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Antimicrobials > Psych drugs > Flashcards

Psych drugs Flashcards

1
Q

Function of benzodiazepine

A
  1. Anxiolytic

2. Hypnotic agent

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2
Q

Name 3 classes of benzodiazepine

A
  1. Short acting: Midazolam
  2. Intermediate acting: Lorazepam, alprazolam
  3. Longer acting: Diazepam
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3
Q

MOA of benzodiazepine (BZD)

A
  1. bind to CNS BZD sites
  2. potentiates GABA action on
  3. GABA dependent binding
  4. increase frequency chloride channels opening

note GABA is inhibitory neurotransmitter

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4
Q

Route of administration of BZD

A
  1. Oral fast onset 30mins-1hr

2. IV: midazolam, lorazepam, diazepam

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5
Q

Adverse effects of BZD (7)

A

4 CNS + 1 CVS

  1. Sedation
  2. Increase drowsiness, reaction time + Decrease motor skill
  3. Anterograde amnesia (forget after drug– esp in IV)
  4. Decrease BP & respiration in predisposed pt (eg IHD)
  5. Paradoxical effect of hallucination/excitement/violence (due to disinhibition by BZD where behaviour normally suppressed)
  6. Floppy child syndrome: 3rd trimester (pls don’t give ans in elderly)
  7. Tolerance & dependence, withdrawal
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6
Q

What’s the characteristic of benzodiazepine induced sleep?

A

Reduced REM & deep stage 4 sleep

compared to natural sleep

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7
Q

Will overdose BZD result in toxicity?

A

No, GABA dependent

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8
Q

What’s insomnia?

A
  1. difficulty falling asleep
  2. maintaining sleep
  3. early morning awakening

–> affects next day fn

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9
Q

Causes of insomnia

A

Internal

  1. anxiety
  2. depression

External

  1. drug induced -caffeine
  2. drug withdrawal- eg. from alcohol/ sleeping pill
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10
Q

What are the 2 Non-benzodiazepine hypnotics?

A

Zolpidem, zopiclone

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11
Q

MOA of non BZD hypnotics

A

Act on BZD sites similar to BZD

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12
Q

Adverse effects of non BZD hypnotics

A
  1. withdrawal

2. abuse potential

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13
Q

What’s depression?

A
  1. symptoms persist for at least 2 weeks

2. severity of symptoms interfere w normal functioning

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14
Q

What’s depression due to?

A

deficiency of monoamines (dopamine/serotonin/noradrenaline)

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15
Q

What are the 4 drug classes of Antidepressants?

A
  1. SSRI
  2. TCA (more effect on NA> serotonin): amitriptyline, imipramine
  3. SNRI
  4. NaSSa
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16
Q

How do SSRI work?

A

Block reuptake of monoamines in synaptic cleft back into pre-synpatic neuron

increase BDNF in post synaptic neuron

17
Q

Name the 4 SSRIs

A
  1. Fluoxetine
  2. Paroxetine
  3. Sertraline
  4. Escitalopram
18
Q

DDI of selective serotonin reuptake inhibitor

A

Inhibition CYP450 enzymes

fluoxetine> paroxetine > sertraline> escitalopram

** eg pt taking anti-hypertensives–> may become hypotensive low BP fainty giddy

19
Q

What are the SSRI adverse effects? (4)

A
  1. Anxiety
  2. Weight loss/gain
  3. Headache, nausea
  4. Sexuality dysfunction

no fatality in overdose

20
Q

What are the TCAs adverse effects? (4)

A
  1. CNS: sedation & fatigue
  2. CVS: tachycardia, arrhythmias, postural hypotension
  3. Anticholinergic effect: glaucoma, blurred vision, urinary retention, constipation
21
Q

What happens if you take too much TCAs amitriptyline/imipramine?

A

Overdose fatality

22
Q

Weighing which antidepressant to give?

A

SSRI– non fatal on overdose
** given to pt w suicide tendencies

TCA– gold standard for severe depression (but CVS arrhythmia)

Atypical antidepressant Mirtazapine– sedating, gd for insomnia

23
Q

Adult neurogenesis in hippocampus/olfactory bulb is upregulated by?

A
  1. exercise
  2. enriched env
  3. learning (hippocampal)
  4. estrogen
  5. AD
24
Q

Effect of AD drugs on hippocampus

A
  1. increased BDNF in hippocampus

2. BDNF protects neurons from neurotoxic damange

25
Q

Adult neurogenesis is down-regulated by?

A
  1. Stress
  2. glucocorticoids
  3. age
  4. opiates
  5. excitatory aa
26
Q

Psychosis is caused by? (hypothesis)

A

excess dopamine transmission (mscl system)

27
Q

Schizophrenia symptoms & duration (+ve & -ve symptoms)

A

++ve symptoms

  1. delusion
  2. hallucination
  • -ve symptoms
    1. blunting of affect
    2. poor [ ]

> 6 months

28
Q

Name the 2 clasess of anti-psychotic drugs

A
  1. Typical (first gen): low potency chlorpromazine, high potency haloperidol
  2. Atypicals (second gen): ROQCA
29
Q

What’s the difference b/n 1st & 2nd generation antipscyhotics?

A

typicals block more dopamine R than serotonin R

30
Q

MOA of antipsychotics

A
  1. TYPICAL
    block D2 > 5-HT2 R
    + block D,M,H,AA
  2. ATYPICAL
    5HT2> D
31
Q

What is the Adverse effect of typical antipsychotic drugs?

A

Extra pyramidal side effects

32
Q

What does EPSE entail? (ADAPT from early to late onset symptoms)

A 
Acute 
Dystonia
Akathisia (cannot sit still)
Parkinsonism
Tardive dyskinesia

malignant syndrome (catatonia, myoglobinemia etc - can be fatal)

33
Q

What are the adverse effects of the atypical antipsychotic drugs?

A

Less EPSE but…

  1. risperidone - epse dose dependent
  2. clozapine- agranulocytosis 2% pt
  3. olanzepine - sedation + weight gain
  4. quetiapine - weight gain

Antimicrobials (11 decks)

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