Pharmacology Flashcards
What is the therapeutic range for lithium and when should this be checked?
0.4-1.0 mol/l
12 hours after dose
(Purple book)
Which is the most important test for some one on clozapine?
FBC - agranulocytosis
This needs to be checked every week for first 18weeks, then every 2 weeks after, and if stable after 1 year then every 4 weeks.
Which antidepressant is considered safest in someone following an MI?
Sertaline
Citapolam - qt interval
Which antidepressant is first choice in children/adolescents?
Fluoxetine
What cardiac side effects are associated with clozapine?
Myocarditis
Arrhythmia
What adverse effects do antipsychotics increase in the elderly?
VTE and stroke
What are the side effects of antipsychotics?
Antimuscarinic: dry mouth, blurred vision, urinary retention, constipation.
Sedation weight gain
Raised prolactin: galactorrhoea, impaired glucose toleratence
NMS
Reduced seizure threshold
Prolonged QT interval (particularly haloperidol)
When is ECT indicated?
Catatonia
Prolonged or severe manic episode
Severe depression that is life threatening
Absolute contraindication in raised intercranial pressure
Which drug can be given to elevate stiffness and restlessness caused by anti-psychotics?
Procyclidine
What is the most common symptoms of atypical antipsychotics?
Weight gain
What are the common side effects of tricyclics antidepressants eg imipramine?
Antimuscurinic
- dry mouth, blurred vision, constipation, urinary retention, drowsiness
Which antidepressant drug can be used in neuropathic pain?
Low-dose amitriptyline
Give 4 examples of ssri?
Citalopram
Sertraline
Fluoxetine
Paroxetine
Serotonin discontinuation syndrome symptoms?
GI- pain, vom, diahorrhea Restlessness Poor sleep Unsteadiness Sweating Parasthesia
What causes lithium toxicity?
Dehydration(reduced renal output)
Eg by diuretics or NSAIDs
Illness/fever
What are the signs of lithium toxicity?
Marked Polyuria/ dipsia Gross tremor Muscle twitching Circulatory collapse Conc >2 may need dialysis
What ongoing monitoring for lithium needed?
FBC- 3 monthly
U&E and creatinine - 6m
THT- yearly
Side effects of lithium
Polyuria Pretibial oedema Fine tremor Hypothyroidism Rarely (renal tuberculo sclerosis
What is the treatment for depressed part of BPAD?
1) quetiapine
2) olazinpine snd fluorite the combination
3) AD and mood stabiliser
What is the treatment for manic part of BPAD?
1) lithium
2) valproate
3) carbimazipine
4) quetiapine
What is reboxetine?
NA reuptake inhibitor
Name a NASS antidepressant?
Mirtazapine
Name 2 SNRIs
Venlafaxine, duloxitine
S/E - constipation, HTN, hypercholestrolaemia
What are this side effects of TCAs?
Anti-muscarinic: drymouth, blurred vision, constipation and urinary retention, narrow angle glaucoma.
Cardio: arrthymias, tachy
Alpha 1- postural hypotension
Histamine - sedation, weight gain
