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YEAR 3 NICE > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Depression in the postnatal period can occur up to how long after birth

A

1 year

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2
Q

post natal depression will go away by itself

A

false and it is not entirely due to hormonal changes

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3
Q

when are antidepressants given for pregnant woman

A

as they are not licensed for breastfeeding women, If psychological treatment is unavailable or unacceptable or symptoms are severe then it is an option

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4
Q

what are the SSRIs of choice in women who are breast feeding

A

Sertraline and paroxetine

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5
Q

what are thepreferrd tricyclic antidepressants

A

Imipramine and nortriptyline

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6
Q

what tricyclic should be avoided in breastfeeding

A

Doxepin

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7
Q

peripartum depression onset is defined as

A

during pregnancy or within 4 weeks after delivery. however general agreement that onset can occur any time within the first year

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8
Q

in the first year after birth, around — of women experience depression and anxiety

A

15-20

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9
Q

the most common mental health problems in pregnancy

A

depression and anxiety

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10
Q

leading cause of maternal death post partum in the first year

A

suicide

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11
Q

examples of assessments for antenatal and post natal depression

A

Edinburgh Postnatal depression scale (EPDS) or the Patient Health Questionnaire (PH!-9)

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12
Q

if a moment has any past or present severe mental illness or a FH of severe perinatal mental illness in a first degreee relative be alert for what in the first 2 weeks after childbirth

A

postpartum psychosis

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13
Q

the universal criteria for depression are

A

ICD-10 and DSM 5

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14
Q

when does baby blues happen

A

presents around the second or 3rd post natal day and resolving by the 5th day.

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15
Q

if women on an antidepressant becomes pregnant what should you not do

A

stop it abruptly

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16
Q

if mild -moderate depression and on a TCA, SSRI or SNRI want to

A

discuss gradually stopping antidepressant

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17
Q

when do symptoms typically appear in ADHD

A

3-7 years old

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18
Q

symptoms of ADHD should be present for at least how long

A

6 months

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19
Q

symptoms of ADHD should be seen in at least 2

A

settings such as home,school, work

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20
Q

some of the diagnostic criteria for ADHD

A

start before 12y/o, occurs in two or more settings, been present for at least 6 months

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21
Q

environmental factors most strongly associated with ADHD are

A

low birth weight and maternal smoking during pregnancy

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22
Q

what type of ADHD accounts for most cases

A

the combined

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23
Q

when to suspect ADHD

A

at least 6 in kids or 5 in adults inattention symptoms and or at lest 6 in kids or 5 in adults hyperactivity-impulsivity symptoms

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24
Q

how should you measure effects of ADHD drug treatments

A

weight, height, blood pressure and heart rate,

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25
Q

how often should weight be measured in children under 10 with ADHD

A

every 3 months

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26
Q

how often should weight be measured in children and young people over 10 y/o

A

in over 10 year olds - 3 and 6 months after treatment and every 6 months thereafter

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27
Q

how often should weight be measured in adults with ADHD

A

every 6 months

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28
Q

how often should height be measured in children and young people on ADHD medication

A

every 6 months

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29
Q

how often should blood pressure and heart rate be measured in someone with adhd

A

before and after each dose change and routinely every 6 months

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30
Q

what advice should be given to adults with adhd on an amphetamine for example dexamfetamine or lisdexamfetamine

A

advice on driving - they should not drive if feel drowsy, dizzy, unable to concentrate

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31
Q

if weight loss becomes a problem with adhd medications then

A

take medication either with or after food rather than before meals

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32
Q

first line for adhd in preschool children

A

adhd focused group parent training programme

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33
Q

what med is usually offered first line for school age children and young people

A

methylphenidate, with lisdexafetamine, dexamfetamine and atomoxetine as possible alternatives

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34
Q

in young people/ school age children if methylphenidate is contraindicated or not effective what may be prescribed for children and adolescents 6-17 years old with ADHD who have insomnia, where sleep hygiene measures have been insufficient

