Psychiatry drugs

Question 1

Which type of benzodiazepines are associated with dependence and withdrawal?

Answer 1

high potency bentos and those assoc. with short half-lives

Question 2

Give examples of benzos with short half-lives.

Answer 2

lorazepam, temazepam, lormetazpenam

Question 3

Give examples of long acting benzos.

Answer 3

diazepam, chlordiazepoxide, alprazolam, clonazepam

Question 4

Describe the pharmacokinetics of benzodiazepines.

Answer 4

rapidly absorbed
strongly bound to plasma proteins & are lipophilic so pass BBB easily.
metabolised into large no. of compounds - excreted mainly as conjugates in urine

Question 5

An overdose of benzodiazepines depresses the respiratory system and CNS.
T/F?

Answer 5

false
barbiturates do but benzos do not.
hence why patients tend to recover from overdoses.

Question 6

List the symptoms of benzodiazepine withdrawal syndrome.

Answer 6

apprehension, anxiety, insomnia.
tremor
nausea
heightened sensitivity to perceptual stimuli and disturbances.
depression & suicidal thinking

Question 7

Benzo withdrawal syndrome can resemble anxiety disorder - how can you differentiate the two?

Answer 7

perceptual disturbances are more likely to indicate benzodiazepine withdrawal

Question 8

How soon do withdrawal symptoms start after stopping a short-acting benzodiazepine?

Answer 8

within 2-3 days

Question 9

How soon do withdrawal symptoms start after stopping a long-acting benzodiazepine?

Answer 9

within a week

Question 10

How long do withdrawal symptoms last for?

Answer 10

3-10 days

Question 11

What type of antipsychotic is chlorpromazine and how does it work?

Answer 11

typical antipsychotic (phenothiazine)
antagonises a1-adrenoceptors, histamine H1-receptors, and muscarinic cholinergic receptors.

Question 12

blockade of a1 and H1 receptors results in what side-effect profile?

Answer 12

sedative profile of chlorpromazine

Question 13

which receptors do atypical antipsychotics tend to antagonise?

Answer 13

5-HT2 and D2 receptors

Question 14

Describe the action of risperidone.

Answer 14

potent antagonist of 5-HT2 and D2; also blocks a1-adrenoceptors (sedation & hypotension)

Question 15

Which atypical antipsychotic has a weaker D2 receptor effect than risperidone but has anticholinergic and H1-receptor blocking activity - giving it strong sedating effects?

Answer 15

olanzapine

Question 16

Describe the action of aripiprazole.

Answer 16

partial dopamine agonist with 5-HT2 receptor blocking and 5-HT1A agonist properties

Question 17

Aripiprazole is less likely to cause weight gain or significant extra-pyramidal effects - why?

Answer 17

Due to the dopaminergic side effects (insomnia, nausea & vomiting) and no effect on histaminergic receptors (no weight gain)

Question 18

Which drugs should you never co-prescribe with clozapine?

Answer 18

carbamazepine, co-trimoxazole and penicillamine - likely to potentiate its depressant effect on white cell count