Pharmalogical Managment Of Mental Healt Disorders

Question 1

Bio pyshco social for treatment each bit

Answer 1

Bio - drugs ECT psychosurgery
Psychological - counselling, talking therapies
Social - housing needs, social support and hospital admission

Question 2

What drug has long half lives and can accumulate over days and weeks- seizure

Answer 2

Diazepam

Question 3

Somme rugs have short half lives and can have significance for withdrawal symptoms example

Answer 3

Venflaxeime

Question 4

What psychotropic drugs require specific physical monitoring

Answer 4

Antipsychotics and lithium

Question 5

Most common route of delivery for psychiatric drugs

Answer 5

Oral
IM only for antipsychotic long acting or rapid tranquilliser

Question 6

Depression core sysmptoms

Answer 6

Low mood
Anhedonia
Lethargy

Question 7

Side effects of SSRI

Answer 7

GI upset
Increased arousal
Insomnia
Sexual dysfunction
Hyponatraemia
Increase risk of GI bleeds especially if take NSAIDs
Long QT
Discontinuations sx

Question 8

Medications for depression

Answer 8

SSRI
SNRI
NASSA
TCA
MAOI

Question 9

Venlafaxine and mirtazapine SNRI AND NASSA work on serotonin and NA when are these used in depress
What are the side effects

Answer 9

Venlafaxine withdrawal sx and is alerting and low sodium
Mirtazapine is a sedating and can cause weight gain

Question 10

She of TCA

Answer 10

Overdose
Cholinergic side effects eg dry mouth and constipation
Less commonly used now due to this

Question 11

MAOI
Se

Answer 11

Tyramine reaction if patients eat certain foods causing a hypertensive crisis - mature cheese due to blockage of dopamine

Question 12

Hypertonia hyperflexxia and autonomic discfunction

Answer 12

Serotonin syndrome

Question 13

First thing to do with someone with mania or bipolar

Answer 13

Stop antidepressant and start antipsychotic like olanzapine

Question 14

Best drug for long term bipolar prophylaxis is lithium what are its side effects

Answer 14

Increased urination
GI disturbances
Tremor
Headache
Thyroid dysfunction and kidney function with lithium toxicity

Question 15

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

Answer 15

GI disturbances eg diarrhoea
Coarse tremor as lithium levels increase
Dizziness
Ataxia
Confusion
Drowsy
Coma and death

Question 16

All patients taking lithium have

Answer 16

Lithium monitoring all in first week unstick stable , screening blood tests before starting too
Ideally avoid in pregnancy - cardiac defects in foetus

Question 17

Valproate is an immune stabiliser and used in epilepsy as well as bipolar
Mechanism of action not understoood - GABA can you use in preg

Answer 17

NO

Question 18

Fine line treatment for antipsychotic disorders

Answer 18

Antipsychotic meds

Question 19

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

Answer 19

Haloperidol , chlorpromazine and zuckopenthixol
Ten to cause extrapyramidal side efefects such as parkinosoions, tardive dyskinesia( involuntary movements around face then body) hypersalivation, akathasia

Question 20

Second gen examples and se

More likely metabolic side affects not extrapyramidal

Answer 20

Olanzapine, risperidone, quetipine
Weight gain, impaired glucose intolerance, prolong QTc - torsade de pointes
Aripiprazole is the exception

Question 21

Treatment for torsades de pointes - ventricular tachycardia with amplitude of the QRS complexes around the isoelectric line

Answer 21

Defibrillated. IV Mg is first line ass stabilises the cardiac membrane

Question 22

NMS - neuroleptic malignant syndrome what is this

Answer 22

A SE that can occur with antipsychotic
Sx
Hyperthermia
Confusion
Sweating
Hypotonia
Autonomic instability

Anyone with this assume this until proven

Question 23

Clozapine when is it used

Answer 23

Used when 2 other antipsychotics have failed

Question 24

SE of clozapine

Answer 24

Myocarditis , thromboembolism, agranulocytosis
Regular blood monitoring is needed

Question 25

Antipsychotics can be used in depot or LAIs as they can help compliance and can be given

Answer 25

Weekly or monthly

Question 26

GAD is using medication what do you use
Use talking therapies before

Answer 26

SSRI
May requir TCA or antipsychotics

Question 27

Benzodiazepines when are they used in anxiety

Answer 27

Short term only
Work on GABA system
Addictive tolerance within 3-14 days
Can cause dangerous withdrawal symptoms including seizures

Question 28

Alzeiherms Dementia treated with what

Answer 28

Acetylcholinesterase inhibtiors - donezipilm rivastigmine and galantsmine
Block breakdown of ach
Indicated in mild to moderate alzeiherms disease

Question 29

Addictions opiate

Answer 29

Opiate substitution like methodone

Question 30

Addiction to alcohol what drug used to block cravings

Answer 30

Acamprostate
Disulfiriam blocks metabolism of alcohol , blocks alcohol dehydrogenase so if someone drinks they have vilolent reaction and becomes sick

Question 31

Treatment for ADHD

Answer 31

Stimulants such as methylphenidate
Side effect of weight gain

Question 32

What drugs should you not give in Parkinson’s because they they have an anti-dopamenergic effect and can cause extrapyramidal side effects

Answer 32

Antipsychotics