A

Melatonin

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35
Q

what is usually offered first line in adults with ADHD

A

methylphenidate or lisdexafetamine

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36
Q

what adhd medication may affect their ability to drive

A

methylphenidate

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37
Q

most common side effects of methylphenidate

A

GI, cardio, CNS

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38
Q

what not to prescribe alongside a person taking atomoxetine

A

a monoamine oxidase inhibitors (MAOIs) - should have a 14 day gap before having the other one

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39
Q

atomoxetine is associated with

A

QT interval prolongation

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40
Q

titrate with caution if atomoxetine given with

A

terbinafine - as CP450 enzyme

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41
Q

effects associated with the amphetamines so deja and lisdex

A

decreased appetite and weight loss

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42
Q

do not prescribe an amphetamine with

A

Moclobemide or a MAOI ( due to risk or serotonin syndrome or symptoms similar to neuroleptic malignant syndrome)

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43
Q
A
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44
Q

avoid amfetamine with

A

atomoxetine( increases risk of psychosis and movement disorders), tricyclic antidepressants

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45
Q

conditions associated with autism

A

sensory problems, GI disturbances (inflammatroy bowel, coeliac, diarrhoea and constipation), and epilepsy

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46
Q

maternal use of sodium valproate increases risk of

A

autism in baby

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47
Q

what are amongst the diagnsotic characteristics of autism

A

stereotypic movement disorder

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48
Q

what scale can be used if you suspect autism in an adult

A

(AQ-10) Autism spectrum Quotient -10 items tool. if scores above 6 refer to autism team

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49
Q

an early sign of autism in children

A

language delay

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50
Q

retts syndrome similar to autism but

A

mainl affects girls and characterised by motor regression, ataxia, hand wringing (characteristic)

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51
Q

manic episode lasts at least

A

1 week accompanied by at elast 3 additional symptoms

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52
Q

hypomanic episode lasts

A

4 days

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53
Q

depressed episode in bipolar lasts

A

at least 2 weeks

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54
Q

what is rapid cycling bipolar defined as

A

least 4 depressive, manic, hypomanic, or mixed epsiodes within a 12 month period

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55
Q

difference between bipolar I and bipolar II

A

bipolar II has hypomania but no evidence of mania

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56
Q

what is known to be one of the most heritable psychiatric disorders

A

bipolar

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57
Q

3 environmental factors for bipolar

A

toxoplasma gondii exposure,
cannabis use/cocaine exposure, childhood trauam

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58
Q

psychiatric condition with the highest lifetime riskfor suicide

A

bipolar

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59
Q

the delusions in bipolar are ussually

A

grandiose

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60
Q

the hallucinations in bipolar are ususally

A

voices

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61
Q

what is not required for a diagnosis of bipolar

A

symptoms of depression

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62
Q

the diagnostic criteria for bipolar in children and young people

A

mania MUST be present
euphoria MUST be present on most days and for most of the time, for at least 7 days

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63
Q

what are not used to diagnose bipoalr

A

questionannaires in priamry care

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64
Q

what is cyclothymia

A

chronic disturbance of mood, consisting of periods of depression and hypomania, where the depressive symptoms do not meet the criteria for a. depressive epidsode

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65
Q

how do you treat mania in bipoalr

A

oral antipsychotic- haloperidol olanzapine, quetiapine or risperidone. second line is then to choose another one out of those 4. 3rd line is lithium or sodium valproate (but not if pre menopausal woman)

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66
Q

what happens to antidepressant medication during mania in bipolar

A

usually tapered and discontinued

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67
Q

treatment of depression in bipolar

A

Quetiapine alone
Olanzapine alone
Lamotrogine alone
Fluoxetine with olanzapine

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68
Q

what may be consdiered for bipolar if lithium is poorly tolerated

A

valproate alone or olanzapine alone

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69
Q

what blood tests should be done if person is taking long term lithium

A

thyroid function and calcium

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70
Q

if woman is on valproate for bipolar and becomes pregnant what should be done

A

dose of valproate should be reduced gradually over at least 4 weeks to minimise the risk of relapse

