Psych Flashcards
What type of drug is mirtazapine? When should it be given? What other effects does it have?
Atypical antipsychotic
Evening as makes drowsy
Can increase appitite
Cyclisine is what type of antiemetics, can we give it IV
Acts on H1 and M1
Don’t give it IV - gives a high and can get stuck on it
Hand foot and mouth disease causative agent
coxsackie A virus
What do we mean by extrapyradmilal side effects?
Parkinsonism
Neurolwpyic malignant syndrome w is related to what?
Dopamine associated drugs
Typical vs atypical generation
All block dopamine receptors
First generation have highaffinity to dopamine so typically generate extra pyramidal side effects
Second not as strong so atypically generate symptoms so atypically generate extra pyramidal side effects
Do clozapine get extra pyramidal side effects?
No
Main extrapyradimal side effects
Akathesia - inner restlessness
Parkinsonism (shuffling gait, expressionless face)
Dystonia - muscle spasm head and neck, can be due to metoclopeomide of domperodome (dopamine blocking antiemetics)
Tardive dyskinesia - lip smacking, puckering
Clozapine main side effect
Agranulocytosis and weight gain (increases hunger)
Myocarditis, long qt
Lower seizure threshold
CONSTIPATION** - reduction in bowel movement, so give laxido !! - can lead to atonic bowel
Seizure like activity on clozapine, why
Because it reduces the threshold
How is clozapine metabolised
In liver cytochrome p450
Nb smoking induces liver enzymes, so if you stop smoking will have more clozapine in body
How can we break secure attatchments for kids?
Nb secure attachment ->
Depressed/withdrawn parent ->
Angry parent ->
Unpredicatable parent (fruit machine) eg drugs/alcohol ->
Bereavement/loss ->
Adopted vs Foster
Adopted = every right as a parent
Foster = Glorified baby sitter - still need parents consent for ops etc
Anxious vs avoidant
Anxious - parents not there/let down/bullied/friendships left them/people not sticking around for them -> project that into current relationships, so they’ll assume that people will leave them
Flattery/if you leave this room I’ll kill myself -> trying to keep people around unhealthily
Avoidant , have been hurt in the past -> expect people will hurt them -> keep them at arms length, have prickly armour on.You have to earn your way into their trust.
Anxious x Avoidant -> depending on the situation will demonstrate both anxious and avoidant. Can turn into Borderline personality disorder
What is akathasia?
Neuropsychiatric symptom of restlessness and an urge to move . Can mean that the patient is in distress or side effect of antipsychotics
Emergency detention certificate vs Short term detention certificate vs cto (compulsory treatment order)
EDC 72 hours - think has mental disorder, fy2 and above should try to get mho but may not be possible. Can’t treat against wish.
Short term 28 days needs psychiatric (section 22 doctor). Needs MHO. Continuously monitored. Can treat against wish. Can appeal against.
CTO = up to 6 months - goes to tribunal to help decide.
Levomyptomazine uses
Nausea - calming effect as it’s slightly an antipsychotic
Memantime uses
Moderate to severe dementia
Detained for more than 2 months, what do you need to give psych meds?
T3 form if unable to consent
T2 if able to consent
Giving meds covertly means what?
Giving patients meds without their knowledge for when we know they’re needing it. Needs reviewing, may be able to then take overtly if improves psych symptoms. Covert medication plan.