrnaline reuptake inhibitors (SNRIs)
- Monoamine oxidase inhibitors (MAOIs)
Why are MAOIs rarely used?
Serious ADRs and DDIs
give 2 examples SSRI drugs
Fluoxetine (Prozac), citalopram, paroxetine, sertraline
Give SSRI ADRs
GI abnormalities
Headache
SSRI Serotonin syndrome (Mania)
Stimulate CNS
Reproductive dysfunction in males
Insomnia
Give the MoA of TCAs
Block reuptake of serotonin and noradrenaline at presynaptic membrane
Give 3 examples of TCAs
imipramine
lofepramine
amitriptiline
Give ADRs of TCAs
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
Give ADRs of SNRIs
Same as SSRIs + some additional actions due to noradrenaline uptake inhibition
Sleep disturbance,
Increased BP
Dry mouth
Hyponatraemia
Give 2 examples of SNRIs
Venlafaxine
Duloxetine
What is psychosis
Lossing contact with reality.
Give the positive symptoms of schizophrenia
Hallucinations
Disturbances of thinking
Delusions
Behavioural change
Give the cognitive symptoms of schizophrenia
Selective attention
Poor memory
Reduced astract thought
What is the main theory behind development of schizophrenia?
Oversecretion of dopamine
How do typical anti-psychotics work in schizophrenia? Name 2 examples
Dopamine (D2) antagonists.
Haloperidal, Chloropromazine
What makes an atypical antipsychotic atypical?
Less likely to cause extrapyramidal signs
How do atypical anti-psychotics work in schizophrenia? Give 4 example drugs. Why are they preferred?
D2 antagonists but only selective pathways meaning less parkinson like symptoms, lactation and sexual dysfunction
Risperidone, olanzipine, clozapine, quetiapine
Give the ADRs of antipsychotics
Weight gain (esp olanzipine)
Hyperprolactinemia
Extra-pyramidal side effects (Parkinson like symptoms)
Cardiac toxicity
Clozapine ADRs
Agranulocytosis due to sever leukopenia
Secere Constipation
Hypersalivation
Weight Gain (25Kg)
What is Neuroleptic Malignant Syndrome and what are it’s symptoms
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.
Define anxiety (pathological)
Fear out of proportion of the situation so that individuals undergo avoidance or physical symptoms e.g. light headedness, SOB
How do you treat anxiety disorders?
Cognative Behavioural Therapy (CBT) first line, then pharmacological.
Anti-depressents then Benzodiazepines (Very addictive)
What MoA of Benzodiazepines
How would you treat an overdose?
ADRs?
GABARs agonist
ADRs - dependence, drowsiness, dizziness, psychomotor impairment, dry mouth, hypotension
Overdose treated with flumazenil - BZD antagonist
Define bipolar disorder (Manic Depression)
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
How do you treat bipolar disorder?
Mood Stabalizers
Lithium, Sodium valproate, Carbamazepine
What are the ADRs of Lithium
How do you treat toxicity/overdose
Nephrotoxic, thyrotoxic, memory problems, thirst, polyuria, tremor, hair loss
Supportive measures, Anticonvulsants, IV Fluids, Haemodialysis
What medications do you use to treat Alzheimers dementia
- Acetyl Cholinesterase Inhibitors
- Donepezil, Galantamine, Rivastigmine
- Early stage
- NMDAr antagonist
- Memantine
- Late Stage
MoA of Acetyl Cholinesterase Inhibitors
ADRs
GI upset, insomnia, bradycardia
