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Pharm > Psychiatric Drugs > Flashcards

Psychiatric Drugs Flashcards

1
Q

What are the 3 core symptoms of depression? Name some other associated symptoms

A

Low mood, lack of pleasure, decreased energy

Loss of concentration, loss of appetite, sleep disturbances, irritability

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2
Q

What are the main theories for depression?

A

Mono amine neurotransmitter deficient

Monoamine receptor deficient

E.g. Seratonin, noradrenaline

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3
Q

What are the 4 classes of drugs used to treat depression?

A

SSRIs, tricyclic antidepressants (TADs), seratonin noradrenaline reuptake inhibitors, MAO inhibitors (rarely prescribed)

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4
Q

Name some SSRIs and state when they would be used

A

Fluoxetine, citalopram, paroxetine

Moderate to severe depression

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5
Q

What are the main ADRs for SSRIs?

A

Anorexia, nausea, diarrhoea, mania, suicidal thoughts

Safe in overdose

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6
Q

Name a tricyclic antidepressant and explain how they work

A

Amitriptyline

Block reuptake of seratonin, noradrenaline, anticholinergic effect at muscarinic receptors, suppress noradrenergic transmission at alpha 1 adrenoreceptors

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7
Q

What are the main side effects of tricyclic antidepressants?

A

Sedation, impaired psychomotor function, lowering of seizure threshold, autonomic effects (reduction in gland function and accommodation block), tachycardia, postural hypotension, constipation

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8
Q

Name 2 serotonin noradrenaline reuptake inhibitors and what are the additional side effects to those with SSRIs?

A

Venalfaxine, duloxetine

Sleep disturbance, increased BP, dry mouth, hyponatraemia

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9
Q

What is schizophrenia?

A

A psychotic condition where patients are not in touch with reality

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10
Q

What are some symptoms of schizophrenia

A

Hallucinations (perception in the absence of a stimulant), disturbances of thinking, delusions, behavioural change, social withdrawal, unusual speech and thought, selective attention, poor memory, anxiety

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11
Q

What is dopamine theory?

A

The suggested cause of schizophrenia being caused by excess dopamine e.g. Amphetamine causes schizophrenia like symptoms and it is best treated with dopamine antagonists (however not negative symptoms)

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12
Q

What are the 4 dopamine pathways?

A

Mesolimbic - emotional response and behaviour

Mesocortical - arousal and mood

Nigrostriatal - pathway damaged in Parkinson’s

Tuberoinfundibular - hypothalamus and pituitary

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13
Q

What effects do dopamine receptor blockers have on the dopamine pathways?

A

Nigrostriatal - extrapyridaminal

Mesocortical - enhanced negative and cognitive symptoms

Mesolimbic - THERAPEUTIC ACTION ON POSITIVE SYMPTOMS

Tuberoinfundibular - hyperprolactinaemia, infertility

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14
Q

What are the actions of antipsychotics?

A

Sedation, tranquilisation, antipsychotic

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15
Q

Name 2 typical antipsychotics

A

Haloperidol, chlorpromazine

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16
Q

What is the first line treatment for schizophrenia? Name some of these drugs

A

Atypical anti psychotics (less extrapyramidal signs)

Olanzipine, risperidone, clozapine, quetiapine

17
Q

What are the main ADRs of atypical antipsychotics?

A

Weight gain (olanzipine), increased prolactin (risperidone), sedation

Clozapine can cause severe constipation, sedation, hyperventilation, weight gain

18
Q

What are the main ADRs of typical antipsychotics? What toxicities can they cause?

A

Extrapyramidal side effects, Parkinsonism, dystonia, postural hypotension, weight gain, hyperprolactinaemia

CNS depression, cardiac toxicity, sudden death with high dose

19
Q

What are the physical symptoms of anxiety?

A

Lightheaded, shortness of breath, hot and cold flushes, nausea, palpitations, numbness, pins and needles

20
Q

What is the first line treatment for anxiety?

A

CBT

21
Q

What pharmacological treatment can be used to treat anxiety? How do they work?

A

Benzodiazepines diazepam, lorazepam

Act on GABA receptors (agonist) to increase inhibitory activity

22
Q

What are the main ADRs of benzodiazepines?

A

Drowsiness, dizziness, psychomotor impairment, dry mouth, blurred vision, tolerance, dependence

23
Q

Which class of drug is teratogenic and what can it cause?

A

Benzodiazepines

Cleft lip

Respiratory depression

24
Q

How would you treat a benzodiazepine overdose?

A

Support for respiratory depression

Flumazenil (GABA receptor antagonist)

25
Q

Bipolar disorder is episodes of depression and mania. What is mania?

A

Excited, happy, optimistic, overactive, poor concentration, poor sleep, rapid speech, psychotic symptoms

26
Q

What drugs can be used to treat bipolar disorder?

A

Lithium - monitor, narrow TW

Valproate

Carbamazepine

Lamotrigine

Antipsychotics

27
Q

What are the main ADRs for lithium?

A

Memory problems, thirst, polyuria, tremor, drowsiness, weight gain

Pharm (18 decks)

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