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Psychiatry > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

What are indications for using antidepressants?

A

Unipolar or bipolar depression
Organic mood disorders
Schizoaffective disorder
Anxiety disorders

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2
Q

How long does it typically take for symptoms to improve after achieving therapeutic dose?

A

3-6 weeks

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3
Q

What are the 5 classifications of antidepressants?

A 
Tricyclics
Monoamine oxidase inhibitors
Selective serotonin reuptake inhibitors
Serotonin/noradrenaline reuptake inhibitors
Novel antidepressants
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4
Q

What do monoamine oxidase inhibitors do?

A

Bind to monamine oxidase preventing inactivation of amines such as norepineohrine, dopamine, and serotonin

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5
Q

What are possible side effects of MAOIs?

A 
Weight gain
Dry mouth
Orthostatic hypotension
Sedation
Sexual dysfunction
Sleep disturbance
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6
Q

What is the serotonin syndrome symptoms?

A 
Abdominal pain
Diarrhoea
Sweats
Tachycardia
HTN
Myoclonus
Irritability
Delirium
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7
Q

How do selective serotonin reuptake inhibitors work?

A

Block presynpatic serotonin reuptake

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8
Q

What are common side effects of SSRIs?

A 
GI upset
Sexual dysfunction
Anxiety
Restlessness
Nervousness
Insomnia
Fatigue or sedation
Dizziness
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9
Q

Why are tricyclic antidepressants potentially dangerous?

A

They can potentially cause antihistaminic, anticholinergic, or antiadrenergic side effects

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10
Q

What do TCAs cause on an ECG?

A

QT lengthening

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11
Q

Where do tertiary TCAs work?

A

Serotonin receptors

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12
Q

What are 3 examples of tertiary TCAs?

A

Amitriptyline
Clomipramine
Doxepin

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13
Q

What are antihistaminic side effects?

A

Sedation

Weight gain

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14
Q

What are anticholinergic side effects?

A 
Dry mouth
Dry eyes
Constipation
Memory deficits
Potential delirium
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15
Q

What are antiadrenergic side effects?

A

Orthostatic hypotension
Sedation
Sexual dysfunction

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16
Q

How do secondary TCAs work?

A

Block noradrenaline

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17
Q

What are 2 examples of secondary TCAs?

A

Desipramine

Nortryptyline

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18
Q

What happens if you eat tyramine rich foods such as cheese or red wine while on MAOIs?

A

Hypertensive crisis

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19
Q

What is discontinuation syndrome?

A

Symptoms if suddenly stop taking medication

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20
Q

What symptoms can be found in SSRI discontinuation syndrome?

A

Agitation
Nausea
Disequilibrium
Dysphoria

21
Q

What are examples of SSRIs?

A 
Paroxetine
Sertraline
Fluoxetine
Citalopram
Escitalopram
Fluvoxamine
22
Q

How do serotonin/norepineohrine reuptake inhibitors work?

A

Inhibit serotonin and noradrenergic reuptake without antihistamine, anticholinergic, and antiadrenergic side effects

23
Q

What are examples of SNRI?

A

Venlafaxine

Duloxetine

24
Q

What conditions can mood stabilisers be used for?

A

Bipolar
Cyclothomia
Schizoaffective

25
Q

What are classes of mood stabilisers?

A

Lithium
Anticonvulsants
Antipsychotics

26
Q

What are indications for lithium?

A

Mania

Depressive episodes

27
Q

What are predictive factors for a positive response to lithium?

A

Prior long-term response or family member with good response
Classic pure mania
Mania which is followed by depression

28
Q

What do you need to do before starting lithium?

A

Baseline U&E and TSH

Don’t give to women of child-bearing age

29
Q

How long does it take to achieve a stable state of lithium?

A

5 days

30
Q

When should you check serum lithium levels?

A

12 hours after each dose until steady state

31
Q

What is the goal for serum lithium in treatment?

A

Between 0.6-1.2

32
Q

What are the most common side effects of lithium?

A

GI - reduced appetite, nausea, vomiting, diarrhoea

33
Q

What are less common side effects of lithium?

A 
Thyroid abnormalities
Nonsignificant leukocytosis
Polyuria/polydipsia
Hair loss
Acne
Reduces seizure threshold
34
Q

What are the different levels of lithium toxicity?

A

Mild - 1.5-2.0
Moderate - 2.0-2.5
Severe - >2.5

35
Q

What are symptoms of mild lithium toxicity?

A 
Vomiting
Diarrhoea
Ataxia
Dizziness
Slurred speech
Nystagmus
36
Q

What are symptoms of moderate lithium toxicity?

A 
Nausea
Vomiting
Anorexia
Blurred vision
Clonic limb movements
Convulsions
Delirium
Syncope
37
Q

What are symptoms of severe lithium toxicity?

A

Generalised convulsions
Oliguria
Renal failure

38
Q

What are examples of anticonvulsants?

A

Valproic acid
Carbamazepine
Lamotrigine

39
Q

What are the two types of antipsychotics?

A

Typicals

Atypicals

40
Q

What are examples of typical antipsychotics?

A

Fluphenazine
Haloperidol
Pimozide

41
Q

How do typical antipsychotics work?

A

D2 dopamine receptor antagonists

42
Q

What are effects of atypical antipsychotics?

A

Sedation

Weight gain

43
Q

How do atypical antipsychotics work?

A

They are serotonin-dopamine 2 antagonists

44
Q

What are examples of atypical antipsychotics?

A

Risperidone
Olanzapine
Quetiapine
Aripiprazole

45
Q

What drug is beneficial for treatment resistant psychosis?

A

Clozapine

46
Q

What are adverse effects of antipsychotics?

A

Involuntary muscle movements
Neuroleptic malignant syndrome
Extrapyramidal side effects

47
Q

What are features of neuroleptic malignant syndrome?

A 
Severe muscle rigidity
Fever
Altered mental status
Autonomic instability
Elevated white cell count
Elevate creatinine phosphokinase
Elevated LFTs
48
Q

What are extrapyramidal side effects?

A

Acute dystonia
Parkinson syndrome
Akathisia

49
Q

What medications can be given to alleviate extrapyramidal symptoms?

A

Anticholinergics
Dopamine facilitators
Beta-blockers

Psychiatry (18 decks)

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