Pharmacology - Summary Flashcards
What are the main side effects of sertraline/ fluoxetine?
Suicidality and anxiety
What are some TCAs?
Clomipramine and amitriptyline
What are the main side effects of TCAs?
Lethal overdose - causes long QT interval
Adrenergic side effects - dry mouth, urinary retention and blurred vision
What is the main side effects of mirtazapine?
Sedating and weight gain
What is the cheese reaction?
An acute attack of hypertension caused by interaction between the MOAI and tyramine (ripe cheese)
MOAI - phenelzine and tranylcypromine
What is the action of typical antipsychotics?
D2 antagonists
Haloperidol and chlorpromazine
What are the main side effects of typical antipsychotics?
Worse EPS
Akathisia which causes increased risk of suicide
What are some atypical antipsychotics?
Quetiapine, risperidone, olanzapine and clozapine
What is the main side effect of quetiapine?
Deranged LFTs
What is the main side effect of risperidone?
Increased prolactin - can cause discharge from nipples
What is the main side effect of olanzapine?
Increased weight gain
When is clozapine used?
When 2 antipsychotics have been used and failed
What is the main side effect of clozapine?
Agranulocytosis - decreased WCC
What are some side effects of lithium?
Intention tremor, interstitial renal fibrosis and hyperthyroidism
ACE inhibitors increase lithium levels
Epstein’s anomaly in 1st trimester
What is the symptoms of lithium toxicity?
GI upset, seizures, nystagmus and oliguria
What is the main side effect of valproate?
Teratogenic - neural tube
What is the main side effect of lamotrigine?
Rash - SJS
Stop immediately if rash appears
What is the main issue with carbemezapine?
Has large amount of drug reactions
What is malignant neuroleptic syndrome caused by?
Antipsychotics
What is malignant neuroleptic syndrome?
Life-threatening complication of treatment with dopamine antagonists
Immediate cessation of drug
Neurotoxicity and muscle damage
What are the symptoms of malignant neuroleptic syndrome?
Pyrexia, rigidity, increased HR, BP, RR and agitation
Slower onset - hours to days
Decreased reflexes - lead pipe rigidity
Normal pupils
What is the management for malignant neuroleptic syndrome?
IV fluids and benzodiazepine
Severe cases - Dantrolene
What is serotonin syndrome?
Caused by antidepressants - lithium, triptans, tramadol, cocaine, and MDMA
What is the symptoms of serotonin syndrome?
Triad of mental status, autonomic hyperactivity (increased HR, BP and RR), and neuromuscular symptoms
Faster onset - hours
Increased reflexes and clonus
Dilated pupils
What is the treatment for serotonin syndrome?
IV fluids and benzodiazepine
Severe causes Cyproheptadine and chlorpromazine
