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HD 4 - dental relevance > Psychiatric disorders > Flashcards

Psychiatric disorders Flashcards

1
Q

4 classifications of hypnotics

A
  1. benzodiazepines
  2. anti-histamines
  3. miscellaneous
  4. barbiturates - old fashioned
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2
Q

how does drug induced sleep effect NREM + REM levels

A

increases NREM, decreases REM

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3
Q

5 actions of benzodiazepines

A
  1. hypnotic
  2. anxiolytic
  3. anticonvulsant
  4. muscle relaxant
  5. amnesic
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4
Q

which of these BDZ has the longest half life:
tempazepma
loprazolam
nitrazepam

A

nitrazepam - used for early morning wakening

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5
Q

3 sites of action of BDZs

A
  1. reticular limbic system RAS - control alertness (hypnotic)
  2. limbic system in cortex - controls emotion (anxiolyitc)
  3. other sites of cortex - anticonvulsant
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6
Q

MOA of BDZ

A

increase GABA - so reduce function in certain brain pathways

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7
Q

if medazolam and methadone are taken together what may happen?

A

respiratory arrest

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8
Q

drug used for BDZ reversal?

A

flumazenil

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9
Q

MOA of antihistamines

A

H2 blockers produce CNS depression

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10
Q

what antihistamine is used in children

A

promethazine

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11
Q

what are Z drugs and at what receptors do they work?

A

hypnotics - non-BDZ but work at BDZ receptors

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12
Q

4 main types of anxiolytics

A
  1. alcohol
  2. BDZs
  3. buspirone
  4. beta blockers
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13
Q

which BDZ reduces alcohol/drug withdrawal

A

chlordiazepoxide

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14
Q

when are buspirone used

A

short term anxiety control for specific reason - does not cause sedation, acts as serotonin agonist

no withdrawal

causes dry mouth

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15
Q

which BDZ in dental formulary?

A

temazepam + diazepam (plus flumazenil)

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16
Q

what is the difference between hypochondriasis + somatisation?

A 
hypochondriasis = focuses on underlying disease
somatisation = focuses on symptoms
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17
Q

psychogenic pain characterisitcs:

A 
inconsistent with anatomical landmarks
investigations negative
continuous
prevents sleep but doesn't wake up 
analgesia ineffective
associated with emotional factors
18
Q

what causes korsakoffs psychosis?

A

B1/thiamine deficiency most commonly associated with chronic alcoholism

19
Q

3 positive neurotransmitters

A

adrenaline, noradrenaline, dopamine

20
Q

3 negative neurotransmitters

A

serotonin, GABA, dopamine

21
Q

where does serotonin act?

A

cerebral cortex

22
Q

how does fluoxetine improve mood?

A

blocks re uptake of serotonin

23
Q

dopamine acts on 4 pathways in which part of brain?

A

frontal cortex

24
Q

which neurotransmitter is responsible for reward/motivation?

25
which neurotransmitter mediates arousal?
noradrenaline
26
where are antipsychotics metabolised?
liver
27
which neurotransmitter do APs effect and how?
dopamine - increase decrease chloinergics
28
how do APs effect alcohol + anxiolytics?
increase sedation
29
APs - 4 dentally relevant things to be aware of
EPS xerostomia sedation postural hypotension
30
first choice drug therapy for depression?
SSRIs
31
what guidance should be followed to deal with depression?
NICE CG 90 2009 - depression in adults NICE CG 91 depression in adults with chronic health problems
32
simple MOA for antidepressants?
increasing monoamines
33
4 categories of ADs
SSRIs - selective serotonin inhibitors SNRIs - selective noradrenaline reuptake inhibitors (3rd line) TCA - tricyclic antidepressants MAOIs - monoamine oxidase inhibitors
34
what happens if you take SSRIs + SNRIs together?
serotonin syndrome - pyrexia
35
MOA of SSRIs
block re-uptake of serotonin in pre-synaptic cleft
36
as well as depression, SSRIs may be used for what conditions?
chronic pain e.g. burning mouth syndrome
37
what SSRI is used for burning mouth syndrome?
paroxetine
38
how do SSRIs effect sedation?
decrease sedation
39
why is the MOA of TCAs considered dirty?
non-selective: targets re uptake of both serotonin + Noradrenaline causes antihistaminergic activity (sedation) blocks Na K + Ca channels (decrease pain) enhances GABA peripherally
40
3 disadvantages to TCAs
side effects - (xerostomia) dangerous in overdose 2-3 weeks before effective
41
MAOIs MOA
block monoamine oxide enzyme which degraded monoamines - so increases MA levels
42
symptoms + cause of MAOI crisis?
hypertension + headache dietary intake of monoamine (tyramine rich foods) high + MAOI xs monoamines

HD 4 - dental relevance (12 decks)

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