Psychopharmacology

Question 1

What are the main types of hypnotics

Answer 1

Benzodiazepines:
Diazepam, Temazepam, Lorazepam, Chlordiazepoxide (alcohol withdrawal)

Z-drugs:
zopiclone and zolpidem

melatonin (>55 short term only)

Question 2

Where are hypnotics not to be used

Answer 2

generalised anxiety

Question 3

What are the withdrawal side effects of hypnotics

Answer 3

sleep disturbance, irritability, seizures, breakthrough anxiety, respiratory depression

Question 4

What is the management plan for anxiety

Answer 4

first line and second line = talking treatment

SSRIs (1st line for generalised anxiety disorder is paroxetine) benzodiazepines can be used short term

pregabalin

Question 5

What are the different classes of antidepressants

Answer 5

Selective serotonin reuptake inhibitors
tricyclics (TCA)
serotonin noradrenaline reuptake inhibitors
Tetracyclic (Na and seratonergic action)
monoamine oxidase inhibitors (MAOI)

Question 6

What are the examples of SSRIs

Answer 6

Fluoxetine, Fluvoxamine, Sertraline, Paroxetine, Citalopram

Question 7

what are the side effects of SSRIs

Answer 7

abdominal, suicidality, sexual dysfunction, but safe in OD

Question 8

What are the examples of tricyclics

Answer 8

amitriptyline, lofepramine, trazodone

Question 9

What are the side effects of tricyclics

Answer 9

sedation, anticholinergic, cardiac arrhythmias

Question 10

what are the examples of SNRIs

Answer 10

venlafaxine and duloxetine

Question 11

What are the side effects of SNRIs

Answer 11

suicidality, serotonin syndrome, sexual dysfunction

Question 12

What is an example of a tetracyclic

Answer 12

mirtazapine

Question 13

what is a side effect of tetracyclics

Answer 13

sedation and weight gain

Question 14

What are examples of MAOIs

Answer 14

phenalzine and moclobemide

Question 15

what are the side effects of MAOIs

Answer 15

hypertensive crises related to tyrosine in cheese and red wine

Question 16

What are the 1st generation antipsychotics

and what side effects are more prevalent

Answer 16

sulpiride, haloperidol, flupentixol, chlorpromazine

extra pyramidal side effects

Question 17

What are the 2nd generation or ‘atypical’ antipsychotics and what side effects are more prevalent

Answer 17

olanzapine, risperidone, quetiapine, amisulpride, aripiprazole

metabolic side effects

Question 18

What are the extra pyramidal side effects of antipsychotics

Answer 18

dystonia, tardive dyskinesia and neuroleptic malignant syndrome, Parkinsonism

Question 19

What are the metabolic side effects of antipsychotics

Answer 19

diabetes, weight gain, lipids, neuroleptic malignant syndrome

Question 20

What are the side effects of clozapine

Answer 20

weight gain, agranulocytosis leading to neutropenia

Question 21

How is clozapine monitored

Answer 21

need weekly blood tests for the first 6 months and 2 weekly blood tests after that.

Question 22

Which medications are used as mood stabilisers

Answer 22

lithium
Antipsychotics e.g olanzapine
Anticonvulsants e.g Sodium Valproate, Carbamazepine, Lamotrigine

Question 23

What are the side effects of lithium

Answer 23

renal impairment, tremor, confusion, thyroid dysfunction, weight gain

Question 24

What is one major contraindication for anticonvulsants

Answer 24

risks in pregnancy

Question 25

What drugs are used in ADHD

Answer 25

Methylphenidate (aka ritalin(

Atomoxetine

Question 26

What are the side effects of methylphenidate

Answer 26

appetite suppression, growth reduction, psychosis

Question 27

What are the side effects of atomoxetine

Answer 27

liver dysfunction and suicidality

Question 28

What psychological interventions can be carried out in primary care

Answer 28

counselling
psychoeducation (group/individual)
CBT

Question 29

What psychological interventions can be carried out in secondary care

Answer 29

psychanalytic psychotherapy
group therapy
family therapy