Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialities > Psychiatric drugs > Flashcards

Psychiatric drugs Flashcards

1
Q

What are the risks of SSRI use during pregnancy?

A

Cardiac malformations doubled (2% risk)

3-5x risk of pulmonary hypertension in new born

Neonatal adaption syndrome - 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the methylphenidate medications used for ADHD, and what are their side effects?

A

Ritalin - fast acting 4 hours

Concerta - long acting - 12 hours

Side effects:

  • increased BP
  • headaches
  • insomnia
  • Appetite suppression
  • seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is an alternative drug to methylphenidate and how does it work?

A

Dexamphetamine

- Noradrenaline - dopamine reuptake inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does atomoxetine work? what are some side effects and name contraindication:

A

Noradrenaline reuptake inhibitor

Insomnia
Reduced appetite
Nausea
sexual dysfunction

Phaeochromocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name some less common use medications for ADHD:

A

Clonidine: alpha agonist

Bupropion: DA and NA reuptake inhibitor

Modafinil: NA reuptake inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should be checked first before starting treatment for ADHD?

A

Baseline:

  • BP
  • Weight

**BP and HR need to checked 6 monthly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which drug is licenced for adolescents with depression, and why?

A

Fluoxetine

SSRI can induce thoughts of suicide, especially in younger people. Fluoxetine is least likely to do this.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some of the common side effects of SSRIs?

A

G.I upset

Change in appetite

Hyponatraemia
- especially in elderly

Increased suicidal thoughts
- especially in young

Prolonged QT
- Citalopram

Bleeding
- effect 5HT3 uptake by platelets

Serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How long should SSRIs be used for? and what advice should you give the patient taking them?

A

A further 6 months on from when they start to feel better

Advice
- do not stop suddenly as will cause flu like symptoms.
Decrease gradually over 4 weeks

or 1 year for anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the two most common class of drugs prescribed for depression and what drug class do you need to be careful with?

A

SSRIs
SNRIs

TCAs can be fetal if overdosed on. As such should be avoided or given in low volume to those at risk of suicide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some important side effects of TCAs?

A

Urinary retention

QT prolongation
Arrhythmias
Postural hypotension

Weight gain

Mania - rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some of the major risk factors for suicide?

A

SAD PERSONS

  • Sex - Male
  • Age >40 years
  • Depression
  • Previous attempts
  • Ethanol
  • Rational thinking lost - psychosis
  • Social isolation
  • Organised plan - leaving notes, writing wills
  • No hobbies
  • Sickness (chronic pain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What screening tests/ monitoring should be done prior/ during lithium administration?

A

TFTs
- induces hypothyroidism

Parathyroid function
- can induce hyperparathyroidism

Renal function

  • induces diabetes insipidus (nephrogenic)
  • Reduces glomeruli filtration rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What warnings should be given to someone taking lithium?

A

Carry card explaining they are on lithium

Avoid dehydration
- leads to chronic accumulation

Avoid interactive drugs

  • NSAIDs
  • Diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common endocrinological side effect of lithium?

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What antipsychotic provides the least side effect profile?

A

Aripiprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What investigations or monitoring should be done for people on SSRIs?

A

FBC - G.I bleeding

U&Es - Hyponatraemia - SIADH

ECG
- if on citalopram - increased risk of QTc elongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What SSRI can increase QT length?

A

Citalopram

“in the Citi” there are long queues

19
Q

Which SSRI should be used in someone with a previous M.I?

A

Sertraline

20
Q

What are some important drug interaction with SSRIs:

A

NSAIDs and Aspirin - should be give PPI alongside

Triptans - increases risk of serotonin syndrome

Warfarin and heparin
- if needed recommended to be placed on mirtazapine

21
Q

How do benzodiazepines works?

A

Bind to GABBA receptors and promote more of an influx of Cl- into the cell, hyperpolarising it.

  • induces calm
  • hypnotic effect
  • muscle relaxation as GABA are found in spinal cord
22
Q

What are the common side effects of benzodiazepines? and what is the serious side effects with an overdose and how is it treated?