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71
Q

breastfeeding not advised in woman taking

A

lithium, carbamazepine, clozapine

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72
Q

what are the most commonly prescribed antipsychotics for bipolar

A

second geenration antipsychotics such as olanzapine quetiapine and risperidoen

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73
Q

antipsychotics can be prescribed on their own but also with

A

lithium or valproate

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74
Q

if discontinuing an antipsychtotic and moving on to another antipsychotic the original one the dose should be reduced gradually over how many weeks

A

at least 4

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75
Q

if discontuning an antipsychotic drug and not starting another one how long should it be gradually reduce over

A

3 months

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76
Q

monitroing if on antpsychotic

A

BMI weekly for first 6 weeks then at 3 months. Thereafter every 12 months.
serum electrolystes and urea including creatinine and estimated glomerular filtration rate every 12 monthsm
FBC every 12 months
Blood lipids0 3 months after starting treatment then every 12
plasma glucose of HBa1c at 3 months then every 12 ( hyperglycaemia- polydipsia etc)
Pulse and blood pressure during dose titration and at each dose change
ECG after dose changes
prolactin 6 months after then every 12 ( not required for aripiprazole, cloazapine, quetiapine or olanzapien)
liver function tests every 12 months

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77
Q

clozapine can cause what

A

neutropenia or agranulocytosis and frequent monitoring of FBC is required. constipation is a very common side effect of it

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78
Q

side effects of antipsychtoics

A

extrapyramidal symptoms

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79
Q

examples of extrapyrimadal effects

A

dystonic reactions ( abnormal movemetns of the face an body), Pseudoparkinsonism ( tremor, bradykinesia and rigidity)- these can be alleviated by antimuscarinic drugs such as PROCYCLIDINE

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80
Q

akathisia is

A

motor restlessness -reduce dose of antipsychotic

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81
Q

tardive dyskinesia can be

A

rhythmical, involuntary movements usually lip smakcing and tongue rotating although it can affect the limbs and trunk - if this happens should discontinue drug

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82
Q

what has been reported as an an adverse effec of aripiprazole

A

oculogyric crisis

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83
Q

weight gain is common with all antipsychtotics but more frequent in what generation

A

second -especially clozapine and olanzapine

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84
Q

effects of antipsychotics

A

dyslipdiaemia (raised lipids)
hyperprolactinaemia
sedation
anticholinergic effects
postural hypotension
hyperglycaemia
QT interval prolongation

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85
Q

avoid prescribing antipsychotics with other drugs knwon to prolong the QT interval such as

A

tricyclic antidepressants, erythromycin or antiarrhytmics

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86
Q

rare but fatal side effect of antipsychotics

A

Neuroleptic malignant syndrome

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87
Q

photosensitivity is common iwth what antipsychotic

A

chlorpromazine

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88
Q

what drugs increase the level of antipsychtoics

A

azole antifungals, SSRIs

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89
Q

what things reduce the levels of antipsthotics

A

carbamazepine

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90
Q

when should not drink grapefruti juice

A

if taking pimozide

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91
Q

if on lamotrogine and develop rash

A

drug should be stopped immediately

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92
Q

lithium is available as two salts which are

A

lithium carbonate and lithium citrate

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93
Q

lithium is contraindicated

A

cardiac disease associated with rhythm disorders
significant renal impairment
untreated hypothyroidism
brugada syndrome
low sodium levels
addisons

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94
Q

initial affects of lithium

A

nausea, diarrhoea, vertigo, muscle weakness and a dazed feeling but these often resovle with continued therapy. fine hand tremors, polyuria and polydipsia may persisit

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95
Q

long term effects of lithium

A

hypo or hyper thyroidism

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96
Q

NSAIDS ANd diuretics effects on lithium

A

increase lithium levels

97
Q

how should you monitor someone taking lithium

A

one week after starting, one week after every dose change and weekly until the levels are stable. then every 3 months

