Psychiatry - Drugs + Mental Health Acts Flashcards
what does an emergency detention allow in the MHA 2015?
72hrs of detention
who needs to allow a emergency detention?
doctor
mental health officer
who can put a short term detention in place?
psychiatrist
mental health officer
how long can a short term detention last?
28 days
what is a CTO?
sets out conditions for complicance during treatment
what powers do the police have?
sections 297/8 police can take a person to a safe place (if mentally disordered/need Tx) for 24 hours
what form is used to treat physical disorders?
AWI
section 47
can you get treatment under an emergency detention?
nope
how do SSRIs work?
selectively inhibit 5-HT reuptake
side effects of SSRI?
anti cholinergic decrease libido tremor palps insomnia (take in morning)
which of the SSRIs, are best in
post MI
epilepsy
<18yrs?
post MI - sertraline
epilepsy - citalopram
<18yrs - fluoxetine
what SSRIs are safe in pregnancy? what one is not and why?
citalopram
sertraline
paroxetine has risk of PHt/CVS abnormalities
what drugs to avoid when on SSRIs?
NSAID (GI bleeds)
triptans
warfarin/heparin (switch to mirtazipine)
how do tricyclics work?
bock NA/5HT reuptake in the synaptic cleft
side effects of tricyclics?
anti cholinergic
decrease libido
drowsy (take at night)
adverse effects of tricyclics?
long QT
increased potency by alcohol
cardiotoxic in overdose
how do MAOis work?
inhibits MAO which increased NA/5-HT availability
side effects of MAOis ?
anti cholinergic
jaundice
increase wt
insomnia (take in morning)
what adverse effect can occur on MAOis? Tx?
hypertensive crisis
due to eating lots of foods high in tyramine
phentolamine infusion
what adverse effects do SNRIs have?
worse withdrawal (than SSRIs)
what do NaSSA cause?
wt gain
sedative (take at night)
what bloods should be checked when on a NaSSA?
FBC
what anti depressant is safe in overdose?
SARI
example of a NaSSA?
mirtazapine
example of a SARI?
trazodone
example of a SNRI?
duloxetine
venlaflaxine
example of MAOis?
phenelzine
moblenclamide
example of a tricyclic?
amitryptilline
dosuleptin
how do benzos work? what do they cause?
enhance GABA
anticonvulsant
sedate
anterograde amnesia
what can use of benzos during pregnancy cause?
1st trim - cleft palate
3rd - floppy baby
how does sodium valp work? what should be checked before starting?
blocks Na channels to increase GABA
BMI
FBC
LFTs
side effects of sodium valp?
Vomiting Anorexia L liver toxicity P pancreatits R wt gain O oedema A alopecia T teratogenic/tremor E enzyme inhibition
how does lamotrigine work?
binds to Na to stop glutamate release
side effects of lamotrigine?
rashes
headache
GI upset
what should be checked before starting lamotrigine?
FBC
U+Es
LFTs
side effects of Li?
arrythmias dry mouth wt gain headache hypothyroid nephropathy
what signs are there of lithium toxicity?
D+V tremor sedation seizure arrythmia
what should be done before starting Li, then every 6 months?
ECG
U+Es, eGFR
LFTs, FBC, TFTs
BMI
TFT
U+Es, eGFR
BMI
what is the difference in side effect profile of atypical vs typical antipsychotics?
typical - worse parkinsonism
atypical - worse metabolic
what adverse effects of antipsychotics are there?
BM increase
prolong QT
increase PRL
what should be checked before starting anti psychotics?
ECG PRL BMI BM lipids FBC
what does clozapine carry the risk of?
agranulocytosis
is lithium safe in breastfeeding?
no
what are the risks associated with taking lamotrigine while pregnant?
oral cleft defect
SJS (breastfeeding)
what are the risks associated with taking antipsychotic while pregnant?
growth defects
IUGR
can antipsychotics be taken while breastfeeding?
yes but monitor fetus for lethargy
what are the risks associated with taking carbamazepine while pregnant?
NTD
facial dysmorphia
fingernail hypoplasia
