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Y3 Pyschiatry > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What class do the neurotransmitters NA and seritonin 5-HT belong to?

A

monoamines

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2
Q

Noradrenaline pathways in the brain are widely distributed. T or F

A

true

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3
Q

Where do the NA pathways of the brain originate?

A

brainstem

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4
Q

What primitive features does NA have a role in?

A

arousal and emotion

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5
Q

Serotonin pathways are widely distributed through the cortexes and subcortical areas. T or F

A

true

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6
Q

Where do the serotonin 5-HT pathways of the brain originate?

A

brainstem

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7
Q

Serotonin 5-HT has a role in mood, sleep, feed, behaviour, sensory perception and analgesia. T or F

A

true

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8
Q

What non psychiatric disorder can antidepressants be prescribed for?

A

neuropathic pain

migraine

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9
Q

What is the 1st line antidepressant?

A

there isn’t one. match to patient’s needs - but generally its a SSRI

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10
Q

Give examples of MAOIs monoamine oxidase inhibitors?

A

phenelzine, moclobemide

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11
Q

Typical antidepressants act at the _____ and include the classes _____, ______, _____ and ______. Atypical antidepressants act at the ______.

A

Typical antidepressants act at the synapse and include the classes MAOIs, SSRIs, SNRIs and tricyclics. Atypical antidepressants act post-synaptically.

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12
Q

What must you be mindful of when prescribing MAOIs and why?

A

PTx cannot eat foods containing tyramine (cheese, venison, red wine etc.) since can cause hypertensive crisis

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13
Q

How would a hypertensive crisis due to eating tyramine when taking MAOIs present?

A

headache
SOB
nosebleed

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14
Q

Give examples of MAOI SEs

A

insomnia
postural hypotension
peripheral edema

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15
Q

What is the mechanism of tricyclics?

A

non-selectively inhibit monoamine reuptake

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16
Q

Give examples of tricyclic antidepressants

A

amitriptyline
dosulepin
imipramine
lofepramine

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17
Q

What are the contraindications to tricyclics?

A

elderly / cognitive impairment

suicidal intent - is this true?

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18
Q

Can you overdose on tricyclics?

A

yes - OD is cardiotoxic

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19
Q

What are some side effects of tricyclic antidepressants

A 
anticholinergic SEs
sedation
weight gain
arrhythmia
postural hypotension
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20
Q

Give examples of anticholinergic side effects

A 
blurred vision
constipation
dry mouth
urinary retention
sweating
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21
Q

What is the mechanism of SSRIs?

A

inhibit serotonin 5-HT reuptake at synaptic cleft to increase extracellular 5-HT conc

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22
Q

Can you OD on SSRIs?

A

SSRIs have no OD risk

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23
Q

Give examples of SSRIs

A 
fluoxetine
citalopram
paroxetine
escitalopram
sertraline
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24
Q

What are the side effects of SSRIs

A 
nausea
HA
sweat
vivid dream
anxiety/agitation
sex
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25
Q

Give examples of SNRIs

A

venlafaxine, duloxetine

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26
Q

What is the mechanism of SNRIs

A

non-selectively block reuptake to presynaptic terminal

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27
Q

What are the side effects of SNRIs

A

Same as SSRIs but more likely

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28
Q

What drug class are reboxetine and maprotiline in?

A

antidepressants - NA reuptake inhibitor

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29
Q

What receptor does agomelatine act on?

A

melatonin receptors

30
Q

What is the mechanism of mirtazapine?

A

blocks alpha-2 & 5-HT receptors post-synaptically

31
Q

What are the side effects of mirtazapine?

A

weight gain

sedation (hence good for insomnia)

32
Q

Buproprion is an atypical antidepressant. Its mechanism is a ____ uptake inhibitor

A

dopamine uptake inhibitor

33
Q

Which mood stabiliser blocks the phosphatidylinositol pathway or inhibits glycogen synthase kinase 3β?

A

lithium

34
Q

Lithium has a ____ therapeutic index

A

narrow

35
Q

Does lithium cause weight gain or weight loss?

