Brainscape's Knowledge GenomeTM

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


See full index

Flash Facts > psychiatry > Flashcards

psychiatry Flashcards

1
Q

important side effects of high potency typical antipsychotic drugs

A

EPS extrapyramidal symotoms

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

Low potency typical antipsychotic have propensity to cause what side effects

A

anticholinergic –dry mouth constipation
antihistaminic – sedation
alpha1 blockade—orthostatic hypotension

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

neuroleptic – ie antipsychotics cause what types of extrapyramidal symptoms

A
  1. within hours to 5 days — acute dystonia torticollis oculogyric crisis and opisthotonic crisis
  2. within days or months— akathisia restlessness and parkinsonism ie bradykinesia
  3. over several years– related to length of treatment is tardive dyskinesia–esp orofacial chorea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

treatment of acute dystonia from neuroleptics

A

Antihistaminics with anticholinergic effects – diphenhydramina
benztropine

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

treatment of Akathisia

A

beta blockers
benztropine
benzodiazepines

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

treatment of drug induced parkinsonism

A

benztropine

if not in options tick amantadine

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

treatment of tardive dyskinesia

A

switch to atypical antipsychotics —clozapine
velbenazine (VMAT 2 inhibitor)
deu-tetra-benazine (VMAT 2 inhibitor)

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

difference between neuroleptic malignant syndrome and serotonin syndrome

A

both will have autonomic instablility – vitals are unstable and AMS
but hyperreflexia and clonus is seen with serotonin syndrome
dystonias like rigidity is seen with neuroleptics

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

antidote for serotonin syndrome

A

cyproheptadine— 5HT2 receptor antagonism

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

antidote for neuroleptic malignant syndrome

Neuroleptics cause D2 blockade– increases cAMP

A

dantrolene (RYR receptor blockade on sarcoplasmic reticulum)
Bromocriptine – dopamine agonist
remove the antipsychotic drug / discontinue it

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

drugs causing DRESS syndrome and SJS are similar they are

A

anticonvulsants
sulfa drugs -sulfasalazine
allopurinol
penicillin antibiotics- minocycline / amoxicillin vancomycin

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

drug induced ANCA vasculitis is seen with

A

hyperthyroidism drugs – PTU and methimazole

Hydralazine (vasodilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
drug started
after 2- 8 weeks there is fever, generalised lymphadenopathy 
rash ---erythematous morbilliform rash
facial edema 
EOSINOPHILIA
A

DRESS— drug reaction with eosinophilia and systemic symptoms
Cause is drug induced herpes virus reactivation –>Tcell clonal expansion which cross reacts with drug.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ophthalmic side effect of chlorpromazine antipsychotic

A

corneal deposits

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

OPh side effect of thioridazine antipsychotic

A

retinal deposits

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

5 important facts about clozapine –atypical antipsychotic

A

used in treatment resistant schizophrenia and suicidality in schizophrenia
causes obesity agranulocytosis and seizures
need to monitor BM and WBC counts strictly.

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

lithium toxicity would cause which symptoms

A

tremors– slurred speech hyperreflexia ataxia
seizures
excessive urination — nephrogenic diabetes inspidus

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

treament of lithium toxicity

A

no antidote–
normal saline and hemodialysis because lithium toxicity is usually seen with renal failure pts and lithium is primarily excreted by kidneys.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does kidney handles lithium

A

100 percent filtrered
near completely re absorbed by PCT via sodium channels
thiazides NSAIDS and other drugs affecting kidneys are implicated in lithium toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

drugs acting on NE neurons causing inhibition of NE reuptake

A

SNRI
TCA
bupro-prion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

drugs acting on Serotonergic neurons – inhibiting the serotonin reuptake are

A 
SSRI and SNRI
TCA 
trazodone (weak)
vilazodone
vorti-oxetine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the main mechanism of action of trazodone

A

trazodone is atypical antidepressant with sedative action
blocks 5HT2,
blocks alpha 1 adrenergic (postural hypotension and priapism) and H1 receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

in NE neurons there is an autoreceptor in presynaptic membrane which detects the NE In synaptic cleft and inhibits further release of vesicle fusion. What class is that autoreceptor

A

Alpha 2 adrengergic

24
Q

if alpha 2 adrenergic receptor which is an autoreceptor in presynaptic membrane is inhibited it causes what effect.
which drug acts on it

A

if autoreceptor is inhibited it increases the NE release.
MIRTAZAPINE is one suc alpha 2 autoreceptor blocker
and is used as atypical antidepressant

25
Q

receptors on which mirtazapine acts

A

Alpha 2 blockade- hence NE and serotonin release increases (hence used in depression)
potent 5HT2 and 5HT3 antagonists
Histamine H1 antganonist (hence sedation is SE).