98
Q

if on lithium what should be measured every 6 months

A

BMI, u+Es, eGFR, calcium and thyroid function tests

99
Q

lithium levels should be measured how many hours post dose

A

12

100
Q

woman taking lithium should be on

A

reliable contraception

101
Q

Diarrhoea dn vomitting are effects of

A

lithium toxicity

102
Q

sodium valproate and valproic acid are — for the treatment of bipolar

A

unlicensed

103
Q

not prescribe valproate in those wtih

A

liver dysfunction

104
Q

effects of valproate

A

gastric irritation and hyperammonaemia both of which can lead to intense nausea

105
Q

monitoring for valproate

A

LFTs, BMI, FBC

106
Q

warfarin and aspirin can interact with valproate and

A

precipitate toxicity

107
Q

drugs that inhibit cytochrome P450 enzymes eg erythromycin, fluoxetine and cimetidine can increase

A

valproate levels

108
Q

assessment tool for delirium

A

Short confusion assessment method (short-CAM) or (DSM-5) Diagnostic and statistical manual of mental disorders

109
Q

3 subtypes of delirium

A

Hyperactive, hypoactive and mixed

110
Q

drugs known to precipitate delirium

A

opiods, benzodiazepines and anti cholinergics

111
Q

these are - infection drugs, constipation , urinary retention, dehydration and electrolyte imbalance, pain, sensory impairment

A

precipitating factors for delirium

112
Q

what drugs should be avoidied or used with caution in Parkinsons disease or demntia with lewy bodies

A

ANTIPSYCHOTICS

113
Q

hypERthermia is a symptoms of

A

Neuroleptic malignant syndrom

114
Q

3 drug options for delirium

A

Haloperidol, Lorazepam (only used for challenging behaviou associated with delirium), Levomepromazine ( usually 2/3rd line antiemetic becuase of its sedative effect)

115
Q

most frequently reported side effect of benzodiazepines

A

daytime drowsiness, dizziness, muscle weakness, ataxia

116
Q

alcohol should not be taken with lorazepam due to

A

enhanced sedative effects

117
Q

levomepromazine is what generation

A

first - acts predominatly by blocking dopamine type 2 receptorrs - it is usually given subcutaenously

118
Q

what is a rf for dementia

A

parkinsons

119
Q

2nd most common dementia

A

vascular then lewy bdoy then frontotemporal

120
Q

early onset dementia is defined if before what age

A

65

121
Q

what are these the pathological features of: atrophy of the cerebral cortex, formation of amyloid plaques and neurofibrillary tangles

A

alzheimers

122
Q

patietns with vascular dementia can also present with – at the time of initial assessment

A

transient neurological symptoms, history of gait abnormalities and incontinence at the time of initial assessment

123
Q

what are common in vascular dementia

A

depression and delusion

124
Q

dementia with lewy body is similar to alzheimers but with

A

marked spntaneous fluctuations in cognitive abilities, visual hallucinations and parkinsonism

125
Q

what are lewy bdoies

A

abnormal deposits of protein inside nerve cells

126
Q

differencce between lewy body dementia and parkinsons disease dementia

A

lewy body - cognitive symptoms start before motor symptoms by at least a year
parkisnons disease dementia- motor symptoms develop within 1 year of cognitive symptoms

127
Q

frontotemporal dementia is a common cause of dementia in who

A

younger people

128
Q

what kind of memory is - memeory loss for recent events, repeated questioning and difficulty learning new information

A

episodic memory

129
Q

what dementia increases in a stepwise approach

A

vascular

130
Q

drugs that can worsen dementia

A

anticholinergics - benzodiazepines, anticholinergics, opiods

131
Q

medication for mild to moderate alzheimers

A

acetylcholinesterase inhibitors eg donzepil, galantamine, rivastigmine

132
Q

second line for alzheimers if not tolerate AChE inhibitors

A

memantine

133
Q

first line for lewy body dementia

A

donepezil or rivastigmine

134
Q

patients with frontotemporal dementia should NOT be offered

A

AChE inhibitors or memantine

135
Q

acetylcholinesterase inhinitors and antimuscarinics (tricyclic antidepressants) can cause what side effect

