psych drugs

Question 1

what are the most common adverse side effects of SSRI?

Answer 1

GI upset

citalopram prolongs the QT interval

Question 2

which drugs do SSRIs interact with?

Answer 2

• if taking NSAID prescribe PPI
• NOT recommended to take its warfarin or heparin
• increased risk of serotonin syndrome if taken with triptans

Question 3

what is recommended to be taken instead of SSRI if patient is on warfarin?

Answer 3

mirtazapine

Question 4

what things can precipitate lithium toxicity?

Answer 4

dehydration
renal failure
drugs: diuretics (especially thiazides), ACE inhibitors/angiotensin II receptor blockers, NSAIDs and metronidazole.

Question 5

what are features of lithium toxicity?

Answer 5

coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma

Question 6

which concentrations does lithium toxicity occur at?

Answer 6

> 1.5 mmol/L.

Question 7

what is the therapeutic range of lithium?

Answer 7

0.4-1.0 mmol/L

Question 8

how often should lithium be monitored?

Answer 8

• weekly after initiation and dose change
• then every 3 months after concentrations are stable
• then every 6 months

Question 9

which other parameters should be checked when taking lithium?

Answer 9

every 6 months the following should be checked:

Monitor body-weight or BMI, serum electrolytes, eGFR, and thyroid function

Question 10

when to give activated charcoal in paracetamol overdose?

Answer 10

• if taken less than an hour ago

Question 11

what is the most worrying side effect of clozapine?

Answer 11

agranulocytosis

Question 12

what is the treatment for an acute dystonia arising from antipsychotics?

Answer 12

[rpcyclidine 10mg IM