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Pharmacology > Psychiatry > Flashcards

Psychiatry Flashcards

0
Q

SSRIs pharmacokinetics

A

Almost completely absorbed from gut
Metabolised in liver
Long T1/2 so once daily

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1
Q

SSRIs uses

A

First line for moderate to severe depression

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2
Q

SSRIs ADRs

A 
Anorexia, nausea and diarrhoea 
Mania
Suicidal ideation
Tremor
Extrapyramidal syndromes 
Reasonably safe in overdose
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3
Q

Fluoxetine

A

Prozac

SSRI

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4
Q

Citalopram

A

SSRI
Most selective
Anxiolytic effect but can cause more sedation

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5
Q

Paroxetine

A

Most potent

SSRI

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6
Q

Sertraline

A

SSRI

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7
Q

Tricyclics

A

First generation antidepressants

Still used but not first or second line

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8
Q

Tricyclics mechanism

A

Inhibit NA reuptake
Muscarinic receptor blockade
Alpha 1 adrenoceptor blockade

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9
Q

Tricyclics pharmacokinetics

A

Lipid soluble
Absorbed from gut
Long half life
Liver metabolism

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10
Q

Tricyclics ADRs

A 
Sedation
Psychomotor performance impairment
Lowered seizure threshold 
Reduced glandular secretion
Eye accommodation block 
Tachycardia
Postural hypotension
Impaired myocardial contractility
Overdose leads to cardiac death 
Constipation
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11
Q

SNRIs

A

SSRIs with the property of Na uptake inhibitors grafted on

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12
Q

Amitryptiline

A

Tricyclic

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13
Q

Imipramine

A

Tricyclic

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14
Q

Clomipramine

A

Tricyclic

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15
Q

Lofrepramine

A

Tricyclic

16
Q

Venlafaxine

A

SNRI

17
Q

Duloxetine

A

SNRI

Urinary incontinence

18
Q

SNRIs pharmacokinetics

A

Short half life - may have withdrawal syndrome

19
Q

Olanzapine

A

Atypical antipsychotic

20
Q

Risperidone

A

Atypical antipsychotic

21
Q

Quetiapine

A

Atypical antipsychotic

22
Q

Clozapine

A

Atypical antipsychotic

ADR: agranulocytosis

23
Q

Atypical antipsychotics actions

A

Sedation within hours
Tranquilisation within hours
Antipsychotic takes several days to weeks
Negative symptom improved within weeks

24
Q

Atypical antipsychotic ADRs

A 
Sedation
Extrapyramidal 
Weight gain (Olanzapine) 
Increased prolactin (Risperidone) 
Long QT syndrome
25
Q

Typical antipsychotic actions

A

Dopamine receptor blockade
Anticholinergic
Alpha blockade
Antihistamine

26
Q

Haloperidol

A

Typical antipsychotic

Safe in emergencies

27
Q

Chlorpromazine

A

Typical antipsychotic

28
Q

Typical antipsychotic ADRs

A 
Extra pyramidal
More sedation
CNS depression
Weight gain
Prolactin
Pigmentation 
Long QT
Postural hypotension 
Neuroleptic malignant syndrome
29
Q

Anxiety management

A 
CBT is first line 
SSRIs or SNRIs
Anxiolytics 
Occaisionally antipsychotics
Not benzodiazepines unless need to sedate in emergency
30
Q

Benzodiazepine action

A

Enhance GABA mediated inhibition

31
Q

Mood stabilisers

A 
Lithium
Sodium valproate
Carbamazepine 
Lamotrigine 
Antipsychotics
32
Q

Lithium pharmacology

A

Renal excretion
Slow release preparation given once daily
Levels need monitoring
Monitor kidney and thyroid function

33
Q

Lithium uses

A

Prophylaxis of mania and depression in bipolar
Augmentation of antidepressants in unipolar
Reduces suicidality
Best evidence of all mood stabilisers

34
Q

Lithium ADRs

A 
Memory problems
Thirst
Tremor
Drowsiness
Weight gain
Kidneys
Thyroid
Hair loss 
Rash
35
Q

Lithium toxicity

A 
Narrow therapeutic window 
Tremor, dysarthria, agitation
Give anticonvulsants and fluids 
Vomiting, diarrhoea 
Long term use can effect kidney and thyroid function

Pharmacology (20 decks)

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