Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

What are common effects of adrenergic/noradrenergic receptor?

A

Sweating, tremor, headaches, nausea, dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are common muscarinic receptor effects?

A

Dry mouth, urinary infrequency, thirst, flushed and dry skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are common histamine receptor effects?

A

Drowsiness, dry mouth, dizziness, N+V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do SSRIs work?

A

They increase amount of serotonin in synapse by preventing its reuptake, this leads to a down regulation of serotonin receptors on post synaptic membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are common side effects of SSRIs?

A

Restlessness and agitation on initiation
Nausea, GI disturbance, headache
Weight changes
Sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are some less common side effects of SSRIs?

A

Bleeding (due to serotonin receptors on platelets) and suicidal ideation (gives more energy to potentially carry out suicidal thoughts) affects younger patients more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which SSRI is safest in cardiac disease?

A

Sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which SSRI has the greatest effect on QTc prolongation?

A

Citalopram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which SSRI has a particularly long half life and which has a particularly short half life?

A

Long- fluoxetine
Short- paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which SSRI has greatest risk of serotonin syndrome when stopping or switching from it to another?

A

Fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which SSRI is most at risk of discontinuation syndrome?

A

Paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do SNRIs differ from SSRIs?

A

They also bind to noradrenaline reuptake receptors as well as serotonin ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the side effects of SNRIs?

A

Similar to SSRI side effects but greater potential for sedation, nausea and sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some examples of SNRIs?

A

Duloxetine and venlofaxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Does the sedation effect of mirtazapine decrease if you decrease the dose?

A

No the effect is as strong on histamine receptors with low and high doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the two main side effects of mirtazapine?

A

Weight gain and sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are examples of tricyclic antidepressants?

A

Lofepramine, nortriptyline, amitriptyline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How dangerous are overdoses with tricyclic antidepressants?

A

They can be fatal as they cause QTc prolongation and arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which antidepressants can also be used for neuropathic pain?

A

Tricyclic antidepressants and SNRIs (duloxetine and venlofaxine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which receptors do monoamine oxidase inhibitors type A and type B work on?

A

A- serotonin, B- dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is atypical depression? Which antidepressant group is possibly more effective for this?

A

Depression with increased sleep and appetite
Monoamine oxidase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

MAOIs can have a reaction with amino acid leading to a hypertensive crisis? What is this found in?

A

Tyramine
Found in pickled meats, wine and cheese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long of a washout period is needed after stopping/ switching to another antidepressant from MAOIs?

A

6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which antidepressant had evidence for improvement of difficult to treat cognitive symptoms?

A

Vortioxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What things can you consider when choosing an antidepressant to use?

A

If patient has used a certain type before? How effective was this? Was it tolerated?
Are there particular symptoms that want addressing (e.g weight loss, insomnia, neuropathic pain)
What patient wants/thinks will be most effective (placebo effect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which antidepressant is generally used first line?

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How long should you trial an antidepressant before determining if it having an effect or not?

A

4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

I’d an antidepressant has absolutely no benefit at a typical dose, is it worth increasing the dose?

A

No
Would only increase if there was a partial benefit seen

29
Q

What condition tends to require high doses of antidepressants to treat?

A

OCD

30
Q

What symptoms are characteristic of discontinuation syndrome?

A

Sweating, shakes, agitation, insomnia, headaches, irritability, nausea+vomiting, paraesthesia, clonus

31
Q

Why do paroxetine and venlofaxine have a greater risk of discontinuation syndrome?

A

They have short half lives so there is more leaving the body at a quicker rate when they stop being taken

32
Q

Switching to which antidepressant can help discontinuation syndrome?

A

Fluoxetine as it has a very long half life

33
Q

What are the symptoms of serotonin syndrome?

A

Cognitive- headaches, agitation, hypomania, confusion, coma
Autonomic- shivering, sweating, hyperthermia, tachycardia, nausea and diarrhoea
Somatic- myoclonus, hyper-reflexia, tremor

34
Q

How do we treat serotonin syndrome?

A

Fluids and monitoring

35
Q

How do all antipsychotic work?

A

Reduce the level of dopamine activity at D2 receptors

36
Q

Which dopaminergic pathways are targeted for psychological effects?

A

Mesocortical and mesolimbic

37
Q

All anti-psychotics have the potential to cause what side effects?

A

Sedation, extra-pyramidal signs and weight gain
Acute dystonia (e.g oculogyric crisis)

38
Q

What are some differences between typical and atypical anti-psychotics?

A

Typical more likely to cause extrapyramidal side effects, dizziness and sexual dysfunction
Atypical more likely to cause weight gain, dyslipidaemia and diabetes

39
Q

What investigations are carried out in the monitoring of anti-psychotics? And why are they done?