A

constipation, dry mouth ,urine retention

136
Q

depression definitions

A

at least 5 out of 8 symptoms during the same 2 week period where at least one of the symptoms is depressed mood or loss of interest or pleasure

137
Q

chronic depression defined as having an episode for at least

A

2 years

138
Q

what gender is a rf for depression

A

female

139
Q

what do PHQ-9 and HADS stand for

A

Patient Health Questionnaire 9 and Hospital Anxiety and depression scale

140
Q

what drugs should you avoid in depression due to their risk of death in overdose

A

Tricylics (except for lofepramine) and venlafaxine

141
Q

symptoms of what may strat when taking an antidepressant

A

anxiety ,agitation, hoplessness or suicidal ideas

142
Q

antidepressatns usually start to work within how many weeks

A

4 weeks

143
Q

antidepressants may be needed for how long after symptoms stop to reduce the risk of relapse

A

6 months

144
Q

usually after starting an antidepressant you review in 2 weeks when do you review after 1

A

if 18-25 or particular risk of suicide

145
Q

if already on NSAID, warfarin or aspirin a good antidepressant is

A

Mirtazapine

146
Q

how should antidepressants be prescribed

A

prescribe the starting dose of an antidepressant and titrate up to the recognzed minimum effective dose

147
Q

what antidepressants have the highest risk in overdose

A

tricyclic antidepressants and MAOis

148
Q

what tricyclic has partiuclar risk in overdose

A

dosulepin whereas lofepramine has relatively low toxicity

149
Q

when to not prescribe SSRI

A

manic phase of bipolar

150
Q

when to not prescribe SNRI

A

uncontrolled hypertension

151
Q

very common side effect od SSRIs

A

insomnia

152
Q

scales can use for postnatal depression

A

EDPS or PHQ-9

153
Q

if depressed woman becomes pregnant what not to si

A

stop antidepressants abruptly

154
Q

what is the most common mental health disorder in children and young people

A

depression

155
Q

how often should young person be seen after commencement of fluoxetine for depression

A

weekly contact for the first 4 weeks

156
Q

treatment for fluxoetine in children should be continued for how long after remission

A

at least 6 months

157
Q

when should fluxoetine not be given to children with depression

A

if got poorly controlled epilepsy

158
Q

domestic abuse defined if both people are over what age

A

16

159
Q

what kind of eating disorders are the most commmon

A

atypical- closely resemble then main ones but do not meet diagnostic criteria

160
Q

bulimia nervosa defined as

A

at least once per week for 3 months!!! flashcard is wrong

161
Q

satiety related hormones

A

adiponectin and ghrelin

162
Q

low weight in anorexia is typically below

A

18.5

163
Q

SCOFF questionnaire can be used for

A

anorexia or bulimia

164
Q

raised ESR can indicate what in someone with weight loss

A

an orgnaic cause as it is usuall normal in anorexia

165
Q

what is suggestive of vimiting or laxative absue

A

hypokalaemia

166
Q

generalised anxiety needs to be present for how long

A

6 months

167
Q

what assessmnet tools can be used for GAD

A

GAd 2 and GAD 7

168
Q

first line for GAD

A

SSRI

169
Q

second line for GAD

A

SNRI

170
Q

3rd line for GAD

A

pregablin

171
Q

The SSRIs most commonly prescribed in the Uk for GAD are

A

sertaline, paroxetine and escitalopram (last 2 are licensed)