A

weight gain

36
Q

What should you monitor when prescribing lithium?

A

U+E, TFT, ECG

37
Q

Side effects of lithium?

A 
dry mouth
strange taste
polydipsia/uria
tremor
hypothyroid
renal
nephrogenic DI
38
Q

How does lithium toxicity present?

A

V, diarrhea, coarse ataxic tremor, drowsy, convulsion, coma

39
Q

What is the general mechanism of typical antipsychotics?

A

block D2 receptors in nigrostriatum

40
Q

Give examples of typical antipsychotics

A

Haloperidol, chlorpromazine, thioridazine, fluphenazine

41
Q

What side effect of typical antipsychotics can take years to present?

A

tardrive dyskinesia (orofacial)

42
Q

What hormone disturbance can occur as a side effect of typical antipsychotics and how would this present?

A

> PRL

gynaecomastia, galactorrhea, ED,

43
Q

What side effect of typical antipsychotic occurs soon after beginning the drug, and is managed with anticholinergics?

A

acute dystonic reaction

44
Q

What side effect of typical antipsychotics is managed by decreasing the dose or adding an anti-acetylcholinesterase?

A

Parkinsonism extra-pyramidal

45
Q

Typical antipsychotics cause sedation. T or F

A

true

46
Q

Are typical or atypical antipsychotics better for the negative symptoms of schizophrenia?

A

atypical

47
Q

Give examples of atypical antipsychotics

A

quetiapine, clozapine, olanzapine, risperidone, aripiprazole, olanzapine

48
Q

Atypical antipsychotics block histamine that leads to which side effects?

A

sedation

increased appetite/wt

49
Q

Atypical antipsychotics block Na that leads to which side effects?

A

postural hypotension

50
Q

What is one of the main side effects from atypical antipsychotics?

A

metabolic synd

51
Q

What is the most effective antipsychotic drug?

A

clozapine

52
Q

What are the side effects of clozapine?

A

agranulocytosis
>saliva
myocarditis
weight gain

53
Q

How do you monitor clozapine to prevent agranulocytosis

A

FBC once a week for 6 months. then every 2 weeks

54
Q

Which anticonvulsants can be used as antipsychotics?

A

valproate
lamotrigine
carbamazepine

55
Q

What are the side effects of lamotrigine?

A

SJS stevent johnson synd

diarrhoea/vomiting

56
Q

What are the side effects of carbamazepine?

A

drowsy, ataxic, CVD, induces liver enzymes

57
Q

What is the mechanism of valproate?

A

> GABA

58
Q

What are contraindications to valproate?

A

female of child-bearing age since neural tube defect teratogen

59
Q

Name 5 types of anxiolytics

A 
benzos
pregabalin
beta-blockers
buspirone
barbituates
60
Q

What is the general mechanism of benzos?

A

> GABA inhibition at GABA-A receptor

61
Q

Do benzos have a rapid or slow onset?

A

rapid onset

62
Q

Can you overdose on benzos?

A

no

63
Q

What effect do benzos have on muscle?

A

relaxation

64
Q

Name 3 examples of benzos?

A

lorazepam
diazepam (valium)
chlordiazepoxide

65
Q

Do benzos increase or decrease aggression?

A

decrease

66
Q

Are benzos sedative?

A

yes

67
Q

What effect do benzos have on depression?

A

worsen it

68
Q

Benzos can cause psychosis, >HR, tremor, convulsion, sweat, confuse and agitation by what mechanism?

A

rapid withdrawal

69
Q

What is the mechanism of pregabalin?

A

Ca2+ channel blocker, >GABA

70
Q

Propanolol can be prescribed for ____ anxiety symptoms such as _____ and ____, in the _____ age range.

A

Propanolol can be prescribed for somatic anxiety symptoms such as palpitation and tremor, in the adult age range.

71
Q

If a PTx taking an SSRI and experiences a loss of libido, what medication can you co-administer to prevent this?

A

buspirone

Y3 Pyschiatry (15 decks)

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