Psychiatric Drugs Flashcards
Name some Selective-Serotonin Reuptake Inhibitors
Fluoxetine, Citalopram and Paroxetine
What are SSRIs mechanism of action?
Reduce reuptake of serotonin from synaptic clefts, reducing symptoms of depression.
What are SSRI ADRs?
Anorexia, diarrhoea, tremor, mania, extrapyramidal symptoms.
What is an SSRI and SNRI DDI?
Use in combination with MAOIs can cause a risk if serotonin syndrome.
Name some Serotonin/Noradrenaline Reuptake Inhibitors
Venlafaxine and Duloxetine
What is a contraindication of SNRI use?
Hypertension
What ADRs can SNRIs cause?
Anorexia, diarrhoea, mania, tremor, sleep disturbance, hypertension, dry mouth, hyponatraemia and extra-pyramidal symptoms
How do SNRIs work?
Block serotonin reuptake at low doses, and noradrenaline reuptake at higher doses.
Name some Tricyclic Antidepressants
Amitriptylline, Imipramine, Lafepramine and Clomipromine
What are some contraindications for tryicyclic antidepressants?
Arrythmia, liver failure, recent MI, mania and epilepsy.
How do tricyclic antidepressants work?
Inhibit noradrenaline and serotonin reuptake, as well as weakly antagonising histamine, muscarinic and alpha-1 and 2 adrenoreceptor.
What are ADRs of tricyclic antidepressants?
Arrythmia, constipation, dry mouth, postural hypotension, sedation and weight gain.
What are some Monoamine Oxidase Inhibitors?
Phenelzine, Isocarboxazid, Tranylcypromine
How do MAOIs work?
Inhibit the MAO enzyme, responsible for serotonin and noradrenaline breakdown.
What are some ADRs for MAOIs?
Hypertension, excitement, tremor, dry mouth and blurred vision.
What DDIs exist for MAOIs?
Metabolism of alcohol, opioids and barbituates is reduced in MAOI use, increasing the likelihood of toxicity from these substances.
Name 2 Typical (1st generation) anti-psychotics
Haloperidol, and Chlorpromazine
How do typical anti-psychotics work?
Antagonise dopamine D2 receptors, reducing psychosis, and causing sedation and tranquilisation.
Name some atypical (2nd generation) anti-psychotics
Olanzapine and Risperidone
How do atypical anti-psychotics work?
Antagonise serotonin2A and D2 receptors, producing sedation and tranquilisation, and reducing psychosis.
What are some ADRs of anti-psychotics?
Extrapyramidal symptoms, weight gain, prolactinaemia, pigmentation, neuroleptic malignant syndrome, CNS depression, cardiac toxicty, and prolonged QT.
What are some Extrapyramidal symptoms?
Dystonia, akathisia, and parkonsonism.
How do typical and atypical anti-psychotic ADRs differ?
Atypical anti-psychotics feature less extrapyramidal symptoms.
Why would lithium (lithium carbonate) be used?
As a mood stabiliser to prevent mania or depression in bipolar disorder.
What is a contraindication for lithium use?
Renal impairment
What are symptoms of lithium toxicity?
Restlessness, agitation, dysarthia and coarse tremor.
What are ADRs for lithium?
Memory problems/ learning new information difficulties, thirst, polyuria, fine tremor, drowsiness, weight gain, rash, diarrhoia and alopecia.
What is a DDI of lithium?
NSAIDs, which raise lithium availability.
How is lithium toxicity treated?
IV fluids, haemodialysis and anticonvulsants.
What 2 classes of drugs can treat Alzheimers Disease (non-vascular dementia)?
Acetylcholinesterase inhibitors, and NMDA antagonists.
What acetylcholinesterase inhibitors can be used?
Doneprazil, Galantamine and Rivastigmine
How do acetylcholinesterase inhibitors work?
Increase levels of ACh, improving arousal, memory, mood and attention.
What ADRs exist for acetylcholinesterase inhibitors?
Diarrhoea, anorexia, fatigue, insomnia, headahce and bradycardia, peptic ulceration and COPD exacerbation.
What DDIs exist for acetylcholinesterase inhibitors?
Beta-blockers, which cause increased bradycardia.
How do acetylcholinesterase inhibitors improve alzheimer’s prognosis?
Provide an additional year for which the patient will function well enough to not require full time care.
What is an NMDA antagonist used?
Memantine
What are ADRs for NMDA antagonists?
Hypertension, dyspnoea, headache, dizziness and drowsiness.
