Pharmacology

Question 1

Benzo action, SE, uses, treatment for OD

Answer 1

Enhance inhibitory effects of GABA Give anxiolytic, hypnotic + anticonvulsant effects Can cause respiratory depression Common SE: sedation, dizziness, ataxia, headache, anticholinergic effects Used for alcohol withdrawal, anxiety, insomnia OD: flumazenil

Question 2

Benzo withdrawal S+S, treatment

Answer 2

Anxiety symptoms, hypersensitivity, muscle pains, headache Can cause psychosis, seizures Can use B blocker to reduce intensity of withdrawal symptoms

Question 3

Z drugs action, SE

Answer 3

Act via GABA receptors Less risk of tolerance + dependance than benzos SE: sedation, taste disturbance, GI upset, rebound insomnia Metabolised by P450

Question 4

ECT cautions + how to abort prolonged seizures

Answer 4

Use diazepam to abort prolonged seizure Avoid within 3 months of MI or CVA May get short term memory impairment

Question 5

Neurotransmitters + the disorders associated with them

Answer 5

Ach = Alzheimers Dopamine = Parkinsons, schizophrenia NA = anxiety, depression, cognition, schizophrenia Serotonin = depression, anxiety, schizophrenia, eating disorders GABA = anxiety, Huntingtons, epilepsy

Question 6

Dopamine locations in the brain

Answer 6

Substantia nigra - primary site of degeneration in Parkinsons Ventral tegmental area (mesolimbic/ cortical) Tuberinfundibular pathway

Question 7

Location of noradrenaline

Answer 7

Locus coeruleus

Question 8

Acetylcholine location that is disrupted in Alzheimers

Answer 8

Cell bodies in nucleus basalis of Meynert - axons innervating the hippocampus

Question 9

Acetylcholine receptor types

Answer 9

Nicotinic = muscle ganglionic, CNS type Muscarinic = found in brain, targets for AD treatment

Question 10

Typical vs atypical AP (uses, SE)

Answer 10

Typical: treats positive symptoms only, causes EPSE, raises prolactin Atypical: treats positive and negative symptoms, little EPSEs, less effect on prolactin

Question 11

Methylphenidate - uses, SE

Answer 11

CNS stimulant used in ADHD SE: insomnia, agitation, weight loss, hypertension

Question 12

Switching from one antidepressant to another

Answer 12

Conservative switch = first one stopped, washout period then start new one

Direct switch = if swapping from one SSRI or SNRI to another

Cross taper = if switching to another class but at risk of bad symptoms if without

Question 13

What to use for rapid tranquilisation?

Answer 13

IM Lorazapam 1st line

IM haloperidol + promethazine

Question 14

What tests need to be done before starting an AP?

Answer 14

FBC, UES, LFTS, HBA1C, prolactin, lipids, cholesterol

Question 15

What to give in a benzo addiction?

Answer 15

Diazepam + titrate it down

Question 16

Who can use a section 5.2 and 5.4?

Answer 16

5. 2 - need to be fully registered doctor (FY2)
6. 4 - needs to be registered mental health nurse or LD nurse