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Y5 - Psychiatry > Psych Flashcards - Pharm > Flashcards

Psych Flashcards - Pharm

1
Q

What is the MoA of anti-psychotics?

A

Dopamine (D2) receptor antagonists - decrease stimulation

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2
Q

Name 3 typical antipsychotics

A

Chlorpromazine, haloperidol, flupentixol decanoate (depot)

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2
Q

What is the MoA of antipsychotics?

A

Block DA receptors

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3
Q

What are the S/E of typical antipsychotics?

A

Extrapyramidal S/Es

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4
Q

Name 6 atypical antipsychotics

A

Olanzapine, Risperidone, Quetiapine, Aripiprazole, Amisulpiride, Clozapine

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4
Q

What are the s/e of antipsychotics?

A

Antidopaminergic effects (EPSE)
hyperprolactinaemia
Obesity
Sedation
Increased DM risk
Dyslipidaemia
Anticholinergic effects
Arrythmias
Seizures (esp clozapine)
Neuroleptic malignant syndrome

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5
Q

What is the MoA of Atypical anti-psychotics?

A

Block DA and 5HT2 receptors

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6
Q

What are the indications for atypical antipsychotics?

A

New onset schizophrenia
Unacceptable side effects from typical antipsychotics
Relapse occurs on typical anti-psychotics

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7
Q

What are the commonly used mood stabilisers?

A

Valproate
Lithium
Carbamazepine

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7
Q

Name 4 typical antipsychotics

A

Chlorpromazine
Haloperidol
Flupenthixol
Decanoate

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8
Q

What are the signs of lithium toxicity?

A 
GI disturbance
Sluggishness
Giddiness
Ataxia
Gross tremor
Fits
Renal failure
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9
Q

What is Disulfirams MoA?

A

Irreversible aldehyde dehydrogenase inhibitor

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9
Q

What are the s/e of atypical antipsychotics?

A

Metabolic s/e

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10
Q

What is Acamprosate’s MoA?

A

GABA analogue - reduces cravings

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11
Q

What is the MoA of Lofexidine?

A

Alpha 2 agonist

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11
Q

What is notable about clozapine?

A

Needs blood level monitoring due to risk of agranulocytosis and consequent neutropenia
High seizure risk

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12
Q

What class of drug are benzodiazepines?

A

Anxiolytic

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13
Q

What is the MoA of benzodiazepines?

A

Binds to GABA to enhance neurotransmission

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13
Q

What is resistant schizophrenia?

A

Schizophrenia that does not respond to two or more antipsychotics, at least one atypical, given for at least 6 weeks.

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14
Q

What do you need to be careful of when using benzodiazepines?

A

Tolerance / dependence!

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15
Q

What is Chlordiazepoxide?

A

Benzodiazepine

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15
Q

What would you monitor in PTs on long term anti-psychotics?

A

BMI
BP
Bloods: FBC, LFT, U&E, OGTT, Lipids
Prolactin
ECG - QTc intervals

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16
Q

How can you tell a benzo by its name?

A

Ends in -pam/-am (occasionally -pate)

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17
Q

What are the s/e of benzodiazepines (4)?

A

Drowsiness
Ataxia
Impaired driving skills
Paradoxical aggression

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17
Q

What is neuroleptic malignant syndrome?

A

Potentiall fatal s/e of antipsychotics causing sympathetic overactivity

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18
Q

What are the symptoms of benzodiazepine withdrawal (6)?

A 
Apprehension and anxiety
Insomnia
Tremor
Sensitive to noise
Muscle twitching
Seizures (rarely)
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19
Q

What are the indications for benzodiazepines (10)?

A 
Schizophrenia / psychosis
Mania
Severe anxiety
Anxiety and restlessness in the elderly
Psychomotor agitation
Violent / dangerous / impulsive behaviour
Antiemetic
Depression
Intractable hiccups
Sedation
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20
Q

What is the MoA of buspirone?

A

5HT-1A receptor agonist

20
Q

What are the risk factors for neuroleptic malignant syndrome?

A

Psychosis
Organic brain disease
Alcoholism
Agitation

21
Q

How is buspirone different to benzodiazepines (3)

A

Non-sedating
No apparent tolerance / dependence
Slower and less powerful

22
Q

What are the s/e of buspirone (3)?

