Pharmacology Flashcards
how do monoamine oxidase inhibitors work?
slow down degredarion of monoamines
give examples of monoamine neurotransmitters
serotonin (5-HT)
dopamine
noradrenaline
what are two monoamine oxidase inhibitors?
phenelzine (irrerversible)
moclobemide (reversible)
what are some SE of monoamine oxidase inhibitors?
insomnia
postural hypotension
peripheral oedema
do monoamine oxidase inhibitors have an effect on the metabloism of other drugs?
potentiate effects of other drugs by decreasing their metabolism
what is the ‘cheese reaction’? (monoamine oxidase inhibitors)
hypertensive crisis caused by inhibtion of MO-A in gut
patietns advised to avoid tyramine rich foods- red wine/beer/game
how do tricyclics work?
blocks reuptake of monoamines into presynaptic terminals
give some examples of tricyclic antidepressants
imipramine
dosulepin
amitryptyline
what are some SE’s of tricyclics?
sedation
wgt gain
anticholinergic- blurred vision, dry mouth, constipation
is tricyclic overdose dangerous?
yes- they are cardiotoxic in overdose
how do SSRI’s work?
severly inhibit reuptake of serotonin (5-HT) from synpatoc cleft
give some examples of SSRI’s
fluoextine
citalopram
sertraline
what are some SE’s of SSRI’s?
nausea/headaches
worsened anxiety
sweating/vivid dreams
sexual dysfunction
inc in self harm and suicidal thoughts
what is mirtazipine?
antidepressant with mixed receptor effects
(SE’s- sedation nd wgt gain)
what other monomaine reuptake inhibtor is licensed for use in chronic pain?
duloxetine
what is the standard treatment for biploar disorder?
lithium- usually given as lithium carbonate
lithium has a narrow therapeutic index. why is this important?
bloods must be done 12hrs post dose to montior levels
what are some SE’s of lithium?
dry mouth/ strange taste
tremor
hypothyroidism
N&V
give some antipsychotics
olanzapine
clozapine
risperidone
which antipsychotic can be used in T2DM and why?
risperidone
olanzapine and clozapine are more likely to cause metablic disturbance
what is one major side effect of clozapine?
agranulocytosis- FBC required if patient satrs to feel unwell
antipsychotics are likely to cause weight gain true/false
true- high risk of wieght gain
give some anticonvulsants
valproic acid/sodium valproate
lamotrigine
carbamazepine
what adverse side effect has lamotrogine been linked with?
steven-johnson syndrome
can anti convulsant medications be used in pregnancy?
no- teratogenic, should not be used in women of childbearing age
how long should mood altering medication be trialled before swiching if no results?
at least 2-3 months sometimes 4
which is mor eocmmonly prescribed olanzapien or clozapine?
olanzopine- should only use clozapine in those resistant to other atypicals
what are some drugs used to treat anxiety?
benzos
antidperessants
busiprone
pregabalin (anti-convulsant)
B-blockers
why are SSRI’s commonly used in the treamtent of anxiety?
symtpoms overlap greatly w depression so can tackle both disorders
what neurotransmitter is targetted by benzos, barbituates and alcohol?
GABA A,B,C
what is the effect when benzos etc bind to GABA?
positive allosteric effect- neuron less likely to fire AP
can you stop benzodiazepines suddenly?
no- decrease by 2-2.5mg every 2-3 weeks
which anxiety disorder can moclobemide be used for?
social anxiety disorder
which anxiety disorder can Venlaflaxine be used for?
GAD
parkinsonism is a SE of which drug class?
anti-psychotics
what are the main side effects of mirtazapine?
wgt gain and sedation
why does clozpaine increase risk of seizures?
lowers the threshold making them more likely
what can happen if someone is taking an SSRI and a NSAID?
increased bleeding risk
co-prescribe PPI
what drug can be used to treat tardive dyskinesia?
tetrabenazine
what are some side effects of carbamazepine?
drowsiness
ataxia
induction of liver enzymes
which receptors do antipsychotics at on?
dopamine D2 receptor agonists
are typical or atypical antipsychotics more likely to cause extra-pyramidal side effects?
typical i.e. chlorpromazine, haloperidol, thioidazine
which type of anti-depressant should be avoided in prostatism?
tricylics- due to anticholinergic effects (urinary retention)
which is the preferred drug in treating bipolar suffering primarily w depression?
lamotrogine
what is the preffered drug in treating bipolar w primarily mania/hypomania?
sodium valproate
what are the first and second line treatments in ADHD?
methylphenidate first line
atomoxetine second line
typical or atypical antipsychotics work best in -ve symtpoms of schizophrenia?
atypicals
anti-convulsants block which ion channel?
Na2+
how long shoul danti-depressants be continued for following depressive episode?
at least 6 months
which receptors does memantine act on?
antagonist of NDMA receptors which bind glutamate
rapid cycling bipolar responds best ot which drug class?
anti-convulsants
which drug class is assoc w hyperprolactinaemia?
anti-psychotics
benzodiazepines bind to which neurotransmitter?
GABA A
other than agranulocytosis which other SE can clozapine cause?
postural hypotension
