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AB 4th Year Psychiatry > Psychiatry - Drugs + Mental Health Acts > Flashcards

Psychiatry - Drugs + Mental Health Acts Flashcards

1
Q

what does an emergency detention allow in the MHA 2015?

A

72hrs of detention

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2
Q

who needs to allow a emergency detention?

A

doctor

mental health officer

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3
Q

who can put a short term detention in place?

A

psychiatrist

mental health officer

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4
Q

how long can a short term detention last?

A

28 days

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5
Q

what is a CTO?

A

sets out conditions for complicance during treatment

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6
Q

what powers do the police have?

A

sections 297/8 police can take a person to a safe place (if mentally disordered/need Tx) for 24 hours

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7
Q

what form is used to treat physical disorders?

A

AWI

section 47

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8
Q

can you get treatment under an emergency detention?

A

nope

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9
Q

how do SSRIs work?

A

selectively inhibit 5-HT reuptake

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10
Q

side effects of SSRI?

A 
anti cholinergic
decrease libido
tremor
palps
insomnia (take in morning)
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11
Q

which of the SSRIs, are best in
post MI
epilepsy
<18yrs?

A

post MI - sertraline
epilepsy - citalopram
<18yrs - fluoxetine

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12
Q

what SSRIs are safe in pregnancy? what one is not and why?

A

citalopram
sertraline

paroxetine has risk of PHt/CVS abnormalities

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13
Q

what drugs to avoid when on SSRIs?

A

NSAID (GI bleeds)
triptans
warfarin/heparin (switch to mirtazipine)

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14
Q

how do tricyclics work?

A

bock NA/5HT reuptake in the synaptic cleft

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15
Q

side effects of tricyclics?

A

anti cholinergic
decrease libido
drowsy (take at night)

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16
Q

adverse effects of tricyclics?

A

long QT
increased potency by alcohol
cardiotoxic in overdose

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17
Q

how do MAOis work?

A

inhibits MAO which increased NA/5-HT availability

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18
Q

side effects of MAOis ?

A

anti cholinergic
jaundice
increase wt
insomnia (take in morning)

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19
Q

what adverse effect can occur on MAOis? Tx?

A

hypertensive crisis
due to eating lots of foods high in tyramine

phentolamine infusion

20
Q

what adverse effects do SNRIs have?

A

worse withdrawal (than SSRIs)

21
Q

what do NaSSA cause?

A

wt gain

sedative (take at night)

22
Q

what bloods should be checked when on a NaSSA?

A

FBC

23
Q

what anti depressant is safe in overdose?

A

SARI

24
Q

example of a NaSSA?

A

mirtazapine

25
Q

example of a SARI?

A

trazodone

26
Q

example of a SNRI?

A

duloxetine

venlaflaxine

27
Q

example of MAOis?

A

phenelzine

moblenclamide

28
Q

example of a tricyclic?

A

amitryptilline

dosuleptin

29
Q

how do benzos work? what do they cause?

A

enhance GABA

anticonvulsant
sedate
anterograde amnesia

30
Q

what can use of benzos during pregnancy cause?

A

1st trim - cleft palate

3rd - floppy baby

31
Q

how does sodium valp work? what should be checked before starting?

A

blocks Na channels to increase GABA

BMI
FBC
LFTs

32
Q

side effects of sodium valp?

A 
Vomiting 
Anorexia
L liver toxicity
P pancreatits
R wt gain
O oedema 
A alopecia
T teratogenic/tremor
E enzyme inhibition
33
Q

how does lamotrigine work?

A

binds to Na to stop glutamate release

34
Q

side effects of lamotrigine?

A

rashes
headache
GI upset

35
Q

what should be checked before starting lamotrigine?

A

FBC
U+Es
LFTs

36
Q

side effects of Li?

A 
arrythmias
dry mouth
wt gain
headache
hypothyroid
nephropathy
37
Q

what signs are there of lithium toxicity?

A 
D+V
tremor
sedation
seizure
arrythmia
38
Q

what should be done before starting Li, then every 6 months?

A

ECG
U+Es, eGFR
LFTs, FBC, TFTs
BMI

TFT
U+Es, eGFR
BMI

39
Q

what is the difference in side effect profile of atypical vs typical antipsychotics?

A

typical - worse parkinsonism

atypical - worse metabolic

40
Q

what adverse effects of antipsychotics are there?

A

BM increase
prolong QT
increase PRL

41
Q

what should be checked before starting anti psychotics?

A 
ECG
PRL
BMI
BM
lipids
FBC
42
Q

what does clozapine carry the risk of?

A

agranulocytosis

43
Q

is lithium safe in breastfeeding?

A

no

44
Q

what are the risks associated with taking lamotrigine while pregnant?

A

oral cleft defect

SJS (breastfeeding)

45
Q

what are the risks associated with taking antipsychotic while pregnant?

A

growth defects

IUGR

46
Q

can antipsychotics be taken while breastfeeding?

A

yes but monitor fetus for lethargy

47
Q

what are the risks associated with taking carbamazepine while pregnant?

A

NTD
facial dysmorphia
fingernail hypoplasia

AB 4th Year Psychiatry (5 decks)

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