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psychiatry > pharmacology in psychiatry > Flashcards

pharmacology in psychiatry Flashcards

1
Q

antidepressants used in

A

depression
organic mood disorders
schizoaffective disorders
anxiety disorders: OCD, panic, social phobia, PTSD

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2
Q

antidepressants classification

A

tricyclic acids (TCAs)

monoamine oxidase inhibitors (MAOIs)

selective seratonin reuptake inhibitors (SSRIs)

seratonin/noradrenaline reuptake inhibitors (SNRIs)

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3
Q

how much of a delay (after given dose til symptoms improve) is seen when taking anti depressants?

A

2-4 weeks

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4
Q

what antidepressant is lethal when taken as an overdose?

A

tricyclic antidepressants (TCAs)

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5
Q

side effects of TCAs

A

antihistamine (sedation and weight gain)

anticholinergic (dry mouth and eyes)

antiadrenergic (qt lengthening)

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6
Q

basic physiology of a Monoamine oxidase inhibitors

A

bind to monoamine oxidase to prevent the inactivation of amines such as:

norepinephrine
dopamine
serotonin

(leading to increased synaptic levels)

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7
Q

monoamine oxidase inhibitors side effects

A 
orthostatic hypotension
sedation, weight gain
dry mouth/eyes
sexual dysfunction
sleep disturbance
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8
Q

cheese reaction

A

hypertensive crises when MAOIs are taken with tyramine rich foods or sympathomimetics

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9
Q

serotonin syndrome

A

MAOIs taken with other medicines that increase serotonin or have sympathomimetic effects

abdominal pain, diarrhoea,
sweats, tachycardia, HTN, myoclonus
irritability, delirium

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10
Q

basic physiology of SSRIs

A

block the presynaptic serotonin reuptake

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11
Q

SSRIs treat what?

A

anxiety and depressive disorders

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12
Q

common side effects of SSRIs

A

GI upset

sexual dysfunction

anxiety, restlessness

insomnia, fatigue

discontinuation syndrome: agitation, nausea

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13
Q

common SSRIs:

pharmacological names

A

fluoxetine (prozac)

Sertaline

paroxetine

Citalopram

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14
Q

basic SNRI physiology:

A

inhibit both serotonin and noradrenergic reuptake like the TCAs

(but without antihistamine, anticholinergic or anti-adrenergic side effects)

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15
Q

what are SNRIs used in?

A

depression

anxiety

neuropathic pain

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16
Q

who would you give a mood stabiliser to?

A

bipolar

cyclothymia

schizoaffective

17
Q

what is unipolar depression?

A

persistent/ constant depression

18
Q

3 classes of mood stabilisers:

A

lithium

anticonvulsant

antipsychotics

19
Q

what is the only medication that officially reduces suicide rates?

A

lithium

20
Q

what is the first line mania prophylaxis?

A

carbamazepine (anti convulsant)

21
Q

when would you use anti psychotics?

A

bipolar

schizophrenia

schizoaffective disorder

22
Q

antipsychotic basic physiology

A

D2 dopamine receptor antagonists

23
Q

what is the difference between typical and a typical antipsychotics

A

typical - affect dopamine (dopamine receptor antagonists)

atypical - affect dopamine and serotonin (seratonin-dopamine 2 antagonists)

24
Q

when would you use benzodiazepines?

A

insomnia

parasomnia

anxiety disorders

management of alcohol withdrawal

25
Q

what would you use to treat Korsakoff syndrome?

A

thiamine

26
Q

what is Korsakoff syndrome?

A

chronic memory disorder caused by a lack of thiamine

usually alcohol misuse

27
Q

Korsakoff psychosis:

A

impairment of recent and remote memory
no general cognitive impairment
impaired learning and disorientation

28
Q

what medication can be given in the management of alcohol withdrawal?

A

benzodiazepines

normally chlordiazepoxide

29
Q

what medication should be used as deterrent/ aversion to alcohol?

A

Antabuse (disulfiram)

‘gives effects of hangover immediately after consumption’

30
Q

how would you treat post natal depression?

A

just like depression

SSRI, TCA, MOI, SNRI, CBT, IPT, ECT

31
Q

how do you treat mania?

1st, 2nd, 3rd line

A

antipsychotics

mood stabilisers

lithium

32
Q

how do you treat obsessive compulsive disorder?

A

1st line:
CBT including exposure and response prevention (asking people to resist their urges/ compulsions)

2nd line:
SSRIs (fluoxetine, citalopram)

3rd lines:
TCA (clomipramine)

33
Q

what kind of drug is sodium valproate?

A

mood stabiliser

psychiatry (23 decks)

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