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ESA4 - Clinical Pharmacology > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

What are the core symptoms of depression?

A

Low mood, anhedonia, decreased energy

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2
Q

What are the secondary symptoms of depression?

A

Low appetite, disturbed sleep, irritability, reduced libido, reduced concentration, hopelessness

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3
Q

What is the monoamine hypothesis?

A

Depression due to a deficiency of monoamine neurotransmitters - NA and serotonin

Evidence - certain drugs that deplete these could induce depression

MAOI block monoamine oxidase from destroying neurotransmitters

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4
Q

What is the neurotransmitter receptor hypothesis?

A

An abnormality in the receptors for monoamine transmission leads to depression

Depletion of neurotransmitter causes compensatory upregulation of post synaptic receptors

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5
Q

What are the types of antidepressants?

A

Monoamine oxidase inhibitors (used rarely now)

Monoamine uptake inhibitors (like SSRIs)

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6
Q

Give some examples of SSRIs

A

Fluoxetine, citalopram, paroxetine, sertraline

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7
Q

Which is the most selective of SSRIs?

A

Ciralopram

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8
Q

Name one advantage of fluoxetine

A

Long half life

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9
Q

Which is the most potent reuptake inhibitor?

A

Paroxetine

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10
Q

What are some side effects of SSRIs?

A

Anorexia, nausea, diarrhoea, precipitation of mania, some extrapyramidal syndromes

Can prolong QT interval?

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11
Q

What are the side effects of tricyclics antidepressants?

A

Sedation and impairment of psychomotor performance, reduction in glandular secretions, tachycardia, postural hypotension, constipation

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12
Q

What are some examples of SNRIs?

A

Venlafaxine and fluoxetine

(Second/third line drugs)

Dose dependent - lower doses serotonin action, higher doses NA

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13
Q

What are some side effects of SNRIs?

A

Same as SSRIs, sleep disturbance, increased BP, dry mouth

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14
Q

What are the main dopaminergic pathways?

A

Mesolimbic (emotion and behaviour)
Mesocortical (arousal and mood)
Nigrostriatal (the one in Parkinson’s)
Tuberoinfundibular (hypothalamus and pituitary)

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15
Q

What happens when a D2 antagonist acts on nigrostriatal pathway?

A

Extrapyramidal side effects, dyskinesia

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16
Q

Explain why a patient on D2 antagonists would experience sexual dysfunction

A

Tuberoinfundibular pathway is dopaminergic
Dopamine inhibits prolactin
Takes away the inhibition on prolactin
Hyperprolactinaemia

17
Q

What are some advantages of atypical antipsychotics?

A

Less side effects, different preparations eg dissolvable

First line in schizophrenia

18
Q

What are the side effects of atypical antipsychotics?

A

Extrapyramidal side effects, weight gain, increased prolactin, sedation

19
Q

What is clozapine?

A

Atypical antipsychotic

3rd line agent

Severe side effect profile

20
Q

What are the side effects of clozapine?

A

Severe constipation, sedation, hypersalivation, weight gain, neutropenia, agranulocytosis

Need weekly monitoring via FBC

21
Q

Name some benzodiazepines

A

Diazepam, lorazepam

GABA-BDZ receptor complex

22
Q

What is mania?

A

Feeling unusually excited, happy, optimistic, irritable

Overactive

Poor sleep, concentration, short attention span, rapid speech, poor judgement, increased interest in sex, psychotic symptoms - hallucinations, grandiose delusions

23
Q

What are some mood stabilisers?

A

Lithium, sodium valproate, carbomazepine, lamotrigine

24
Q

What are some uses of Lithium?

A

Prophylaxis of mania and depression in bipolar disorder, augmentation of antidepressants, reducing suicidality

25
Q

What are some side effects of lithium?

A

Memory problems, thirst, polyuria, tremor, drowsiness, weight gain

Effect on kidneys, hypothyroidism, hair loss, rashes

26
Q

What are the effects of lithium toxicity?

A

Vomiting, diarrhoea, coarse tremor, dysarthria, cognitive impairment, restlessness, agitation

27
Q

How do you treat lithium toxicity?

A

Anticonvulsants, increased fluid intake/IV fluids, haemodilaysis (in overdose)

28
Q

What are some examples of acetyl cholinesterase inhibitors?

A

Donepezil, galantamine, rivastigmine

29
Q

What is an example of an NMDA antagonist?

A

Meantime

30
Q

What medications can be used to treat dementia?

A

Acetyl cholinesterase inhibitors and NMDA antagonists

31
Q

What are some important side effects of acetyl-cholinesterase inhibitors?

A

Nausea, vomiting, anorexia, diarrhoea, fatigue, insomnia, headache, bradycardia

32
Q

What are some common side effects of memantine (an NMDA receptor antagonist)?

A

Hypertension, dyspnoea, headache, dizziness, drowsiness

ESA4 - Clinical Pharmacology (20 decks)

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