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Jason's MD3 Psychiatry Rot > Pharma In Psychiatry > Flashcards

Pharma In Psychiatry Flashcards

1
Q

Important issue in psychiatry pharma? What is %

A

Non-compliance, partial or complete

50% discontinue

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2
Q

Antidepressants used in what disorders?

A 
Major depression
Panic disorder
OCD (SSRIs)
Generalized anxiety disorder (venlafaxine)
PTSD
Narcolepsy

Neuropathic pain states (TCAs)

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3
Q

How long antidepressants take to work?

A

2-4 weeks

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4
Q

Any difference in response rates between members of same class? Or between classes?

A

No if you’re doing group studies.

Can make a difference in individuals.

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5
Q

What improves in first week for antidepressants?

A

Sleep disturbance

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6
Q

Side effects of antidepressants? Antimuscarinics/anticholinergic?

A 
Dry mouth
Blurred vision
Constitution
Urinary hesitancy
Glaucoma
Delirium
Cog disturbance
Cardiovascular effects
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7
Q

H1 receptor SFx? Antihistaminergic

A

Sedation
Weight gain
Drowsiness
Metabolic syndrome

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8
Q

SFx of a1/2 receptor, antiadrenergics

A

Hypotonia

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9
Q

Inhibition of noradrenaline reuptake SFx?

A

Tremor
Tachy cardia
Restless

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10
Q

SSRI SFx?

A 
Gastro upset
Nausea
Less appetite
Weight loss
Headache
Motor restlessness
Serotonin syndrome 
Sexual dysfunction
SIADH (older patients)
Risk of bleeding (on warfarin)
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11
Q

When are SSRIs given?

A

During day to prevent sleep disturbance

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12
Q

How to treat SFx sexual dysfunction from SSRI drugs?

A

Adjust dose

Change drug

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13
Q

Important rare SFx of antidepressants ?

A

change in Electrical conduction of heart.
Esp. In ppl with preexisting heart condition
Withdrawal syndrome

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14
Q

What drug is Citalopram?

A

SSRIs

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15
Q

What drug is paroxetine?

A

SSRIs

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16
Q

What drug is sertraline?

A

SSRI

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17
Q

Which SSRI drug most likely to cause withdrawal?

A

Paroxetine

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18
Q

What drug is Prozac?

A

Fluoxetine

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19
Q

How many half-lives take to leave body?

A

7 half-lives

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20
Q

Which SSRI can be used in paeds?

A

Fluvoxamine

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21
Q

risk of SSRIs in adolescents?

A

Increased risk of suicide

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22
Q

3 SNRIs?

A

Venlafaxine
Duloxetine
Desvenlafaxine

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23
Q

What dose needed in SNRIs to get actual noradrenergic effects?

A

150-225mg that you get noradrenergic

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24
Q

SNRI has what SFx?

A

Withdrawal effect

Sweating - dose dependednt

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25
Name an alpha - 2 antagonist.
Mirtazepine indirect effects on: 5HT, noradrenaline, H1, 5HT2C receptors - weight gain
26
Mirtazepine Sfx?
Very sedative
27
Mirtazepine used for what?
Anti-anxiety effect
28
Effects on which receptors cause weight gain?
H1 | 5TH2C
29
Mirtazepine risk on blood?
Blood dyscrasias
30
What is Agomelatine? How does it work? Used for? When given?
Multimodal agents Melatonin agonist 5HT2C antagonist Used for sleep disturbance Given at night
31
What is reboxetine?
NA reuptake inhibitor | Not used. Much
32
What is vortioxetine?
5HT reuptake inhibitor 5HT1A agonist 5HT3 antagonist actions
33
Indications for anxiolytics?4 things
Generalized anxiety disorder Phobias Sleep disturbance Anxiety from med disorder
34
4 classes of anxiolytics
Benzos Buspirone Antidepressants Beta blockers
35
Main use of benzos? Chloride ion
Sleep disturbance Panic attacks Phobias
36
Main SFx prob with benzos?
bad Withdrawal | Addictive
37
Benzos NOT used in 3 things:
Simple phobias PTSD OCD
38
Most important benzos SFx?
1. Behavioural disinhibition (rage, hostility, aggressiveness) 2. Psychomotor impairment 3. Cognitive impairment 4. Abrupt Withdrawal phenomena (seizures) 5. Rebound insomnia
39
Suffix for benzos?
- pam | - lam
40
Most used benzo hypnotic?
Temazepam
41
Flunitrazepam important how?
'Date rape' drug Long half life Short duration of action
42
What are zopiclone and zolpidem? How long to use?
Hypnotic agents for sedation Short term use (Max 10 days)
43
Benzos work on what receptor?
GABA-A
44
Buspirone works on what? | Takes how long?
5HT-1A partial agonist Take weeks to work
45
When is Busiprone used for?
PTSD | Social phobia
46
Important SFx with Buspirone?
Dysphoria on initiation | Not useful for benzo withdrawal
47
Indications for antipsychotics?
``` Schizophrenia (Psychotic symptoms only) Bipolar disorder manic psychotic Brief psychosis Depression (psychotic) Delirium ``` Methamphetamine overdose
48
When use haloperidol?
Delirium in ICU
49
Haloperidol risk?
Extrapyramidal symptoms
50
When use intramuscular injection for antipsychotics?
Non-compliance
51
When use atypical antipsychotics?
``` First line Positive Negative Relapse Restablisation Maintenance ```
52
3 most important drugs of atypical antipsychotics
Olanzipine Risperidone Then clozapine if failed
53
Clozapine serious SFX?
Agranular cytosis | Cardiomyopathy, myocarditis
54
Quetiapine in low dose used for what
Hypnotic agent.
55
Quetiapine indicated for
``` Bipolar Depression Schizo PTSD Generalized anxiety disorder Sleep disturbances ```
56
Notable SFx of atypical antipsychotics?
Weight gain (Olanzapine and clozapine) T2DM
57
main Risperodone side effects?
Extrapyramidal SFx Increase prolactin QTc
58
2 classes for mood stabilizing for bipolar?
Lithium | Anticonvulsants
59
Name 4 anticonvulsants
Sodium valproate Carbamazepine Lamotrigine Topiramate
60
Lithium needs two things before starting:
Need thyroid/FBE, ECG, renal function Baseline Checked every 6 months
61
Why is renal function important in lithium?
Lithium not metabolized, only removed by kidneys
62
When take bloods for lithium?
12 hours after dose to get trough 0.4-0.8
63
Optimal dose in psychiatry?
Titration to dose response | Dose that gets them better

Jason's MD3 Psychiatry Rot (23 decks)

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