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10- Psychiatry > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

how do monoamine oxidase inhibitors work?

A

slow down degredarion of monoamines

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2
Q

give examples of monoamine neurotransmitters

A

serotonin (5-HT)

dopamine

noradrenaline

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3
Q

what are two monoamine oxidase inhibitors?

A

phenelzine (irrerversible)

moclobemide (reversible)

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4
Q

what are some SE of monoamine oxidase inhibitors?

A

insomnia

postural hypotension

peripheral oedema

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5
Q

do monoamine oxidase inhibitors have an effect on the metabloism of other drugs?

A

potentiate effects of other drugs by decreasing their metabolism

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6
Q

what is the ‘cheese reaction’? (monoamine oxidase inhibitors)

A

hypertensive crisis caused by inhibtion of MO-A in gut

patietns advised to avoid tyramine rich foods- red wine/beer/game

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7
Q

how do tricyclics work?

A

blocks reuptake of monoamines into presynaptic terminals

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8
Q

give some examples of tricyclic antidepressants

A

imipramine

dosulepin

amitryptyline

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9
Q

what are some SE’s of tricyclics?

A

sedation

wgt gain

anticholinergic- blurred vision, dry mouth, constipation

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10
Q

is tricyclic overdose dangerous?

A

yes- they are cardiotoxic in overdose

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11
Q

how do SSRI’s work?

A

severly inhibit reuptake of serotonin (5-HT) from synpatoc cleft

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12
Q

give some examples of SSRI’s

A

fluoextine

citalopram

sertraline

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13
Q

what are some SE’s of SSRI’s?

A

nausea/headaches

worsened anxiety

sweating/vivid dreams

sexual dysfunction

inc in self harm and suicidal thoughts

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14
Q

what is mirtazipine?

A

antidepressant with mixed receptor effects

(SE’s- sedation nd wgt gain)

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15
Q

what other monomaine reuptake inhibtor is licensed for use in chronic pain?

A

duloxetine

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16
Q

what is the standard treatment for biploar disorder?

A

lithium- usually given as lithium carbonate

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17
Q

lithium has a narrow therapeutic index. why is this important?

A

bloods must be done 12hrs post dose to montior levels

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18
Q

what are some SE’s of lithium?

A

dry mouth/ strange taste

tremor

hypothyroidism

N&V

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19
Q

give some antipsychotics

A

olanzapine

clozapine

risperidone

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20
Q

which antipsychotic can be used in T2DM and why?

A

risperidone

olanzapine and clozapine are more likely to cause metablic disturbance

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21
Q

what is one major side effect of clozapine?

A

agranulocytosis- FBC required if patient satrs to feel unwell

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22
Q

antipsychotics are likely to cause weight gain true/false

A

true- high risk of wieght gain

23
Q

give some anticonvulsants

A

valproic acid/sodium valproate

lamotrigine

carbamazepine

24
Q

what adverse side effect has lamotrogine been linked with?

A

steven-johnson syndrome

25
Q

can anti convulsant medications be used in pregnancy?

A

no- teratogenic, should not be used in women of childbearing age

26
Q

how long should mood altering medication be trialled before swiching if no results?

A

at least 2-3 months sometimes 4

27
Q

which is mor eocmmonly prescribed olanzapien or clozapine?

A

olanzopine- should only use clozapine in those resistant to other atypicals

28
Q

what are some drugs used to treat anxiety?

A

benzos

antidperessants

busiprone

pregabalin (anti-convulsant)

B-blockers

29
Q

why are SSRI’s commonly used in the treamtent of anxiety?

A

symtpoms overlap greatly w depression so can tackle both disorders

30
Q

what neurotransmitter is targetted by benzos, barbituates and alcohol?

A

GABA A,B,C

31
Q

what is the effect when benzos etc bind to GABA?

A

positive allosteric effect- neuron less likely to fire AP

32
Q

can you stop benzodiazepines suddenly?

A

no- decrease by 2-2.5mg every 2-3 weeks

33
Q

which anxiety disorder can moclobemide be used for?

A

social anxiety disorder

34
Q

which anxiety disorder can Venlaflaxine be used for?

A

GAD

35
Q

parkinsonism is a SE of which drug class?

A

anti-psychotics

36
Q

what are the main side effects of mirtazapine?

A

wgt gain and sedation

37
Q

why does clozpaine increase risk of seizures?

A

lowers the threshold making them more likely

38
Q

what can happen if someone is taking an SSRI and a NSAID?

A

increased bleeding risk

co-prescribe PPI

39
Q

what drug can be used to treat tardive dyskinesia?

A

tetrabenazine

40
Q

what are some side effects of carbamazepine?

A

drowsiness

ataxia

induction of liver enzymes

41
Q

which receptors do antipsychotics at on?

A

dopamine D2 receptor agonists

42
Q

are typical or atypical antipsychotics more likely to cause extra-pyramidal side effects?

A

typical i.e. chlorpromazine, haloperidol, thioidazine

43
Q

which type of anti-depressant should be avoided in prostatism?

A

tricylics- due to anticholinergic effects (urinary retention)

44
Q

which is the preferred drug in treating bipolar suffering primarily w depression?

A

lamotrogine

45
Q

what is the preffered drug in treating bipolar w primarily mania/hypomania?

A

sodium valproate

46
Q

what are the first and second line treatments in ADHD?

A

methylphenidate first line

atomoxetine second line

47
Q

typical or atypical antipsychotics work best in -ve symtpoms of schizophrenia?

A

atypicals

48
Q

anti-convulsants block which ion channel?

A

Na2+

49
Q

how long shoul danti-depressants be continued for following depressive episode?

A

at least 6 months

50
Q

which receptors does memantine act on?

A

antagonist of NDMA receptors which bind glutamate

51
Q

rapid cycling bipolar responds best ot which drug class?

A

anti-convulsants

52
Q

which drug class is assoc w hyperprolactinaemia?

A

anti-psychotics

53
Q

benzodiazepines bind to which neurotransmitter?

A

GABA A

54
Q

other than agranulocytosis which other SE can clozapine cause?

A

postural hypotension

10- Psychiatry (11 decks)

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