Psych medications quiz Flashcards

Question

What are the extrapyramidal side effects of first generation antipsychotics?

Answer 1

Akathesia (restlessness) acute dystonia (tongue protrusion, torticollis, head tilt to one side + chin lift and oculogyric crisis e.g. abnormal eyeball rotation) parkinsonism (tremor, rigidity, brady-kinesia) tardive dyskinesia (lip smaking, involuntary face/jaw movements)

Answer 2

H1 antagonism = sedation and weight gain due from blocking tuberoinfundibular D2 = high prolactin (esp 1st gen) = galactorhoea, gynaecomastia, amenorrhoea, impotence M1 antagonism: dry mouth, constipation, blurred vision, urinary retention postural hypotension, A1 antagonism = problems ejaculating, postural hypotension, nasal stuffiness increased seizure risk esp in those already with epilepsy prolonged QT - predisposing to ventricular arrhythmias

Answer 3

``` mesolimbic mesocortical nigrostriatal tuberoinfundibular - action of drugs that target all the D receptors = TF lead to side effects because Extra pyramidal due to NS and high PRL due to tuberoinfundibular.(D2 normally inhibs PRL) ```

Answer 4

the positive symptoms in schizophrenia are liked to (inc) D in the mesolimbic pathway the negative symptoms in schizophrenia are linked to the (inc) D in the mesocortical pathway

Answer 5

neutropenia and agranulocytosis constipation myocarditis weight gain

Answer 6

WBC monitoring --> @baseline, then 1/7 for 18 weeks then 1/14 for 1 year then monthly thereafter also regular lipid and weight screens and regular fasting glucose

Answer 7

the main psychiatric emergency = a life threatening rxn to antipsychotic medication (albeit its rare) it is potentially fatal w untreated mortality in 70-90%

Answer 8

(up) hyperthermia, tachycardia, tachypnoea, severe muscle rigidity fluctuating consciousness levels, increased creatinine phosphokinase (CPK, found in heart, brain and muscle tissue)

Answer 9

ABC stop antipsychotic fluid balance supportive

Answer 10

acute manic or hypomanic episode management recurrent depressive disorder prophylaxis of bipolar affective disorder

Answer 11

``` Early: abdo pain, nausea, metallic taste, fine tremor, thirst, polyuria, weight gain, oedema Longer term: thyroid dysfunction renal impairment ```

Answer 12

lithium has a narrow therapeutic window. it is excreted by the kidneys and is treated by the body like sodium --> plasma lithium levels are affected by hydration levels and other meds that affect the kidneys e.g. diuretics and NSAIDs

Answer 13

``` reduced consciousness cerebellar ataxia coarse tremor dysarthria (musc control disorder) D&V --> if untreated --> seizures, cardiac arrest, renal failure, coma, death ```

Answer 14

mood stabiliser, not to be prescribed to women of child bearing age due to teratogenicity which is 1/10

Answer 15

``` valproate lithium lamotrigine carbamazepine quetiapine ```

Answer 16

drug used to control alcohol dependence cravings (after detox programmes)

Answer 17

a benzodiazepine used to prevent seizure risk in heavy alcoholism (prescribed in a stepwise sliding regimen)

Answer 18

acetylcholinesterase inhibitors are first line e.g. | DONEPEZIL

Answer 19

another option for the tx of alzheimers disease (ach-esterase inhibitor) than 1st line donepezil

Answer 20

40-70% of people with AD benefit from the drugs they report reduced anxiety, memory, motivation and concentration improvements and improved ability to continue ADLs

Answer 21

``` loss of appetite nausea vomiting diarrhoea caution: pts with bradycardia ```

Answer 22

if the SE of donepezil are intolerable to the patient... memantine is another option... an NMDA receptor antagonist blocks excess glutamate so the progression of symptoms slows e.g. disorientation and ADL difficulties also evidence of it helping w/ delusions, aggression and agitation

Psych medications quiz Flashcards

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