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M&M drugs - C.U > Psychiatric drugs > Flashcards

Psychiatric drugs Flashcards

1
Q

Mechanism of action of SSRIs

A

Inhibit the uptake of serotonin by neurones. So increasing the duration its in the synaptic cleft.

Improves mood and physical symptoms.

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2
Q

SSRIs are first line for?

A

Moderate / severe depression

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3
Q

Cautions for SSRIs (2)

A

Epilepsy

Peptic ulcer disease

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4
Q

Why should SSRIs be used with caution in the young?

A

Can be associated with increased risk of self harm / suicidal thoughts.

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5
Q

2 contraindications for SSRIs?

A

Bipolar disorder

Mania phase

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6
Q

6 SE of SSRIs

A

GI upset - N&V and diarrhoea

Decreased appetite

Weight gain / loss

Hyponatraemia esp. in the elderly.

Rarely increase in suicidal thoughts and behaviours

Sexual dysfunction

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7
Q

3 common SSRIs

A

Citalopram
Sertraline
Fluoxetine

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8
Q

SSRIs interact specifically with?

A

MOIs

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9
Q

SSRIs should be used in caution …..(4)

A

Epilepsy (lowers the seizure threshold)
Young patient
Peptic ulcer disease
Hepatic impairment

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10
Q

Normal starting does for SSRI

A

20mg tablet OD

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11
Q

How long do SSRIs take to start working?

A

few weeks

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12
Q

How long should SSRIs be taken for as a minimum?

A

6 months once symptoms improve

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13
Q

What happens if you stop SSRIs suddenly?

A

GI upset
flu like withdrawl symptoms
Sleeplessness

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14
Q

Antipsychotics mainly target which symptoms of psychosis?

A

+ve

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15
Q

What is the mechanism of action of antipsychotics?

A

Antagnoise D2 receptors

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16
Q

Difference between first and second generation antipsychotics

A

improved efficiency in treatment resistant schizophrenia

Works against -ve symptoms more

Lower risk of extra-pyramidal SE

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17
Q

What are patients especially at risk of with second generation APs?

A

Metabolic syndrome - weight gain, DM and lipid changes

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18
Q

What happens as a result of APs targeting the nigrostriatal pathway?

A

Extrapyramidal SE

  • Parkinsonian symptoms
  • Actue dystonia
  • Akathisia
  • Neuroleptic malignant syndrome
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19
Q

What hormones does dopamine inhibit the release of?

A

Prolactin

20
Q

Hyperprolactinaemia symptoms produced by APs (3)

A

Galatorrhoea
Amenotrhea
Sexual dysfunction

21
Q

Anticholinergic SE caused by APs (4)

A

Dry mouth
Constipation
Urinary retention
Blurred vision

22
Q

Why can APs cause arrhythmias?

A

Prolong the QT interval

23
Q

What causes postrural hypotension in APs?

A

Alpha adrenergic receptor blockade

24
Q

Histamine blockade in APs lead to?

A

Sedation and weight gain

25
Q

Caution for AP

A

CV disease

26
Q

3 serious SE of clozapine

A

Agranulocytosis
Myositis
Cardiomyopathy

27
Q

2 contraindications of APs

A

Severe HD

History of neutropenia

28
Q

2 uses of APs in psychosis

A

Acute and prophylactically

29
Q

2 possible methods of administration of APs

A

Daily oral treatment

Slow release IM injections

30
Q

What time is it best to take APs?

A

bedtime

31
Q

What should be done on patients on APs each year?

A

Annual health screen

32
Q

Mechanism of action of tricyclic AD?

A

inhibit uptake of serotonin and noradrenaline at the synapse.

33
Q

Tricyclic AD second line for?

A

Moderate / severe AD

34
Q

4 types of receptors blocked by tricyclic AD?

A

H1
Alpha
Muscarinic
Dopamine

35
Q

4 symptoms of blocking antimuscarinic receptors -

A

Dry mouth
Urinary retenion
Constipation
Blurred vision

36
Q

Blockade of H1 receptors in Tricyclic AD leads to -

A

Sedation

37
Q

Tricyclic AD blocking alpha receptors leads to -

A

postural hypotension

38
Q

What problems can Tricyclic AD cause on the heart?

A

Arrhythmia’s and ECG changes

39
Q

How may tricyclic AD cause changes to the brain? (3)

A

Convulsions
Hallucinations
Mania

40
Q

Blocking of dopamine receptors causes what in tricylic AD?

A

Sexual dysfunction

Breast changes

41
Q

What should tricyclic AD not be prescribed with?

A

MOI

s

42
Q

Two preparations of tricyclic AD -

A

Tablet / oral solution

43
Q

How long do tricyclic AD take to work?

A

2 weeks

44
Q

How long should patients take tricyclic AD?

A

at least 6m after symptoms improve

45
Q

Sudden withdrawl of tricyclic AD can lead to? (4)

A

GI upset
Influenza symptoms
Neuro symptoms and Sleep disturbance

46
Q

Clozapine monitoring

A

every week for 18 weeks
then every 2 weeks
then @ at a year - monthly

M&M drugs - C.U (3 decks)

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