26
Q

name the SNRI ones to remember

A

Venlafaxine
duloxetine
milna-cipran

27
Q

what is the non psychiatric uses of milnacipran or duloxetine

A

fibromyalgia

28
Q

name the TCAs

A

amitriptyline - nortryptyline
imipramine - desipramine- clomipramine
doxepin-amoxapine

29
Q

treatment of TCA toxicity

A

TCA toxicity is fatal due to arrhythmias because of prolonged QT interval from sodium channel inhibition. Treatment is Sodium bicarbonate

30
Q

Olanzapine is used to treat which eating disorder

A

Anorexia nervosa

31
Q

Doc for bedwetting noturnal enuresis

A

Desmopressin

Imipramine

32
Q

Which anti psychotic causes ejaculatory disturbances

A

Thioridazone

33
Q

Drugs for alcohol use disorder

A

Disulfiram
Naltrexone
Acamprosate
Gabapentin topiramate

34
Q

Which two drugs which lower seizure threshold are not given to a person with alcoholism

A

Haloperidol

Buproprion

35
Q

Repititive outburst with irrational behaviour throughout the day in a child

A

Dmdd

Dysruptive mood dysregulation disorder

36
Q

Sjs/ Ten rash causing anticonvulsant drugs

A

Lamotrigine
CBZ
PHENOBARBITAL
PHENYTOIN

37
Q

Two mechanisms by which nimedipine a selective CCB is neuroprotective in SAH

A

prevents vasospasm by causing cerebral vasodilatation

Decreases calcium mediated excitotoxicity

38
Q

A very important adv reaction of succinyl choline in patients with burns crush injury denervation like GBS or quadriplegia is

A

Hyperkalemia and later arythmias
Because succinylcholine causes prolonged blockade due to increase in number of nAChR in these patients

Rhabdomyolysis may occur also contributing to hyperkalemia
ach receptor is non specific for ion allows sodium in and k out

39
Q

Important side effect of atracurium

A

It releases histamine— hence hypotension flushing and bronchoconstriction

Its metabolite laudanosine causes seizures

40
Q

Four important uses of diazepam

A

Anxiolytic in GAD or panic attacks
Sedative hyponotic for short term insomnia treatment
As anticonvulsant in status epilepticus or as first line with chlordiazepoxide for seizures in alcohol withdrawl
Or as muscle relaxant to relieve umn spasticity in stroke pts and tetanus

41
Q

Benzodiazepines as a class should not be give with which other drugs

A

Barbiturates— excessive cns depression

Alcohol

Gen 1 antihistaminics— sedation

Neuroleptics

42
Q 
Name the condition
Pt has unpleasant sensation in legs
Urge to move them which releases tht sensation
Worst at night
So pts usually have sleep onset insomnia
A

Restless leg syndrome

43
Q

causes of restless leg syndrome are

A

Idiopathic or iron deficiency
Uremia
Diabetes esp with neuropathy

44
Q

What is the treatment of restless leg syndrome

A

Avoiding alcohol or sleep deprivation

Dopamine agonists like pramipexole
Gabapentin pregabalin

45
Q

Pathology for restless leg syndrome

A

Cns iron def even though serum iron is normal

Abnormalities in dopaminergic transmission

46
Q

Name the drugs inducing restless leg syndrome

Why

A

The following drugs interfere with brain dopaminergic transmission and hence cause worsening of rls symptoms

Dopamine antagonists—antipsychotics and antiemetics like metoclopramide
First gen antihistaminics- diphenhydramine
Antidepressants—like ssri and mirtazapine

47
Q

Spasticity in cerebral palsy is because of

A

Loss of descending inhibitory control

Hence there is hyperreflexia clonus

48
Q

Spasticity in cerebral palsy is treated with

A

Drugs that increase Gaba inhibitory neurotransmittor

Bzd acts via gaba A receptor which is fast because it is a chloride channel

Baclofen acts via GABA b which is slow because it is a gpcr opening potassium channels

49
Q

What is glycine in neurology

A

It is a inhibitory neurotranmitter in spinal cord rather than brain

50
Q

Blockage of glycine receptors is seen in

A

Strychnine poisoning leading to increased muscle contraction

51
Q

Name three drugs for ga induction

A

Propofol- shud not be used in cvs collapse pts

Etomidate— cvs neutral but shud not be used used in septic shock because of adrenocortical suppression

Ketamine—has sympathomimetic effects— helps respiratory failure pts but can cause cvs risk and raised ict

52
Q

Mechanism of action of three ga inducers

A

Propofol and etomidate are gaba agonists

Ketamine is nmda antagonist

Of these only propofol is highly lipophillic hence used for long term sedation, causes elevated triglycerides and lipase

53
Q

Opiates act on meu receptors.

What is is effect at presynaptic membrane

A

Meu receptors are transmem receptors linked to inhibitory G proteins
Results in closure of calcium channels and hence reduced calcium influx which is needed for vesicular fusion and release

Hence it reduces release of excitatory neurotransmittors like Ach, norepinephrine, serotonin, glutamate and substance P

54
Q

Opiates act on meu receptors in post synaptic membrane as well. What are its effects there

A

Hyperpolarisation

Because of opening of potassium channels and outflux of potassium ions

55
Q

Levels of action of opiates

A

Spinal as well as supraspinal in brain to produce analgesia

At cord it acts at both presynaptic and post synaptic membrane but effects are different

56
Q

Most serious side effect of clozapine is

A

Agranulocytosis

Seizures

57
Q

Gingival hyperplasia is a side effect of which drug

A

Phenytoin
Because it increases expression of platelet derived growth factor
Gingival macrophages get activated because of PDGF and cause gingival and bone hyperplasia

Flash Facts (23 decks)

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