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AY Psychiatry > Psych treatments > Flashcards

Psych treatments Flashcards

1
Q

How do SSRI’s work?

A

Selective presynaptic blocade of serotonin reuptake

Inhibit P450 enzyme

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2
Q

How long do SSRI’s take to work?

A

2-3 weeks

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3
Q

Side effects of SSRI’s

A

Tremor
N + V
Headache
Diarrhoea

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4
Q

Contraindications for SSRI’s

A

Mania

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5
Q

How do TCA’s work?

A

Pre-synaptic blocake of NA, serotonin & dopamine

Blocks muscarinic, histaminergic & alpha-adrenergic receptors

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6
Q

Side effects of TCA’s

A

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

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7
Q

Contraindications for TCA’s

A

Recent MI
Arrhythmias
Severe liver disease
Mania

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8
Q

How do MAO inhibitors work?

A

prevent breakdown of NA,serotonin & dopamine

Increase storage of NA & 5-HT

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9
Q

What are MAO inhibitors used for?

A

Atypical depression
Chronic pain
Anxiety
Migraine prophylaxis

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10
Q

Side effects of MAO inhibitors

A

Avoid tyramine containing foods – Hypertensive crisis

Flushing, headache,hypertension, CVA

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11
Q

How do you treat hypertensive crisis caused by MAO inhibitors?

A

Alpha-blockade (e.g. phentolamine)

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12
Q

Contraindications for MAO inhibitors?

A

Phaeochromocytoma
CV disease
Hepatic failure
Mania

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13
Q

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

A

NSAIDs
ACE inhibitors
Diuretics

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14
Q

Contraindicationsfor lithium

A 
Pregnancy & breast feeding 
Decreased renal function 
Thyroid problems 
CV disease
Neuro conditions (Parkinson's, Huntington's)
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15
Q

How does Lamotrigine work?

A

Na channel blocker - decreases excitability

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16
Q

Side effects of carbamazepine

A

Agranulocytosis
Aplastic anaemia
Cerebellar symptoms

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17
Q

Side effects of valproate

A 
Weight gain 
Sedation 
Hair loss 
Ankle oedema 
Tremor
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18
Q

Examples of 1st Gen anti-psychotics

A 
Haloperidol 
Chlopromzine 
Sulpiride
Flupentixol 
Zuclopenthixol
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19
Q

Examples of 2nd Gen anti-psychotics

A 
Clozapine 
Olanzapine 
Quetapine 
Risperidone 
Amsulpride
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20
Q

Contraindications for anti-psychotics

A 
Severely reduced conscious level 
Phaeochromocytoma 
Parkinson's disease
Epilepsy 
Cardiac disease
Metabolic syndrome
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21
Q

How do most anti-psychotics work?

A

Antagonism of D2 receptors in the mesolimbic pathway

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22
Q

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

A

Excess ACh

Decreased dopamine

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23
Q

How do nezos work?

A 
Bind to benzo receptors on GABAa complex 
Increases GABA ffinity 
Increase Cl influx 
Hyperpolarisation 
Decreased excitability
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24
Q

Which benzo in particular causes anterograde amnesia & impaired coordination?

A

Rohypnol

25
Q

What is the first line drug for detoxing in addiction?

A

Diazepam

26
Q

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

A

Thiamine

27
Q

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

A

Naltrexone

28
Q

What is the first line medication for ADHD?

A

Methyphenidate (Ritalin)

29
Q

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

A

Donepizil

Rivastigmine

30
Q

What drug is used to treat severe Alzheimer’s?

A

Memantine

31
Q

What is the first line drug treatment for LB dementia?

A

Rivastigmine

32
Q

What drugs are first line for generalised anxiety disorder?

A

Escitalopram or Sertraline

33
Q

Which drug is first line for social anxiety disorder?

A

Sertraline

34
Q

Side effects of sertraline

A

GI upset

Increased bleeding risk

35
Q

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

A

Paroxetine

36
Q

What are the side effects of paroxetine?

A

Abnrmal dreams
Increased bleeding
GI upset
Sexual dysfunction

37
Q

What are the steps of management for PTSD?

A

CBT
Eye movement
Paroxetine

38
Q

Which SSRI is used for OCD in kids?

A

Fluoxetine

39
Q

Which SSRI is used for OCD in adults?

A

Paroxetine

40
Q

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

A

Respiridone

41
Q

What drug is used for hyperactivity in ASD?

A

Methyphenidate

42
Q

Which patients should Methylphenidate not be given to?

A

Patients with a tic

43
Q

What drug should be used for sleep disturbance in ASD?

A

Melatonin

44
Q

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

A

IM Olanzapine

45
Q

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

A

Lithium + Risperidone

46
Q

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

A

Lithium or valproate

47
Q

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

A

Olanzapine + fluoxetine

48
Q

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

A

Lithium

49
Q

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

A

Lithium

50
Q

What is the treatment for depression predominant bipolar disorder?

A

Lamotrigine

51
Q

When in pregnancy should bipolar medication be avoided?

A

1st trimester

52
Q

What is the treatment for a suicidal bipolar patient?

A

Lithium

53
Q

What is the treatment for a suicidal schizophrenic patient?

A

Lithium + clozapine

54
Q

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

A

Fluxoetine

55
Q

What anti-psychotic is used first line in delirium?

A

Haloperidol

56
Q

What is the drug treatment for borderline personality disorder?

A

Lamotrigine

57
Q

What is the treatment for chronic schizophrenia?

A

Oral risperidone

58
Q

What should be used for treatment resistant schizophrenia?

A

Clozapine

AY Psychiatry (10 decks)

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