A

Headaches
Nervousness
Lightheadedness

22
Q

What are the risks of tricyclic antidepressants?

A

Overdose
Lots of s/e

23
Q

Why are beta-blockers used in anxiety?

A

Relieve physical symptoms - palpitations / tremor

24
Q

What are the contraindications to beta-blocker use?

A

Asthma, Bronchospasm, COPD
HF, heart block
Systolic BP <90
Low pulse

25
Q

What is the antidote for benzodiazipine OD?

A

Flumazenil

25
Q

Name 3 Monoamine Oxidase Inhibitors

A

Phenelzine
Isocarboxaid
Tranylcypromine

26
Q

What is Zopiclone?

A

Hypnotic, cyclopyrrolone

27
Q

What is the MoA of zopiclone?

A

Potentiates GABA

28
Q

What is zolpidem?

A

Hypnotic, imidazopyridine

28
Q

Name an SNRI

A

Venlafaxine

29
Q

What do antipsychotics do?

A

Reduce hallucinations
Reduce delusions
Reduce psychomotor excitement

30
Q

Name a NaSSa

A

Mirtazapine

31
Q

What are the unwanted targets of antipsychotics?

A

Block Noradrenergic and chlinergic receptors

32
Q

Name an NRI

A

Reboxitine

33
Q

What are the indications for antipsychotics?

A 
Schizophrenia
Psychosis
Mania
Severe anxiety
Psychomotor agitation / excitement
Violent / dangerous / impulsive behaviour
Antiemesis
Depression
Intractable hiccups
Sedation
Anxiety / restlessness in the elderly
34
Q

What are the s/e of typical antipsychotics?

A

Acute extrapyramidal s/e
Hyperprolactinaemia
Tardive dyskinesia

36
Q

What situations is haloperidol particularly good in?

A

Head injuries

Polypharmacy

37
Q

What would affect lithium levels?

A

Dehydration
Sodium depletion
Thiazide diuretic use

38
Q

Name 6 atypical antipsychotics

A 
Olanzapine
Risperidone
Quetiapine
Aripiprazole
Amisulpiride
Clozapine
39
Q

What are the indications for ECT?

A

Severe depression
Catatonia
Prolonge / severe manic episodes
Resistant depression

40
Q

What is the indication for clozapine?

A

Resistant schizophrenia

42
Q

What antipsychotics are available as depots?

A

Typical - clopixol, depixol

Atypical - risperdal consta, paliperidone

44
Q

Which antipsychotic would you worry about prolactin levels?

A

Risperidone

46
Q

What are the symptoms of neuroleptic malignant syndrome?

A 
Fever
Sweating
Rigidity
Confusion
Fluctuating consciousness
Labile BP
Tachycardia
Elevated CPK
Leucocytosis
47
Q

Which antipsychotics normally cause neuroleptic malignant syndrome?

A

High potency typicals with a recent / rapid change in dose. Or abrupt withdrawal of anticholinergics.

49
Q

Name 2 tricyclic antidepressants

A

Imipramine

Amitryptaline

51
Q

Name 3 SSRIs

A

Fluoxetine
Paroxetine
Sertraline

52
Q

What are the risks of SSRIs

A

Increased suicide risk

Withdrawal syndrome

54
Q

What are the risks of monoamine oxidase inhibitors?

A

Hazardous interactions with food and drugs

55
Q

Which foods do monoamine oxidase inhibitors interact with?

A

Red wine

Cheese

57
Q

What is an SNRI?

A

Serotonin and noradrenaline reuptake inhibitor

59
Q

What is a NaSSa?

A

Noradrenergic and specific serotonergic antidepressants

61
Q

What is an NRI?

A

Noradrenaline reuptake inhibitor

62
Q

What are the s/e of mood stabilisers?

A

Achaphysia - this correlates with high suicide rate

63
Q

What are the risks of Lithium?

A

Narrow therapeutic window

Many interactions

64
Q

How is litihium excreted?

A

Renally

66
Q

Name 5 mood stabilisers

A 
Litihium
Sodium valproate
Carbamazepine
Lamotrigine
Topiramate
68
Q

What is a typical course of ECT?

A

6-12 sessions, twice a week

Y5 - Psychiatry (4 decks)

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