172
Q

SNRIs that can be given for GAD are

A

duloxetine and venlafaxine

173
Q

most common adverse effect of diazepam relate to

A

its sedative effect

174
Q

options for drugs for OCD

A

SSRI or clomipramine

175
Q

5 SSRIs licensed for OCD

A

escitalopram
fluoxetine
fluvoxamine
paroxetine
sertraline

176
Q

person under 18 with OCD should only be prscribed an SSRI following

A

assessment and diagnosis by a psychiatrist

177
Q

what can you not give to those under 18 with OCD

A

clomipramine

178
Q

example of an opiod

A

heroin

179
Q

symptoms of opiod intoxication

A

constriction of pupils, itching and stractching, low blood pressure and pulse

180
Q

acute opiod withdrawl symptoms

A

watering eyes, rhinorrhoea, dilated pupils

181
Q

want to vaccinate all drug users against what

A

hep A and B

182
Q

what is a drug that is licensed for the symptoms of opiod withdrawl

A

lofexidine

183
Q

what out of methadone and buprenorphine is only a partial agonist

A

buprenorphine

184
Q

common side effect of buprenorphine is

A

anxiety

185
Q

what are not recommened in opiod dependance

A

methadone tablets

186
Q

what is the form that methadone is recommended

A

ORAL SOLUTION

187
Q

what is the most characterstic symptom of PTSD

A

re-experiencign symptoms - flashbacks or nightmares

188
Q

adverse effects with a SSRI or SNRI early in treatment may be

A

increased anxiety, agitation and sleeping problems

189
Q

drugs that can give for pTSD

A

venlaxafine or SSRI

190
Q

what SSRIs are licensed for PTSD

A

paroxetine and sertaline

191
Q

contraindication of SNRI if

A

uncontrolled hypertesnion, with MAOI

192
Q

one unit of alchol is defined as

A

10ml of pure ethanol

193
Q

one unit of alcohol is roughly equal to half a pint of beer, small measure of spirit, standard measure of wine

A
194
Q

what bloods are abnormal in alcholol problem

A

gamma glutamyl transferase(GGT) and Mean corpuscular volume (MCV)

195
Q

signs of an alcohol problem

A

dilated ffacial capillaries, bloodshot eyes, hand tremor

196
Q

signs of wernickes encephalopathy

A

ataxia, opthalmoplegia, nystagmus, acute confusion

197
Q

treatement of wernickes encephalopathy

A

parenteral thiamine

198
Q

acamprosate is a drug that can be given for what

A

alcohol problems

199
Q

examples of positive symptoms

A

thought disturbance, delusions, hallucinations

200
Q

a medical condition that can cause schozophrenia

A

sepsis

201
Q

what can cause schizhophrenia

A

certain medicines, susbstance misuse and some medical conditions

202
Q

what can precede the development of a psychotic disorder

A

emotional diturbance

203
Q

when should an antipsychotic not be given unless under advice from a consultant psychiatrist

A

not be given to the person while awaiting specialist assessment

204
Q

what is a delusion of reference

A

the belief that ordinary evetns, objects or the behaviour of others has a meaning specifically for the person for example that people on the radio are talking to or about them eg refering to them

205
Q

what is delusion of persecution

A

belief that other people are plotting against the person

206
Q

schizhoprehnia symptoms need to be present most fo the time for how long

A

1 month

207
Q

prescribed drugs that can cause psychosis

A

anticonvulsants, high dose corticosteriods, levodopa, dopamine agonists or opiods

208
Q

what symptoms should you be asking in a psychosis review particularly if they are taking a first generation antipsychotic or risperidone

A

riased prolactin so low libido, sexual dysfunction, menstrual abnormalities , galactorrhoea

209
Q

people taking what antipsychotic are managed exclusively in secondary care

A

clozapine

210
Q

clozapine can cause

A

neutropenia or agranulocytosis

211
Q

what monitoring is needed for those on clozapine

A

FBC weekly for 18 weeks after treatment then every 2 weeks for the next 18 weeks and then every 4 weeks after

212
Q

antipsychtocics increase the QT interval what other drugs also do and so makes it even more of something to watch

