Psychiatry Flashcards
What are the components of the MSE?
ABS/MAT/PCI
Appearance & Behaviour
Speech
Mood& Affect
Thoughs
Perception
Cognition
Insight
What are the two classification systems used in psychiatry?
Which is used in the UK?
DSM-IV and the ICD-10
ICD-10 is used in the UK (Americans can’t count to 10…)
Give some examples of SSRIs
What are some of the side effects associated with this class of anti-depressant?
Fluoxetine
Sertraline
Citalopram
Escitalopram
Paroxetine
Largely safe, but some can exhibit discontinuation effects due to having a longer half-life
Other side effects include nausea, vomiting, diarrhoea, agitation/restlessness, insomnia, sexual dysfunction, hyponatraemia (especially important in elderly)
How are SSRIs metabolised?
In the liver, via Cytochrome P450 (Phase i metabolism)
Give some examples of SNRIs
What are some of the associated side effects?
Venlafaxine
Duloxetine
Largely similar side effect profile to SSRIs
Also dose-related increase in BP
Can cause seizures in overdose
To be avoided with alcohol or those with established liver disease
What is one of the other recognised uses of Duloxetine?
Useful in treating neuropathic or MSK pain
Give some examples of noradrenaline reuptake inhibitors (NARIs)
How does the efficacy of NARIs compare to SSRIs and SNRIs?
What are some of the associated side effects of NARIs?
Reboxetine
Lofepramine (TCA)
NARIs are less effective than SSRIs/SNRIs
Side effects include excessive sweating, postural hypotension and insomnia
What family of anti-depressants does mirtazapine fall under?
How is this drug often given?
What are some of the associated side effects of mirtazapine?
Mirtazapine is an alpha-2 adrenoreceptor antagonist
Often given in combination with another antidepressant, such as an SSRI to manage treatment-resistant depression
Associated side effects include increased appetite and weight gain, and sedation
