Psychiatry Flashcards
Which drug classes do the following drugs belong to?
- citalopram
- duloxetine
- venlafaxine
- reboxetine
- mirtazepine
- amitryptiline
- phenelzine
- moclobemide
- SSRI
- SNRI
- SNRI
- Selective noradrenaline reuptake inhibitor
- presynaptic alpha 2 adrenoreceptor blocker
- TCA
- MAOI
- reversible inhibitor of Monoamine oxidase A
- What is the MOA of SSRIs?
- Name some side effects of SSRI treatment
- How long should SSRIs be continued?
- inhibit presynaptic 5-HT reuptake
- 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 - at least 6 months following remission
In which patient group are SNRIs contraindicated?
elderly
Name common adverse effects of reboxetine
- insomnia
- dizziness
- dry mouth
- constipation
- nausea
- excessive sweating
- what is the MOA of mirtazepine?
- name some common adverse effects of mirtazepine
- in what patient group is mirtazepine contraindicated?
- antagonist of pre-synaptic alpha2 adrenoreceptors. Thought to lead to enhanced noradrenergic and serotinergic activity
- GI upset, headache, insomnia, abnormal dreams, confusion, convulsions
- elderly
- Name 2 indications of TCAs
- What is the MOA of TCAs
- What side effects are common?
- second line treatment for moderate to severe depression
neuropathic pain - 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
Name 4 conttaindications of Phenylzine
- phaochromocytoma
- congestive heart failure
- kidney disease
- hepatic impairment
What type of side effects are common with the use of MAOI and reversible inhibitors of monoamine oxidase A?
antimuscarinic side effects
Name side effects of lithium therapy
- GI side effects
- tremor
- thyroid enlargement and hypothyroidism
- weight gain
- hair loss
Why is it important to monitor renal function in patients undergoing lithium therapy?
- eliminated unchanged by the kidney
- prolonged treatment can cause renal tubular damage
- inhibits ADH
- promote aldosterone secretion
Which other drugs interract with lithium?
- diuretics
- ACE/ARBs
- NSAIDs
Name 3 anticonvulsants used in the management of bipolar disorder
- Sodium valproate
- Carbamazepine
- Lamotrigine
Name 2 reasons why cautions must be taken when using anticonvulsants in the treatment of bipolar disorder
- teratogenic
- Interfere with CYP450 enzymes
- carbamazepine is an inducer
- valproate is an inhibitor
Name 4 conventional antipsychotics
- chlorpromazine
- haloperidol
- sulpiride
- flupentixol
Name 5 atypical antipsychotics
- aripiprazole
- clozipine
- olanzipine
- quetiepine
- risperidone
Name 6 side effects which are associated with antipsychotic therapy
- extrapyramidal side effects
- sedation
- antimuscarinic side effects
- orthostatic hypotension
- weight gain
- prolactin elevation
Name 8 parameters which should be monitored in patients undergoing antipsychotic treatment
- FBC
- U&E
- LFT
- Blood lipids
- Weight
- Blood glucose
- BP
- ECG
- What drug is indicated first line for generalised anxiety disorders
- which drugs are indicated for Acute stress reactions/PTSD?
- sertraline
2. paroxetine or mirtazepine
When are benzodiazepines indicated for anxiety disorders?
short term relief of anxiety that is severe, disabling, or causing the patient unacceptable distress
- Which drug is used first line for rapid tranquilisation?
- 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)
- lorazepam
2. olanzapine, haloperidol, promethazine
What parameters need to be monitored after a patient has undergone parenteral rapid tranquillisation?
- temperature
- pulse
- BP
- hydration status
- resp rate
- level of conscuousness
Name 2 drugs used in patients undergoing alcohol withdrawal
- pabrinex
2. chlordiazepoxide
What is the MOA of methedone and buprenorphine?
opioid agonists. Block the acute effects of other opioids
What is naltrexone?
Opioid antagonist
- In which patients in naltrexone recommended?
- How does it work?
- What should patients be advised of?
- detoxified formerly opioid dependent people who are highly motivated to remain in an abstinence programme.
- decreases cravings for opioids and decreases risk of overdose
- resuming opioid use after discontinuation of antagonist therapy is associated with risk of overdose, due to loss of tolerance to opioids
