pharmacology

Question 1

What are the first line antidepressants?

Answer 1

Selective serotonin reuptake inhibitors

Question 2

What are examples of SSRIs?

Answer 2

Fluoxetine (Prozac)
Citalopram
Sertraline
Paroxetine

Question 3

Which SSRI is best for IHD?

Answer 3

sertraline

Question 4

How long does it roughly take SSRIs to work?

Answer 4

6 weeks

Question 5

What are side effects of SSRIs?

Answer 5

Anxiety; appetite abnormal; arrhythmias; arthralgia; confusion; depersonalisation; drowsiness; dry mouth; fever; gastrointestinal discomfort; haemorrhage; headache; hyperhidrosis; malaise; memory loss; menstrual cycle irregularities; mydriasis; palpitations; paraesthesia; QT interval prolongation; sexual dysfunction; skin reactions; sleep disorders; taste altered; tinnitus; tremor; urinary disorders; visual impairment; vomiting; weight changes

Question 6

What are second line antidepressants?

Answer 6

SNRI -serotonin and noadrenaline reuptake Inhibitor.

NaSSA- noradrenergic and specific serotonergic antidepressant

Question 7

Give an example of a SNRI

Answer 7

venlafaxine

duloxetine

Question 8

Give an example or NaSSA

Answer 8

mirtazapine

Question 9

What are the third line antidepressants?

Answer 9

tri cyclic antidepressants (TCA)

Question 10

Give an example of a TCA

Answer 10

Amitriptyline.
Amoxapine.
Desipramine 
Doxepin.
Imipramine
Nortriptyline
Protriptyline.
Trimipramine

Question 11

What are the side effects of TCAs?

Answer 11

blurred vision, dry mouth, nausea, dangerous OD

Question 12

What are first line anti psychotics

Answer 12

second generation:
resperidone, quetiapine, olanzapine
third generation:
aripiprazole

Question 13

What are the side effects of anti psychotics?

Answer 13

weight gain, dyslipidemia and hyperglycaemia. QT elongation, more likely to have seizures, ED and decreased libido

Question 14

What side effects does olanzapine specifically cause?

Answer 14

raised prolactin, particularly bad for weight gain

Question 15

What side effects are particular to aripiprazole?

Answer 15

restlessness

Question 16

What are second line antipsychotics?

Answer 16

first generation:
haloperidol
chlorpromazine

Question 17

What side effects do first generation antipsychotics cause?

Answer 17

extra pyramidal due to low B vitamins, eg acute dystonia

Question 18

How do you treat the side effcts of first gen antipsychotics?

Answer 18

procyclodine

Question 19

What are third line antipsychotic?

Answer 19

clozapine

Question 20

What can be used as a mood stabiliser first line?

Answer 20

lithium

Question 21

What are second line mood stabilisers?

Answer 21

quetiapine (good for psychotic sx)
sodium vaporate
carbamazepine

Question 22

What are the side effects of lithium?

Answer 22

lithium toxicity, nephrotoxic, hypothyroid
nausea/vomiting, diarrhoea
fine tremor
nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus
ECG: T wave flattening/inversion
weight gain
idiopathic intracranial hypertension
leucocytosis
hyperparathyroidism and resultant hypercalcaemia

Question 23

What is contraindicated with lithium?

Answer 23

NSAIDs

Question 24

What are used as hypnotics?

Answer 24

benzodiazapines eg diazepam, lorezapam

Question 25

What is the cheese effect and what drugs does it happenw with?

Answer 25

An acute attack of hypertension that can occur in a person taking a monoamine oxidase inhibitor (MAOI) drug who eats cheese, caused by an interaction of the MAOI with tyramine

e.g. rasagiline and selegiline

Question 26

SE antipsychotics in elderly

Answer 26

Antipsychotics in the elderly - increased risk of stroke and VTE

Question 27

Which SSRI is most likely to lead to heart arrythmias?

Answer 27

Citalopram is the most likely selective serotonin reuptake inhibitor (SSRI) to lead to QT prolongation and Torsades de pointes.

Question 28

Which atypical antipsychotic has the lowest SE profile?

Answer 28

aripiprazole