Psych Flashcards
What is the reversal agent for benzodiazepines?
Flumazenil
What is the reversal agent for opioids?
Naloxone
What is the calculation for units of alcohol?
Volume (L) x Percentage
What are the 4 questions of the cage questionaire?
Have you ever felt like you should cut down?
Do you get annoyed when people comment on your drinking
Do you feel guilty about your drinking?
Have you ever had a morning eye-opener to get rid of your hangover?
What effect does alcohol have on neurotransmitters?
It is a relaxant/ suppressant therefore enhances the inhibitory GABA
What effect does chronic alcohol abuse have on the blood?
Anaemia, high MCV
Often mixed folate and B12 deficiency
Reduced platelet production
Which nerve palsy is a consequence when people are drunk? What is the classic sign?
Radial nerve palsy
Typical sign is a drooping wrist
What are the early symptoms of alcohol withdrawal? When do they occur?
Tremor Nausea Sweating Agitation Tachycardia Raised BP
<24 hours
What are the late symptoms of alcohol withdrawal? When do they occur/
Delusions Confusions Diarrhoea Convulsions Auditory hallucinations After 48 hours= delirium tremens
Which drug should be used to treat the symptoms of alcohol withdrawal?
Chlordiazepoxide
What are the symptoms of delirium tremens?
Loads of sweating
Tremor
Visual hallucinations
Auditory hallucinations
What is the management of delirium tremens?
Benzo for 10 days
Thiamine
Fluid replacement
What is the consequence of thiamine deficiency?
Wernicke’s encephalopathy/ korsakov’s syndrome
What is the triad of symptoms in wernicke’s?
Opthamoplegia and nystagmus (eye signs)
Confusion
Ataxia
How does Korsakov’s present?
Anterograde memory disorder. Old memories can be accessed but new ones cannot be made
Peripheral neuropathy
Confabulation
What is the management of wernicke’s?
Thiamine
Sedation
Fluids <3
Which drug can be prescribed to put people off drinking by causing nasty side effects?
Disulfiram
Which two medications should be prescribed for those who have achieved abstinence and wish to maintain it?
Acamprosate and disulfiram
Which drug can be given to people still actively drinking to help them reduce?
Naltrexone. Works by reducing the positive effects of drinking
What are the contraindications of naltrexone?
Liver failure and opioid abuse
What are the contraindications to disulfiram?
Ischaemic heart failure
psychosis
Which type of antipsychotics have fewer motor side effects?
Atypical
Name a few typical (first generation) antipsychotics?
Chlorpromazine
Haloperidol
Fluphenazine
Name a few atypical (second generation) antipsychotics?
Clozapine Risperidone Sertindole Aripiprazole Olanzapine Quetiapine
Which type of antipsychotic is more effective at combating the negative symptoms seen in schizophrenia?
Atypical
What is the mechanism of action for antipsychotics?
Blockade of dopamine receptors (mostly D2 receptors)
Also block neuroreceptors for other neurotransmitters including histamine, ach and serotonin
What are the clinical effects of antipsychotics?
Depression of emotional responses
Sedation
Anti-emetic effect
Anti-histamine effect
How are antipsychotics eliminated?
Liver metabolism
Why is the IM dose of antipsychotics significantly lower than the oral dose?
Due to first pass metabolism
What are the extrapyramidal effects of antipsychotics?
Akathisia- restlessness
Acute dystonia
Parkinsonism
Tardive dyskinesia
What are the common side effects of atypical antipsychotics?
Weight gain Drowsiness Antimuscarinic effects Postural hypotension Photosensitivity Prolonged QT
What is the life threatening side effect of clozapine?
Agranulocytosis
What is the presentation of neuroleptic malignant syndrome?
Fever Rigidity Hypertension Sweating Urinary incontinence Altered consciousness Delirium Blood CK is really high
What are the clinical features of GAD?
Persistent anxiety Apprehension Motor tension Increased sympathetic activity Hypervigilance Panic attacks
What is the pathophysiology of GAD?
Overactivity of 5-HT neurons
What us the management of GAD?
Lifestyle changes- avoid caffiene, alcohol, nicotine and try to exercise
Breathing techniques, headspace etc
CBT
SSRIs
Propanolol
Benzos if severe for short term use only
What are the 3 types of bipolar disorder?
Type 1= manic and depressive 1:1
Type 2= Depression is more dominant, 5:1
Rapid cycling= >4 episodes of mania and depression
What is the definition of mania?
Elated mood lasting 1-2 weeks with psychotic symptoms
What is the definition of hypomania?
Elevated mood with no psychotic symptoms, must last >4 days
What are the features of mania?
Elevated mood grandiosity Delusions and hallucinations Auditory hallucinations (usually 2nd person) Pressured speech General increase in activity Increased feelings of self worth
