Pharmalogical Managment Of Mental Healt Disorders Flashcards
Bio pyshco social for treatment each bit
Bio - drugs ECT psychosurgery
Psychological - counselling, talking therapies
Social - housing needs, social support and hospital admission
What drug has long half lives and can accumulate over days and weeks- seizure
Diazepam
Somme rugs have short half lives and can have significance for withdrawal symptoms example
Venflaxeime
What psychotropic drugs require specific physical monitoring
Antipsychotics and lithium
Most common route of delivery for psychiatric drugs
Oral
IM only for antipsychotic long acting or rapid tranquilliser
Depression core sysmptoms
Low mood
Anhedonia
Lethargy
Side effects of SSRI
GI upset
Increased arousal
Insomnia
Sexual dysfunction
Hyponatraemia
Increase risk of GI bleeds especially if take NSAIDs
Long QT
Discontinuations sx
Medications for depression
SSRI
SNRI
NASSA
TCA
MAOI
Venlafaxine and mirtazapine SNRI AND NASSA work on serotonin and NA when are these used in depress
What are the side effects
Venlafaxine withdrawal sx and is alerting and low sodium
Mirtazapine is a sedating and can cause weight gain
She of TCA
Overdose
Cholinergic side effects eg dry mouth and constipation
Less commonly used now due to this
MAOI
Se
Tyramine reaction if patients eat certain foods causing a hypertensive crisis - mature cheese due to blockage of dopamine
Hypertonia hyperflexxia and autonomic discfunction
Serotonin syndrome
First thing to do with someone with mania or bipolar
Stop antidepressant and start antipsychotic like olanzapine
Best drug for long term bipolar prophylaxis is lithium what are its side effects
Increased urination
GI disturbances
Tremor
Headache
Thyroid dysfunction and kidney function with lithium toxicity
Lithium toxicity is a life threatening emergency caused by too much lithium in the blood needs to get out via urine so often triggered be infection leading to dehydration
Sx
GI disturbances eg diarrhoea
Coarse tremor as lithium levels increase
Dizziness
Ataxia
Confusion
Drowsy
Coma and death
All patients taking lithium have
Lithium monitoring all in first week unstick stable , screening blood tests before starting too
Ideally avoid in pregnancy - cardiac defects in foetus
Valproate is an immune stabiliser and used in epilepsy as well as bipolar
Mechanism of action not understoood - GABA can you use in preg
NO
Fine line treatment for antipsychotic disorders
Antipsychotic meds
Antipsychotics are all dopamine antagonists all have some activity on other neurotransmitters such as serotonin
Split into first and second gen
All require monitoring minimum annually including BMI and bloods
What are first generation antipsychotics - examples and SE
Haloperidol , chlorpromazine and zuckopenthixol
Ten to cause extrapyramidal side efefects such as parkinosoions, tardive dyskinesia( involuntary movements around face then body) hypersalivation, akathasia
Second gen examples and se
More likely metabolic side affects not extrapyramidal
Olanzapine, risperidone, quetipine
Weight gain, impaired glucose intolerance, prolong QTc - torsade de pointes
Aripiprazole is the exception
Treatment for torsades de pointes - ventricular tachycardia with amplitude of the QRS complexes around the isoelectric line
Defibrillated. IV Mg is first line ass stabilises the cardiac membrane
NMS - neuroleptic malignant syndrome what is this
A SE that can occur with antipsychotic
Sx
Hyperthermia
Confusion
Sweating
Hypotonia
Autonomic instability
Anyone with this assume this until proven
Clozapine when is it used
Used when 2 other antipsychotics have failed
SE of clozapine
Myocarditis , thromboembolism, agranulocytosis
Regular blood monitoring is needed
Antipsychotics can be used in depot or LAIs as they can help compliance and can be given
Weekly or monthly
GAD is using medication what do you use
Use talking therapies before
SSRI
May requir TCA or antipsychotics
Benzodiazepines when are they used in anxiety
Short term only
Work on GABA system
Addictive tolerance within 3-14 days
Can cause dangerous withdrawal symptoms including seizures
Alzeiherms Dementia treated with what
Acetylcholinesterase inhibtiors - donezipilm rivastigmine and galantsmine
Block breakdown of ach
Indicated in mild to moderate alzeiherms disease
Addictions opiate
Opiate substitution like methodone
Addiction to alcohol what drug used to block cravings
Acamprostate
Disulfiriam blocks metabolism of alcohol , blocks alcohol dehydrogenase so if someone drinks they have vilolent reaction and becomes sick
Treatment for ADHD
Stimulants such as methylphenidate
Side effect of weight gain
What drugs should you not give in Parkinson’s because they they have an anti-dopamenergic effect and can cause extrapyramidal side effects
Antipsychotics
