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Psychiatry > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the therapeutic range for lithium and when should this be checked?

A

0.4-1.0 mol/l
12 hours after dose

(Purple book)

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2
Q

Which is the most important test for some one on clozapine?

A

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.

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3
Q

Which antidepressant is considered safest in someone following an MI?

A

Sertaline

Citapolam - qt interval

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4
Q

Which antidepressant is first choice in children/adolescents?

A

Fluoxetine

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5
Q

What cardiac side effects are associated with clozapine?

A

Myocarditis

Arrhythmia

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6
Q

What adverse effects do antipsychotics increase in the elderly?

A

VTE and stroke

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7
Q

What are the side effects of antipsychotics?

A

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)

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8
Q

When is ECT indicated?

A

Catatonia
Prolonged or severe manic episode
Severe depression that is life threatening

Absolute contraindication in raised intercranial pressure

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9
Q

Which drug can be given to elevate stiffness and restlessness caused by anti-psychotics?

A

Procyclidine

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10
Q

What is the most common symptoms of atypical antipsychotics?

A

Weight gain

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11
Q

What are the common side effects of tricyclics antidepressants eg imipramine?

A

Antimuscurinic

- dry mouth, blurred vision, constipation, urinary retention, drowsiness

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12
Q

Which antidepressant drug can be used in neuropathic pain?

A

Low-dose amitriptyline

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13
Q

Give 4 examples of ssri?

A

Citalopram
Sertraline
Fluoxetine
Paroxetine

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14
Q

Serotonin discontinuation syndrome symptoms?

A 
GI- pain, vom, diahorrhea 
Restlessness
Poor sleep
Unsteadiness
Sweating 
Parasthesia
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15
Q

What causes lithium toxicity?

A

Dehydration(reduced renal output)
Eg by diuretics or NSAIDs
Illness/fever

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16
Q

What are the signs of lithium toxicity?

A 
Marked Polyuria/ dipsia
Gross tremor 
Muscle twitching 
Circulatory collapse
Conc >2 may need dialysis
17
Q

What ongoing monitoring for lithium needed?

A

FBC- 3 monthly
U&E and creatinine - 6m
THT- yearly

18
Q

Side effects of lithium

A 
Polyuria
Pretibial oedema
Fine tremor
Hypothyroidism
Rarely (renal tuberculo sclerosis
19
Q

What is the treatment for depressed part of BPAD?

A

1) quetiapine
2) olazinpine snd fluorite the combination
3) AD and mood stabiliser

20
Q

What is the treatment for manic part of BPAD?

A

1) lithium
2) valproate
3) carbimazipine
4) quetiapine

21
Q

What is reboxetine?

A

NA reuptake inhibitor

22
Q

Name a NASS antidepressant?

A

Mirtazapine

23
Q

Name 2 SNRIs

A

Venlafaxine, duloxitine

S/E - constipation, HTN, hypercholestrolaemia

24
Q

What are this side effects of TCAs?

A

Anti-muscarinic: drymouth, blurred vision, constipation and urinary retention, narrow angle glaucoma.
Cardio: arrthymias, tachy
Alpha 1- postural hypotension
Histamine - sedation, weight gain

25
Q

How to prevent GI bleeds in someone taking SSRI and aspirin?

A

Give PPI eg lansoprazole

26
Q

What are the features of benzodiazepine withdrawal?

A

Insomnia, irritability, anxiety, tremor, loss of appetite, tinnitus, perspiration, perceptual disturbances, seizures.

27
Q

What’s the mechanism of action for benzodiazepines and barbiturates?

A

Both GABAa
Benzodiazepines- increase the frequency of chloride channels
Barbiturates- increases the duration of chloride channel opening

28
Q

What are the acute adverse effects of phenytoin?

A

Dizziness, Diplopia, nystagmus, slurred speech, ataxia,

Confusion and seizures

Psychiatry (19 decks)

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