A

erythromycin, co-trimoxazole, pregablin

213
Q

these blood tests are performed at what:
fasting glucose HbA1c, lipid profile, U&Es, FBC, LFTs, Prolactin

A

psychosis review

214
Q

breastfeeding is fine on an antipsychotic except for

A

clozapine

215
Q

difference in action of first and second gen antipsychotics

A

first - primarily exert effecting by blocking dopamine 2 receptors in the brain
2nd gen - act on range of recepetors

216
Q

what gen antipschotics are associated with lower extra pyramidal symptoms

A

second gen - atypical

217
Q

even though second gen antipsychotics are associated less so with extra pyramidal symptoms what other important adverse affects are they associated with

A

weight gain, glucose intolerance and hyperprolactinaemia

218
Q

these are: Benperidol

Chlorpromazine

Flupentixol

Haloperidol

Levomepromazine

Pericyazine

Perphenazine

Pimozide

Prochlorperazine

Promazine

Sulpiride

Trifluoperazine

Zuclopenthixol

A

typical

219
Q

the atypical antipsychotics are

A

Amisulpride

Aripiprazole

Clozapine

Olanzapine

Paliperidone

Quetiapine

Risperidone

220
Q

examples of extrapyramidal symptoms caused by antipsychotics

A

Dystonic reactions (abnormal movements of the face and body), and pseudoparkinsonism (tremor, bradykinesia, and rigidity) — these can be alleviated by antimuscarinic drugs, such as procyclidine (should not be prescribed routinely).
Akathisia (motor restlessness) — can often be relieved by reducing the dose of the antipsychotic.
Tardive dyskinesia — late-onset movement disorder that can occur with prolonged use of antipsychotics. It is characterized by rhythmical, involuntary movements, usually lip-smacking and tongue rotating, although it can affect the limbs and trunk. It may be persistent and can sometimes worsen on treatment withdrawal. The drug should be discontinued on appearance of early signs.

221
Q

weight gain is common with all antipsychtoics but more frequent in

A

second gen especailly clozapine and olanzapien

222
Q

photosensitivity is common with what antipsychotic

A

chlorpromazine

223
Q

what antipsychotics are associated with increased risk in eldelry with demntia

A

olanzapine and risperidone

224
Q

sedation and dyslipidaemia are side effects of that

A

antipsychotics

225
Q

antipsychotics have an an hypotensive effect so what drugs increase thsi

A

antihypertensives

226
Q

do not drink grapefruit jucie with what antipsychotic

A

pimozide

227
Q

what reduces plasma levels of clozapine, haloperidol and risperidone by half

A

carbamazepine

228
Q

some ssris can

A

increase levels of some antipsychoticsx

229
Q

how long should a psychotic disorder patient be responsibility of the secondary care team

A

for first 12 months or unitil their condition is stabilized (whichever is longer)

230
Q

how often should BMI be measured after antipsychoticc

A

weekly for first 6 weeks then at 3 motnhs then every 12 motnths

231
Q

what are gamma-aminobutyric acid (GABA) receptor agonists which have hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties

A

benzodiazepines

232
Q

what are z drugs

A

non-benzodiazepine hypnotics, developed with the intention of overcoming some of the adverse effects of benzodiazepines

233
Q

the 2 Z drugs available in the UK

A

zolpidem and zopiclone

234
Q

anxiolytics means

A

alleviating anxiety states

235
Q

2 approaches for stop benzopdiazepines or z drugs

A

The two potential approaches for withdrawal are slow dose reduction of the person’s current benzodiazepine or z-drug, or switching to an approximately equivalent dose of diazepam, which is then tapered down.

236
Q

why is switching to diazepam an option for stopping benzodiazeipines

A

i think it migght be easier to allow for small reduction in dose - not 100% sure though

237
Q

do not prescribe diazepam if got

A

acute porphyria is one example

238
Q
A

YEAR 3 NICE (14 decks)

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