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Pharm > Psychiatric drugs > Flashcards

Psychiatric drugs Flashcards

1
Q

Types of antidepressants

A 
SSRIs
NSRIs
Mirtazapine
Tricyclic antidepressants
MAOIs
Vortioxetine
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2
Q

Examples of SSRIs

A 
Sertraline
Fluoxetine
Citalopram
Venlafaxine
Paroxetine
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3
Q

MoA of SSRIs

A

Inhibit serotonin reuptake so increase concentration of serotonin in synaptic cleft
Leads to down regulation of post synaptic receptors

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4
Q

Side effects of SSRIs

A 
GI disturbance
Weight change
Agitation
Sexual dysfunction 
Discontinuation syndrome 
Serotonin syndrome (fluoxetine)
QTc prolongation (citalopram)
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5
Q

Examples of NSRIs

A

Duloxetine

Venlaxafine

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6
Q

Side effects of NSRIs

A

Similar to SSRIs except higher incidence of:
Nausea
Sexual dysfunction
Sedation

Venlaxafine can exacerbate heart failure

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7
Q

What antidepressants treat neuropathic pain

A

NSRIs

Tricyclic antidepressants

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8
Q

Indications for mirtazapine

A

Weight loss and insomnia with depression

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9
Q

Side effects of mirtazapine

A

Histamine side effects - sedation

Weight gain

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10
Q

Side effects of tricyclics

A

Muscurinic and histaminic (sedation, diarrhoea)

Arrhythmia in overdose

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11
Q

Disadvantages of MAOIs

A

Risk of tyramine reaction

Need 6 week washout period before changing to another antidepressant due to drug interactions

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12
Q

Examples of MAOIs

A

Moclobamide

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13
Q

What does vortioxetine treat

A

Cognitive symptoms in depression

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14
Q

What to do if antidepressants had no improvement in 2-3 weeks

A

Significant side effects switch immediately or see if get better in few weeks before switching
For depression- switch
For anxiety- increase dose

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15
Q

Describe discontinuation syndrome

A 
Sweating
Shaking
Agitation
Insomnia
Headache
Clonus
N+V
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16
Q

Features of serotonin syndrome

A

Cognitive: headache, agitation, hypomania
Autonomic: sweats, hyperthermia, tachycardia, diarrhoea, vomiting
Somatic: clonus, hyperreflexia, tremor

17
Q

Management of serotonin syndrome

A

Fluids

Monitoring

18
Q

Target pathways of antipsychotics

A

Mesocortical

Mesolimbic

19
Q

Unwanted pathways of antipsychotics and example side effects

A

Nigrostriatal - extrapyramidal side effects

Tuberoinfundibular - amenorrhoea, lactorrhoea, sexual dysfunction

20
Q

Side effects of all antipsychotics

A 
Sedation
Extrapyramidal
Weight gain
Acute dystonia/oculogyric crisis 
QTc prolongation
21
Q

How to treat extrapyramidal side effects with antipsychotics

A

Give anticholinergics (procyclidine) to modulate dopamine:ACh ratio

22
Q

When should procyclidine not be given for antipsychotic side effects

A

Not if tardive dyskinesia only symptoms as can exacerbate

23
Q

Examples of typical and atypical antipsychotics

A

Typical: haloperidol, flupenthixol
Atypical: clozapine, risperidone, olanzapine, aripiprazole

24
Q

Which side effects are more common in typical and atypical classes

A

Typical: extrapyramidal, sexual dysfunction
Atypical: weight gain, hyperlipidaemia, diabetes

25
Q

Monitoring for antipsychotics

A 
FBC
Lipids
HbA1c
LFTs
ECG
BP
HR
Weight (weekly, then every 3 months)
26
Q

When should clozapine be given

A

When 2 antipsychotics haven’t worked

27
Q

Sided effects of clozapine

A

Salivation
Urinary incontinence
Agranulocytosis
GI hypomobility - need to monitor bowel movement and can give prophylactic laxatives

28
Q

Describe neuroleptic malignant syndrome

A

Life threatening reaction to antipsychotics characterised by fever, confusion, muscle rigidity, sweating and autonomic instability

29
Q

Life threatening complications of neuroleptic malignant syndrome

A

Rhabdomyolysis
Seizures
Renal failure

30
Q

Treatment for neuroleptic malignant syndrome

A

Stop antipsychotics
Fluid resuscitation
Lower temperature

Pharm (20 decks)

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