A

Impaired motor co-ordination
Drowsiness
Inability to concentrate

Serious:

  • respiratory arrest
  • coma

Flumazenil
*caution if suspected overdosed with other substances

23
Q

How do Barbiturates work?

A

Prolong the opening of GABA receptors increasing Cl- influx

High doses can stimulate the GABA receptors.

  • causing strong CNS depression
  • phenobarbital
24
Q

How long following doses of Clozapine will the dose need to be restarted again slowly?

A

48 hours

25
Q

What are the common side effects of anti-psychotic drugs?

A

Within hours:

  • Acute dystonia (opisthotonus, Torticollis)
  • procyclidine management

Within days:
- Akathisia
(unable to sit still)

Within weeks/ months:
- Parkinsonism

Years:
- Tardive dyskinesia
involuntary facial movements

Other important side effects:

  • weight gain
  • metabolic syndrome
  • QT prolongation (haloperidol)

*increased DVT and stroke risk in elderly patients

26
Q

Which anti-psychotic drugs are less likely to cause adverse effects such as tardive dyskinesia, acute dystonia etc?

A

Atypical/ second generation anti-psychotics:

Risperidone
Olanzapine
Clozapine
Quetiapine

27
Q

After changing the dose of lithium, when will levels need to be rechecked?

A

1 week 12 hours after dose

28
Q

What are the adverse effects of lithium?

A

Nausea and vomiting

Nephrotoxicity / Diabetes insipidus

Thyroid enlargement - hypothyroidism

T wave flattening/ inversion

Hyperparathyroidism - hypercalcaemia

29
Q

What SSRIs are associated with increased risk in pregnancy?

A

Fluoxetine: 3rd trimester persistent pulmonary hypertension

Paroxetine: 1st trimester - congenital heart defects

30
Q

If a patient on lithium develops low mood, constipation, difficult concentrating and abdominal pain - why might this be?

A

Hyperparathyroidism

- hypercalcaemia

31
Q

What are some important side effects of SSRIs?

A

Increased suicide idealisation when first starting
- especially in <25 years

G.I upset/ bleeding

Hyponatremia

Increased QT interval

32
Q

List two SNRI:

A

Venlafaxine

Duloxetine

33
Q

name some TCAs and list some serious side effects:

A
  • Amitriptyline
  • Clomipramine
  • Nortriptyline
  • Imipramine
  • drugs are anti-muscarinic and alpha antagonists.
  • expect side effects accordingly

Side effects:

  • fatal arrhythmias
  • Urinary retention
  • Hypotension
  • sedation
34
Q

In MAOIs what is the chemical which competes with it to cause hypertensive crisis?

A

Tyramine

- which induces wide spread vasoconstriction

35
Q

What type of drug is mirtazapine?

A

Noradrenageric and specific serotonin antidepressant

NaSSAs

36
Q

What is the chronological order of how symptoms from antipsychotics begin?

A

Acute dystonic reactions

Akathisia (inability to sit still, restless)
- days to weeks

Parkinsonism
- weeks to months

Tardive dyskinesia
- months to years

37
Q

Is procyclidine? and when is it used?

A

An anti-cholinergic drug

- used for acute dystonia

38
Q

What are the side effects of hyper-prolactinaemia caused by second generation anti-psychotics?

A 
Gynecomastia 
Galactorrhoea 
Infertility 
Osteoporosis 
Breast cancer
39
Q

Outwith lithium, name some other mood stabilisers:

A

Carbamazepine
Lamotrigine
Sodium valproate

40
Q

What are the indications for benzodiazepines?

A 
Short term anxiety 
Alcohol detoxification 
Short term insomnia 
Sleep disorders 
Emergancy termination of seizures
41
Q

What patients have a paradoxical reaction to benzodiazepines?

A

Lewy body dementia

- neuroleptic malignant syndrome risk

42
Q

What is the course of ECT?

A

Twice weekly in a course of 6-12 treatments

43
Q

What are some indications to ECT and some side effects?

A

Indications:

  • Unipolar depression
  • Bipolar depression
  • catatonia
  • mania
  • schizophrenia

side effects:

  • most side effects are GA related
  • antegrade memory loss
  • headache
  • increased risk of suicide due to increased motivation to begin with

Specialities (63 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions