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Phase 2 Y3 PPT > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Which drug classes do the following drugs belong to?

  1. citalopram
  2. duloxetine
  3. venlafaxine
  4. reboxetine
  5. mirtazepine
  6. amitryptiline
  7. phenelzine
  8. moclobemide
A
  1. SSRI
  2. SNRI
  3. SNRI
  4. Selective noradrenaline reuptake inhibitor
  5. presynaptic alpha 2 adrenoreceptor blocker
  6. TCA
  7. MAOI
  8. reversible inhibitor of Monoamine oxidase A
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2
Q
  1. What is the MOA of SSRIs?
  2. Name some side effects of SSRI treatment
  3. How long should SSRIs be continued?
A
  1. inhibit presynaptic 5-HT reuptake
  2. GI effects
    sexual dysfunction
    SIADH
    anorexia with weight loss
    reduced convulsive threshold
    sudden withdrawal syndrome after long term use
    increased suicidal ideation in patients under 25
  3. at least 6 months following remission
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3
Q

In which patient group are SNRIs contraindicated?

A

elderly

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4
Q

Name common adverse effects of reboxetine

A
  • insomnia
  • dizziness
  • dry mouth
  • constipation
  • nausea
  • excessive sweating
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5
Q
  1. what is the MOA of mirtazepine?
  2. name some common adverse effects of mirtazepine
  3. in what patient group is mirtazepine contraindicated?
A
  1. antagonist of pre-synaptic alpha2 adrenoreceptors. Thought to lead to enhanced noradrenergic and serotinergic activity
  2. GI upset, headache, insomnia, abnormal dreams, confusion, convulsions
  3. elderly
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6
Q
  1. Name 2 indications of TCAs
  2. What is the MOA of TCAs
  3. What side effects are common?
A
  1. second line treatment for moderate to severe depression
    neuropathic pain
  2. inhibits neuronal uptake of serotonin and NA (but also antagonises a variety of other receptors)
3. antimuscarinic side effects
    sedation
    hypotension
    convulsions
    hallucinations and mania
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7
Q

Name 4 conttaindications of Phenylzine

A
  1. phaochromocytoma
  2. congestive heart failure
  3. kidney disease
  4. hepatic impairment
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8
Q

What type of side effects are common with the use of MAOI and reversible inhibitors of monoamine oxidase A?

A

antimuscarinic side effects

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9
Q

Name side effects of lithium therapy

A
  1. GI side effects
  2. tremor
  3. thyroid enlargement and hypothyroidism
  4. weight gain
  5. hair loss
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10
Q

Why is it important to monitor renal function in patients undergoing lithium therapy?

A
  1. eliminated unchanged by the kidney
  2. prolonged treatment can cause renal tubular damage
  3. inhibits ADH
  4. promote aldosterone secretion
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11
Q

Which other drugs interract with lithium?

A
  • diuretics
  • ACE/ARBs
  • NSAIDs
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12
Q

Name 3 anticonvulsants used in the management of bipolar disorder

A
  • Sodium valproate
  • Carbamazepine
  • Lamotrigine
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13
Q

Name 2 reasons why cautions must be taken when using anticonvulsants in the treatment of bipolar disorder

A
  • teratogenic
  • Interfere with CYP450 enzymes
    • carbamazepine is an inducer
    • valproate is an inhibitor
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14
Q

Name 4 conventional antipsychotics

A
  • chlorpromazine
  • haloperidol
  • sulpiride
  • flupentixol
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15
Q

Name 5 atypical antipsychotics

A
  • aripiprazole
  • clozipine
  • olanzipine
  • quetiepine
  • risperidone
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16
Q

Name 6 side effects which are associated with antipsychotic therapy

A
  • extrapyramidal side effects
  • sedation
  • antimuscarinic side effects
  • orthostatic hypotension
  • weight gain
  • prolactin elevation
17
Q

Name 8 parameters which should be monitored in patients undergoing antipsychotic treatment

A
  1. FBC
  2. U&E
  3. LFT
  4. Blood lipids
  5. Weight
  6. Blood glucose
  7. BP
  8. ECG
18
Q
  1. What drug is indicated first line for generalised anxiety disorders
  2. which drugs are indicated for Acute stress reactions/PTSD?
A
  1. sertraline

2. paroxetine or mirtazepine

19
Q

When are benzodiazepines indicated for anxiety disorders?

A

short term relief of anxiety that is severe, disabling, or causing the patient unacceptable distress

20
Q
  1. Which drug is used first line for rapid tranquilisation?
  2. Which drugs are indicated if the patient has a known and confirmed hx of antipsychotic drug use or does not respond to drug 1 after 1 hour? (3)
A
  1. lorazepam

2. olanzapine, haloperidol, promethazine

21
Q

What parameters need to be monitored after a patient has undergone parenteral rapid tranquillisation?

A
  • temperature
  • pulse
  • BP
  • hydration status
  • resp rate
  • level of conscuousness
22
Q

Name 2 drugs used in patients undergoing alcohol withdrawal

A
  1. pabrinex

2. chlordiazepoxide

23
Q

What is the MOA of methedone and buprenorphine?

A

opioid agonists. Block the acute effects of other opioids

24
Q

What is naltrexone?

A

Opioid antagonist

25
Q
  1. In which patients in naltrexone recommended?
  2. How does it work?
  3. What should patients be advised of?
A
  1. detoxified formerly opioid dependent people who are highly motivated to remain in an abstinence programme.
  2. decreases cravings for opioids and decreases risk of overdose
  3. resuming opioid use after discontinuation of antagonist therapy is associated with risk of overdose, due to loss of tolerance to opioids

Phase 2 Y3 PPT (8 decks)

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