Psych treatments

Question 1

How do SSRI’s work?

Answer 1

Selective presynaptic blocade of serotonin reuptake

Inhibit P450 enzyme

Question 2

How long do SSRI’s take to work?

Answer 2

2-3 weeks

Question 3

Side effects of SSRI’s

Answer 3

Tremor
N + V
Headache
Diarrhoea

Question 4

Contraindications for SSRI’s

Answer 4

Mania

Question 5

How do TCA’s work?

Answer 5

Pre-synaptic blocake of NA, serotonin & dopamine

Blocks muscarinic, histaminergic & alpha-adrenergic receptors

Question 6

Side effects of TCA’s

Answer 6

Sedation, weight gain, dry mouth, retention
Postural hypotension
Tachycardia,arrhythmia, heart block, syncope

Question 7

Contraindications for TCA’s

Answer 7

Recent MI
Arrhythmias
Severe liver disease
Mania

Question 8

How do MAO inhibitors work?

Answer 8

prevent breakdown of NA,serotonin & dopamine

Increase storage of NA & 5-HT

Question 9

What are MAO inhibitors used for?

Answer 9

Atypical depression
Chronic pain
Anxiety
Migraine prophylaxis

Question 10

Side effects of MAO inhibitors

Answer 10

Avoid tyramine containing foods – Hypertensive crisis

Flushing, headache,hypertension, CVA

Question 11

How do you treat hypertensive crisis caused by MAO inhibitors?

Answer 11

Alpha-blockade (e.g. phentolamine)

Question 12

Contraindications for MAO inhibitors?

Answer 12

Phaeochromocytoma
CV disease
Hepatic failure
Mania

Question 13

Which medications should be avoided with a patient who is taking lithium?

Answer 13

NSAIDs
ACE inhibitors
Diuretics

Question 14

Contraindicationsfor lithium

Answer 14

Pregnancy & breast feeding 
Decreased renal function 
Thyroid problems 
CV disease
Neuro conditions (Parkinson's, Huntington's)

Question 15

How does Lamotrigine work?

Answer 15

Na channel blocker - decreases excitability

Question 16

Side effects of carbamazepine

Answer 16

Agranulocytosis
Aplastic anaemia
Cerebellar symptoms

Question 17

Side effects of valproate

Answer 17

Weight gain 
Sedation 
Hair loss 
Ankle oedema 
Tremor

Question 18

Examples of 1st Gen anti-psychotics

Answer 18

Haloperidol 
Chlopromzine 
Sulpiride
Flupentixol 
Zuclopenthixol

Question 19

Examples of 2nd Gen anti-psychotics

Answer 19

Clozapine 
Olanzapine 
Quetapine 
Risperidone 
Amsulpride

Question 20

Contraindications for anti-psychotics

Answer 20

Severely reduced conscious level 
Phaeochromocytoma 
Parkinson's disease
Epilepsy 
Cardiac disease
Metabolic syndrome

Question 21

How do most anti-psychotics work?

Answer 21

Antagonism of D2 receptors in the mesolimbic pathway

Question 22

Why do patients get EP side effects with anti-psychotics?

Answer 22

Excess ACh

Decreased dopamine

Question 23

How do nezos work?

Answer 23

Bind to benzo receptors on GABAa complex 
Increases GABA ffinity 
Increase Cl influx 
Hyperpolarisation 
Decreased excitability

Question 24

Which benzo in particular causes anterograde amnesia & impaired coordination?

Answer 24

Rohypnol

Question 25

What is the first line drug for detoxing in addiction?

Answer 25

Diazepam

Question 26

What may be given alongside diazepam in addiction detox if Wenickes Encephalopathy is suspected?

Answer 26

Thiamine

Question 27

What is the first line drug for prevention of relapse in addiction?

Answer 27

Naltrexone

Question 28

What is the first line medication for ADHD?

Answer 28

Methyphenidate (Ritalin)

Question 29

What are the first line medications for mild-moderte Alzheimer's?

Answer 29

Donepizil | Rivastigmine

Question 30

What drug is used to treat severe Alzheimer's?

Answer 30

Memantine

Question 31

What is the first line drug treatment for LB dementia?

Answer 31

Rivastigmine

Question 32

What drugs are first line for generalised anxiety disorder?

Answer 32

Escitalopram or Sertraline

Question 33

Which drug is first line for social anxiety disorder?

Answer 33

Sertraline

Question 34

Side effects of sertraline

Answer 34

GI upset | Increased bleeding risk

Question 35

What should be used as long term treatment for panic disorder?

Answer 35

Paroxetine

Question 36

What are the side effects of paroxetine?

Answer 36

Abnrmal dreams Increased bleeding GI upset Sexual dysfunction

Question 37

What are the steps of management for PTSD?

Answer 37

CBT Eye movement Paroxetine

Question 38

Which SSRI is used for OCD in kids?

Answer 38

Fluoxetine

Question 39

Which SSRI is used for OCD in adults?

Answer 39

Paroxetine

Question 40

Which drug should be used for ahort term aggresion in ASD?

Answer 40

Respiridone

Question 41

What drug is used for hyperactivity in ASD?

Answer 41

Methyphenidate

Question 42

Which patients should Methylphenidate not be given to?

Answer 42

Patients with a tic

Question 43

What drug should be used for sleep disturbance in ASD?

Answer 43

Melatonin

Question 44

What treatment should be administered for a bipolar patient who is acutely aggitated & hospitalized?

Answer 44

IM Olanzapine

Question 45

What drugs should be given for a moderate-severe bipolar episode if they are not aggitated?

Answer 45

Lithium + Risperidone

Question 46

What treatment should be given for a mild-moderate bipolar epidsode if they are not aggitated?

Answer 46

Lithium or valproate

Question 47

What should be given for acute depression in a bipolar patient?

Answer 47

Olanzapine + fluoxetine

Question 48

What is the treatment for rapid cycling (4+ episodes a year) bipolar disorder?

Answer 48

Lithium

Question 49

What is the firs line management for mania predominant bipolar disorder?

Answer 49

Lithium

Question 50

What is the treatment for depression predominant bipolar disorder?

Answer 50

Lamotrigine

Question 51

When in pregnancy should bipolar medication be avoided?

Answer 51

1st trimester

Question 52

What is the treatment for a suicidal bipolar patient?

Answer 52

Lithium

Question 53

What is the treatment for a suicidal schizophrenic patient?

Answer 53

Lithium + clozapine

Question 54

What is the treatment for a patient who is suicidal andhas depession or a personality disorder?

Answer 54

Fluxoetine

Question 55

What anti-psychotic is used first line in delirium?

Answer 55

Haloperidol

Question 56

What is the drug treatment for borderline personality disorder?

Answer 56

Lamotrigine

Question 57

What is the treatment for chronic schizophrenia?

Answer 57

Oral risperidone

Question 58

What should be used for treatment resistant schizophrenia?

Answer 58

Clozapine