Psychiatric drugs Flashcards
Name 2 SSRIs. (2)
Fluoxetine, Paroxetine, Citalopram, Sertraline
Name 3 indications for SSRIs. (3)
Depression Anxiety OCD PTSD Bulimia (fluoxetine)
Name 4 side effects of SSRIs. (4)
GI: nausea, vomiting, anorexia, weight loss, diarrhoea (usually transient and dose related)
Sexual: lower libido, delayed orgasm
Hypersensitivity reactions
Other: headache, anxiety, restlessness, sleep disturbance
Name one contraindication for SSRIs. (1)
Mania Bipolar disorder (caution)
How long until the beneficial effects of SSRIs will be felt? (1)
2 weeks for any effect, 6 weeks for full effect.
Name 2 TCAs. (2)
Amitriptyline, Imipramine, Lofepramine, Clomipramine.
Name 2 indications for TCAs. (2)
Depression
OCD (clomipramine)
Neuropathic pain (amitriptyline)
Nocturnal enuresis
Name 4 side effects of TCAs. (4)
Antimuscarini: dry mouth, blurred vision, constipation, urinary retention
Drowsiness
CV: postural hypotension, arrhythmias
TOXICITY in OD: cardiotoxic, respiratory failure, seizures, convulsions, coma
Name 2 contraindications for use of TCAs. (2)
Recent MI Arrhythmias Severe liver disease Mania (caution in bipolar) High risk of suicide
How long until the beneficial effects of TCAs will be felt? (1)
2 weeks for any effect, 6 weeks for full effect.
Name one MAOI. (1)
Name 3 foods that should be avoided. (3)
Phenelzine, Moclobemide
Cheese, Non-fresh fish/meat, Broad beans, Bovril/Oxo, Alcohol
Name one SNRI. (1)
Venlafaxine
Name 3 side effects of mirtazapine. (3)
Increased appetite
Weight gain
Oedema
Sedation
Name 3 examples of atypical anti-psychotics (3)
Name 3 examples of typical anti-psychotics (3)
Atypical: Olanzapine, risperidone, quetiapine, aripiprazole, amisulpiride, clozapine
Typical: Chlorpromazine, haloperidol, flupenthixol, sulpiride
Name 3 indications for the use of anti-psychotics. (3)
Schizophrenia Other psychotic illness Mania Agitation Prophylaxis of bipolar (olanzapine)
Name 3 side effects of the atypical anti-psychotics. (3)
Weight gain Postural hypotension Drowsiness Diabetes Extra-pyramidal side effects (can occur but more common in typical)
Which medicines are associated the most with extra pyramidal side effects? (1)
Describe the different kinds of extrapyramidal side effects. (4)
Typical antipsychotics (also atypicals but not as much)
- Parkinsonism
- Acute dystonia (grimacing, abnormal movement, facial spasms, torticollis, jaw dislocation, altered behaviour)
- Tardive dyskinesia (irreversible, involuntary movements of oral-lingual region)
- Akathesia (restlessness)
What is neuroleptic malignant syndrome? (2)
Rare but potentially fatal complication of anti-psychotics.
Hyperthermia, fluctuating consciousness, rigidity and autonomic dysfunction.
Increased white cells and creatinine phosphokinase.
Lasts for 5-7 days after cessation of treatment.
When can a patient try clozapine? (1)
After an adequate trial of two anti-psychotic agents, one of which must have been atypical.
Name 3 side effects associated with clozapine. (3)
Agranulocytosis Constipation Tachycardia Hypersalivation Sedation Hypertension Weight gain Diabetes Convulsions Myocarditis
When is clozapine contraindicated? (3)
Severe heart disease
Severe renal disease
Active liver disease
History of bone marrow disorders
Discuss 2 very important point to mention to a patient that is commencing clozapine therapy. (2)
Adverse effects: especially agranulocytosis; regular FBC (weekly for 18 weeks then fortnightly, then monthly)
Hence initiation ends to occur in the inpatient setting.
If more than 2 days of doses are missed then they will need to be re-titrated from beginning.
Name 2 short acting anxiolytics and 2 long acting anxiolytics. (4)
Short: temazepam, lorazepam
Long: diazepam, nitrazepam
Name 3 indications for benzodiazepines. (3)
short term relief of anxiety insomnia alcohol withdrawal status epilepticus premedication before minor surgery e.g. endoscopy
