Psych Drugs Flashcards
Nephrogenic diabetes insipidus
Lithium
Fine tremor
Lithium at therapeutic level
Causes of hypothyroidism
Lithium
Anorexia Nervosa
ECG changes associated with lithium use?
T wave flattening or inversion
Hyperparathyroidism and resultant hypercalcaemia
Lithium
What is the therapeutic range for lithium?
0.4-1.0
When should lithium samples be taken for monitoring purposes?
12 hours post-dose
How often should lithium levels be measured?
weekly after dose change until stable, 3 monthly following
Monitoring requirements for lithium use
Lithium level
Thyroid and renal function - 6 monthly
Monitoring requirements for venlafaxine
Blood pressure and ECG
List extrapyramidal side effects
Akathisia
Dystonia
Tardive dyskinesia
Parkinsonism
Examples of acute dystonia
Torticollis
Oculogyric crisis
Examples of tardive dyskinesia
Pouting
Chewing
What is akathisia?
Restlessness
Drugs causing EPSE
Antipsychotics - first generation > second generation
Side effects of second-generation antipsychotics?
Increased appetite Weight gain Metabolic syndrome Sexual dysfunction Postural hypotension Reflex tachycardia antimuscarinic SEs
Drug most associated with hyperprolactinaemia
Risperidone
Drug most commonly associated with metabolic syndrome
Olanzapine
Signs of lithium toxicity
Vision changes Diarrhoea Vomiting Hypokalaemia Tremor Dysarhtria Coma
Side effects of Lithium
LITHIUM Lethargy Insipidus Tremor Hypothyroidism Intestinal symptoms Urine output increased Metallic taste
Which drug family increase risk of VTE and stroke when used in the elderly?
Antipsychotics
Flu-like symptoms
Shock sensations
Vivid dreams
Irritabilty
SSRI discontinue symptoms
Which drug family causes hyponatraemia, GIT symptoms and bleeding risk?
SSRI
Which SSRI should be used if there is a PMH of CVD?
Sertraline
Side effects of mirtazepine?
Appetite increase, weight gain, and sedation
Discontinuation of tricyclic antidepressants?
GIT upset, agitation, vivid dreams
Which antipsychotic is associated with long QT?
Haloperidol
Which SSRI is most associated with ECG changes such as torsade de pointes?
Citalopram
When does neuroleptic malignant syndrome usually start?
Within hours to days of commencement of antipsychotic
Pyrexia Muscle rigidity Tachycardia Increased blood pressure Hyporeflexia Pupils normal
Neuroleptic malignant syndrome
Abnormal blood results in neuroleptic malignant syndrome
Raised CK
Leukocytosis
May develop AKI
St John’s Wart may interact with what?
SSRI -> serotonin syndrome
Pyrexia Rigidity Tachycardia Hypertension Hyperreflexia Dilated pupils
Serotonin Syndrome