A

FBC- risk of bone marrow suppression
Lipids- risk of dyslipidaemia
HbA1c- risk of diabetes
ECG- risk for QTc prolongation
Weight and blood pressure- signs of metabolic syndrome

40
Q

How often is monitoring undertaken for antipsychotics?

A

At three months then yearly. Ideally weekly weight recording taken

41
Q

What is neuroleptic malignant syndrome?

A

A rare life-threatening reaction to antipsychotics

42
Q

What are the symptoms of neuroleptic malignant syndrome?

A

Fever, confusion, muscle rigidity, sweating autonomic stability

43
Q

How is NMS distinguished from serotonin syndrome?

A

CK will be very elevated in NMS but may be slight raised or normal in SS
Fluctuating BP and HR seen in NMS but not in SS

44
Q

How is neuroleptic malignant syndrome treated?

A

Stop antipsychotics, give benzos for acute behavioural disturbance, fluid resuscitation, reduce temp
Treat rhabomyolysis- fluids and sodium bicarbonate
Relax muscles- lorazepam or dantrolene

45
Q

How do we treat the extra-pyramidal side effects of anti-psychotics?

A

Anticholinergics like procyclidine (also benzatropine and trihexphenidyl)

46
Q

How do we treat acute dystopias cause by anti-psychotics?

A

Administer IM or IV anticholinergics

47
Q

What does oculogyric crisis look like?

A

Neck arched and eyes rolled back

48
Q

Although clozapine is an effective anti-psychotic, what are some of its negative side effects?

A

Hyper salivation, urinary incontinence. Potential for agranulocytosis and gastrointestinal hypomobility (may lead to fatal bowel obstruction)

49
Q

How we do we treat agranulocytosis from clozapine use?

A

Stop clozapine
Stop other bone marrow suppressing drugs
Lithium and granulomata colony-stimulating factor can help in arise levels
Contact haematology

50
Q

What types of drugs are used to treat anxiety?

A

Beta blockers, benzodiazepines, pregabalin and antidepressants

51
Q

What condition is propanolol famously contraindicated in?

A

Asthma

52
Q

How to beta blockers like propanolol help anxiety?

A

By reducing autonomic nervous system activation. Bio-psycho- feedback reduced anxious thoughts stemming from anxiety symptoms

53
Q

What are some considerations with benzodiazepine use for anxiety?

A

Significant potential for tolerance and dependence and therefore misuse so used cautiously and not Ivan for more than six weeks

54
Q

What are examples of hypnotics (sleeping tablets)?

A

Benzodiazepines: temazepam, lormatazepam, nitrazepam
Non-Benzos: zopiclone, zolpidem

55
Q

Mood stabilisers used to treat bipolar disorder come from which three drug groups?

A

Lithium
Anticonvulsants (e.g sodium valproate)
Atypical antipsychotics (quetiapine)

56
Q

Does lithium have a wide or narrow therapeutic window?

A

Narrow

57
Q

Which organ handles all the metabolism and excretion of lithium?

A

The kidneys

58
Q

How often does lithium need monitoring after being started?

A

Weekly after dose change until level stable then 3 monthly

59
Q

How does evidence suggest that lithium affects suicide risk?

A

Reduces suicide and self harm

60
Q

What are the side effects of lithium?

A

Metallic taste in mouth/dry mouth, fine tremor, polydipsia and polyuria, weight gain and GI disturbance

61
Q

What are some potential longer term effects of lithium?

A

Hypothyroidism, renal impairment

62
Q

What are symptoms of lithium toxicity?

A

Confusion, coarse tremor, nausea and vomiting, ataxia and seizures

63
Q

What can increase lithium levels?

A

Dehydration (encourage pts to drink lots when hot)
Other medications: NSAIDS, loop diuretics, ACE inhibitors

64
Q

What are the most common anticonvulsants used in bipolar as mood stabilisers?

A

Sodium valproate, lamotrigine, carbamazepine

65
Q

What drugs are used in ADD and ADHD?

A

Methylphenidate (CNS stimulant)
Atomoxetine (noradrenaline re-uptake inhibitor)

66
Q

Why would we not give methylphenidate to a patients with previous drug problems?

A

Stimulants like this have potential for misuse and dependency

67
Q

Why is there a decreased risk of dependency with atomoxetine compared to methylphenidate?

A

The increase in dopamine with atomoxetine takes several weeks to reach effect

68
Q

Why do we measure childrens height that are on CNS stimulants?

A

They may have the potential to stunt growth

69
Q

What are common side effects of tricyclic antidepressants?

A

Antagonism of histamine receptors: Drowsiness
Antagonism of muscarinic receptors: dry mouth, blurred vision, constipation, urinary retention
Anatagnism of adrenergic receptors: postural hypotension
Lengthening of QT interval

Psychiatry (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions