Psychopharmacology Flashcards
What are the main types of hypnotics
Benzodiazepines:
Diazepam, Temazepam, Lorazepam, Chlordiazepoxide (alcohol withdrawal)
Z-drugs:
zopiclone and zolpidem
melatonin (>55 short term only)
Where are hypnotics not to be used
generalised anxiety
What are the withdrawal side effects of hypnotics
sleep disturbance, irritability, seizures, breakthrough anxiety, respiratory depression
What is the management plan for anxiety
first line and second line = talking treatment
SSRIs (1st line for generalised anxiety disorder is paroxetine) benzodiazepines can be used short term
pregabalin
What are the different classes of antidepressants
Selective serotonin reuptake inhibitors tricyclics (TCA) serotonin noradrenaline reuptake inhibitors Tetracyclic (Na and seratonergic action) monoamine oxidase inhibitors (MAOI)
What are the examples of SSRIs
Fluoxetine, Fluvoxamine, Sertraline, Paroxetine, Citalopram
what are the side effects of SSRIs
abdominal, suicidality, sexual dysfunction, but safe in OD
What are the examples of tricyclics
amitriptyline, lofepramine, trazodone
What are the side effects of tricyclics
sedation, anticholinergic, cardiac arrhythmias
what are the examples of SNRIs
venlafaxine and duloxetine
What are the side effects of SNRIs
suicidality, serotonin syndrome, sexual dysfunction
What is an example of a tetracyclic
mirtazapine
what is a side effect of tetracyclics
sedation and weight gain
What are examples of MAOIs
phenalzine and moclobemide
what are the side effects of MAOIs
hypertensive crises related to tyrosine in cheese and red wine
What are the 1st generation antipsychotics
and what side effects are more prevalent
sulpiride, haloperidol, flupentixol, chlorpromazine
extra pyramidal side effects
What are the 2nd generation or ‘atypical’ antipsychotics and what side effects are more prevalent
olanzapine, risperidone, quetiapine, amisulpride, aripiprazole
metabolic side effects
What are the extra pyramidal side effects of antipsychotics
dystonia, tardive dyskinesia and neuroleptic malignant syndrome, Parkinsonism
What are the metabolic side effects of antipsychotics
diabetes, weight gain, lipids, neuroleptic malignant syndrome
What are the side effects of clozapine
weight gain, agranulocytosis leading to neutropenia
How is clozapine monitored
need weekly blood tests for the first 6 months and 2 weekly blood tests after that.
Which medications are used as mood stabilisers
lithium
Antipsychotics e.g olanzapine
Anticonvulsants e.g Sodium Valproate, Carbamazepine, Lamotrigine
What are the side effects of lithium
renal impairment, tremor, confusion, thyroid dysfunction, weight gain
What is one major contraindication for anticonvulsants
risks in pregnancy
