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Psychiatry > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What drugs can cross the BBB?

A

Small, lipophilic drugs

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2
Q

What are some clinical uses of antidepressants?

A

Depression
Dysthymia
Anxiety
Panic disorders, OCD, PTSD, PMS dysmorphic, bulimia, neuropathic pain

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3
Q

3 categories of antidepressant drugs

A

Monoamine oxidase inhibitors
Monoamine reuptake inhibitors
Atypical drugs

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4
Q

What is a type of monoamine reuptake inhibitor? (4)

A

Tricyclics
Non-selective reuptake
Selective serotonin reuptake
Noradrenaline reuptake

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5
Q

3 examples of monoamines

A

Dopamine, NA, 5-HT

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6
Q

Depression results from a functional deficit of ________ in particular _____ and ______

A

Monoamine transmitters

Serotonin, NA

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7
Q

Precursor for serotonin

A

Typtophan

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8
Q

Precursor for NA

A

Tyrosine

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9
Q

What does MAO do?

A

It metabolizes NA and 5-HT

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10
Q

Examples of MAO inhibitors

A

Phenelzine

Moclobemide

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11
Q

Mode of action for MAO inhibitors

A

Irreversible (phenelzine) or reversible (moclobemide) inhibitors of MAO-A and B

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11
Q

Mode of action for MAO inhibitors

A

Irreversible (phenelzine) or reversible (moclobemide) inhibitors of MAO-A and B

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12
Q

What are side effects of MAO inhibitors?

A

Cheese reaction - hypertensive crisis caused by inhibition of MAO in gut by irreversible inhibitors preventing breakdown of dietary tyramine and by multiple drugs that potentiate amine transmission
Insomnia
Postural hypotension
Peripheral oedema

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13
Q

People on MAOinhibitors can’t have

A

Cheese, gravy

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14
Q

Tricyclic anti-depressants common side effects

A

Anti-cholinergic, sedation, weight gain, cardiotoxic

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15
Q

When do you take tricyclic antidepressants?

A

At night before bed

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16
Q

Example of SSRI

A

Fluoxetine, citalopram, sertraline

17
Q

SE of SSRIs

A

Nausea, headache, worsened anxiety, increase in self-harm, sweating/vivid dreams, hyponatraemia in the elderly

18
Q

Which anti-depressant drugs are more NA selective? 5-HT selective? Non-selective?

A

NA: Reboxetine, protiptylline
5-HT: Sertraline, fluoxetine, citalopram
Non: amitriptyline

19
Q

What drug should be avoided in people with IHD that is now depressed?

A

Tricyclic

20
Q

Lithium mode of action

A

May block phosphatidylinositol pathway or inhibit glycogen synthase kinase 3B - not sure but causes numerous unwanted affects down the line

21
Q

Monitoring of someone on lithium

A

12 hour post-dose blood levels

Target range 0.4-1

22
Q

Does lithium get metabolized?

A

No, you can’t metabolize an element

23
Q

To the renal tubules, lithium and _____ are indistinguishable

A

Sodium

24
Q

Antipsychotic drugs

A

Quetiapine, aripiprazole, olanzapine, lurasidone

25
Q

MAOi examples

A

Phenelzine

Moclobemide

26
Q

3 MOA reuptake inhibitors

A

Tricyclics
SSRI
SNRI

27
Q

SNRI example

A

Venlafaxine, duloxetine

28
Q

What do TCAs do?

A

Block the reuptake of monoamines into presynaptic terminals (NA and 5-HT)

29
Q

SSRI discontinuation effects

A

FINISH - flu-like, insomnia, nausea, imbalance, sensory disturbance, hyperarousal

30
Q

Triad of symptoms in serotonin syndrome

A 
Autonomic instability (hypertension, tachycardia, hyperthermia, sweating) 
Neuromuscular abnormality (tremor, clonus, hypertonicity, hyperreflexia)
Mental state changes (delirium, agitation, pressured speech, hyper vigilance, confusion, coma)
31
Q

AVOID in panic disorder

A

BZD

32
Q

First line panic disorder treat

A

SSRI

33
Q

2nd line panic disorder

A

Imipramine, clomipramine

34
Q

GAD treatment

A

BZD 2-4 weeks
1st line: SSRI
2nd line: SNRI or pregabalin

35
Q

Pharmacological effects of BZD

A 
Reduce anxiety and aggression 
Hypnosis/sedation 
Muscle relaxation 
Anticonvulsant 
Anterograde amnesia
36
Q

Lithium requires what post dose?

A

Blood monitoring

0.4-1

37
Q

Lithium side effects

A 
Dry mouth/strange taste
Polydipsia and polyuria
Tremor 
Hypothyroidism 
Long term reduced renal function 
Nephrogenic DI 
Weight gain
38
Q

Prophylaxis in bipolar disorder

A

1st - lithium

2nd - valproate (not in women of child bearing), olanzapine

39
Q

Treat neuroleptic malignant syndrome

A

Discontinue drug

Add an agonist (bromocriptine)

40
Q

What drug prolongs the QT interval?

A

Clozapine

Psychiatry (22 decks)

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