Psychopharmacology 3 Flashcards

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1
Q

What should be considered in prophylaxis for psychotic diseases

A
Life long
Complaince issues
Lack of insight
Consider long acting IM injection
May need to use mental health act 

Relapses reduces functionality and IQ. Don’t want to relapse

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2
Q

What are the adverse effects of antipsychotics

A

Tardive dyskinesia- involuntary muscle movements that may not resolve with drug discontinuation.

Neuroleptic malignant syndrome- only psychiatric emergency, svere muscle rigidity, fever, altered mental state, autonomic instability, elevated WBC, CPK and LFT’s. potetnially fatal

Extrapyramidla side effects- Acute dystonia, parkinson syndrome, akathisia

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3
Q

What should be started to reduce the chance of extrapyramidla side effects?

A

Anticholinergics such as benztropine, thexyphendyl, diphenhydramine

Dopamine facilitators such as amantandine

Beta-blockers such as propanolol

Need to watch for anticholinergic SE, particularly if taken with other meds with anticholienbrgic actions e.g. triycylics

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4
Q

What bloods would you do before starting someone on an antipsychotic?

A

Fasting liid profile
Fasting blood sugar
LFT’s
CBC

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5
Q

What is akathisia?

A

Restlessness, can’t sit still patients describe it as feeling uncomfortable in their skin

Associated with higher risk of suicide. Treat it with anxiolytic or propranolol

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6
Q

What are anxiolytics

A

Used to treat panic disorder, generalised anxiety disorder, substance related disorder and their withdrawal,

In anxiety disorders use aniolytics and SSRI’s or SNRI’s

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7
Q

What is buspirone?

A

Anioxyltic

pros- good augmentatiopn strategy
No sedation

CONS- mtakes about 2 weeks to work, no sedation to take the edge off as in benzo’s

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8
Q

What are benzodiazepines?

A

Used to treat insomnia, parasomnias and anxiety disorders

Often used for CNS depressant withdrawl protocols e.g. ethanol withdrawl

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9
Q

What are the side effects of benzodiazepines

A
Somnolence
Cognitive deficits
Amnesia
Disinhibiton
Tolerance
Dependence
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10
Q

Should you use benzodiazepines to treat anxiety?

A

No treat it with SSRI’s

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11
Q

What are the take home points?

A

Be clear on the diagnosis and any co-morbid diagnoses

Try to treat 2 birds with one stone

Select on side effect profile

Monitor efficacy and tolerance

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12
Q

What anti psychotic drug would you use to treat schizophrenia with high cholesterol

A

Risperidone

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