Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

Choice of agent and dosage?

A

Acceptable side effect profile

Lowest effective dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Important to remember in psychopharmacology?

A

Delayed response of many drugs

Drug-drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Indications for an antidepressant?

A

Unipolar and bipolar depression
Organic mood disorders
Schizoaffective disorder
Anxiety disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Typical antidepressant delay?

A

3-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When would you choose another antidepressant or augment with another agent?

A

If no improvement after at least 2 months at an adequate dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Classifications of antidepressants?

A 
Tricyclics (TCAs)
MAOIs (Monoamine Oxidase Inhibitors)
SSRIs
SNRIs (Serotonin/ Noradrenaline Reuptake Inhibitors) 
Novel antidepressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why are tricyclic antidepressants generally not used?

A

Very effective but poor side effect profile (antihistaminic, anticholinergic, antiadrenergic)
Lethal in overdose
Can cause QT lengthening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antihistaminic side effects?

A

Sedation

Weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anticholinergic side effects?

A 
Dry mouth
Dry eyes
Constipation
Memory deficit
(potentially delerium)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antiadrenergic side effects?

A

Orthostatic hypotension
Sedation
Sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Examples of a tertiary TCA?

A

Amitriptyline
Clomipramine
Doxepin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MAOI method of action and example?

A

Bind to monoamine oxidase, preventing inactivation of amines (norepinephrine, dopamine and serotonin)
Phenelzine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Side effects of MAOIs?

A 
Orthostatic hypotension
Weight gain
Dry mouth
Sedation
Sexual dysfunction
Sleep disturbance
Cheese reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cheese reaction?

A

Hypertensive crisis when taken with tyramine rich foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Potential uses of MAOIs?

A

Treatment resistant depession

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why would you need to wait if switching from an SSRI to a MAOI?

A

Wait at least 2 weeks to avoid serotonin syndrome

5 weeks if fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common side effect of SSRIs?

A 
GI upset
Sexual dysfunction
Anxiety
Restlessness
Nervousness
Insomnia
Fatigue or sedation
Dizziness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

SSRI examples?

A 
SFCP
Sertraline
Fluoxetine
Citalopram
Paroxetine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Benefits of sertraline?

A

Weak P450 interactions
Short half life
Less sedating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Disadvantages of sertraline?

A

Max absorption requires a full stomach

Increased number of GI adverse drug reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Benefits of fluoxetine?

A

Long half life

Initially activating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Disadvantages of fluoxetine?

A

Long half life and metabolite build up
P450 interactions
More likely to induce mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do SNRIs work?

A

Inhibit both serotonin and noradrenaline reuptake like TCAs but without the same side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Uses for SNRIs?

A

Depression
Anxiety
(possibly neuropathic pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Examples of SNRIs?

A

Venlafaxine

Duloxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Examples of novel antidepressants?

A

Mirtazapine

Buproprion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Indications for mood stabilisers?

A

Bipolar
Cyclothymia
Schizoaffective disorder

28
Q

Classes of mood stabilisers?

A

Lithium
Anticonvulsants
Antipsychotics

29
Q

Only drug to reduce suicide rate?

A

Lithium

30
Q

Factors predicting a positive response to lithium?

A

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

31
Q

What needs to be done before starting lithium?

A

Baseline EUC and TFT

rule out pregnancy

32
Q

Goal therapeutic range for lithium?

A

0.6-1.2

33
Q

What monitoring is needed on lithium treatment?

A

EUC and TFT monitoring (6 months)

Drug level monitoring (3 months)

34
Q

Most common side effects of lithium?

A 
GI distress
Thyroid abnormalities
Polyuria/polydipsia (ADH antagonism)
Reduces seizure threshold, cognitive slowing, intention tremor
Non significant leukocytosis
Hair loss
Acne
35
Q

Mild lithium toxicity?

A

1.5 - 2.0

Vomiting, diarrhoea, dizziness, slurred speech

36
Q

Moderate lithium toxicity?

A

2.0 - 2.5

Nausea, vomiting, anorexia, blurred vision, clonic limb movements, convulsions, delerium

37
Q

Severe lithium toxicity?

A

> 2.5

Generalised convulsions, oliguria, renal failure

38
Q

Example of anticonvulsants?

A

Valproic acid (Valproate)
Carbamazepine
Lamotrigine

39
Q

Is valproate as effective as lithium?

A

For mania prophylaxis, but not as effective in depression prophylaxis

40
Q

What needs to be done before starting valproate?

A

Baseline LFT, FBC and pregnancy test (folic acid supplementation in women)

41
Q

Therapeutic range for valproate?

A

50-125 micrograms/ml

42
Q

Side effects of valproate?

A 
Thrombocytopenia
Nausea/vomiting and weight gain
Sedation, tremor
Hair loss
Increased risk of neural tube defect
43
Q

Indications for carbamazepine?

A

First line for acute mania and mania prophylaxis

‘Rapid cyclers’

44
Q

Monitoring for carbamazepine?

A

LFT, FBC and an ECG

Check dose after 1 month, induces own metabolism

45
Q

Carbamazepine side effects?

A 
Rash
Nausea/vomiting
Sedation
AV conduction delays
Aplastic anaemia
Water retention (vasopressin like effect)
Multiple drug interactions
46
Q

Lamotrigine side effects?

A

Nausea/vomiting
Sedation, dizziness
Severe: Stevens Johnson’s Syndrome

47
Q

Indications for antipsychotics?

A

Schizophrenia
Schizoaffective disorder
Bipolar disorder (for mood stabilisation and/or psychotic features)
Psychotic depression
Augmenting agent in treatment resistant anxiety disorders

48
Q

Dopamaine pathways?

A

Mesocortical
Mesolimbic
Nigrostriatal
Tuberoinfundibular

49
Q

Typical antipsychotics? (Drug names)

A

D2 dopamine receptor antagonists
Haloperidol
Fluphenazine
Chlorpromazine

50
Q

Side effects of typical antipsychotics?

A 
Extrapyramidal side effects 
Tremor
Slurred speech
Akathisia
Dystonia
Paranoia
51
Q

Atypical antipsychotics? (Drug names)

A

Aripiprazole
Risperidone
Olanzapine
Quetiapine

52
Q

Side effects of risperidone?

A

Sexual dysfunction
Most likely to induce hyperprolactinemia
Weight gain
Sedation

53
Q

Side effects of olanzapine?

A

Weight gain

May cause hypertriglyceridemia, hypercholesterolemia, hyperglycemia

54
Q

Side effects of quetiapine?

A

Most likely to cause orthostatic hypotension

Weight gain but not as bad as olanzapine

55
Q

Antipsychotic not associated with weight gain?

A

Aripiprazole

56
Q

Efficacy of antipsychotics?

A

1/3 good response
1/3 average response
1/3 no response

57
Q

Treatment resistant?

A

Clozapine, only drug shown to be beneficial in treatment resistance

58
Q

Efficacy of clozapine?

A

Same rule of thirds
1/3 do well
1/3 reasonable
1/3 non responders

59
Q

Why is clozapine not a first line drug?

A

Because of side effects

60
Q

Side effects of clozapine?

A

Agranulocytosis
Increased risk of seizures
Associated the most with weight gain, sedation and abnormal LFTs

61
Q

If clozapine is not effective?

A
  • Add another antipsychotic to clozapine
  • Add lithium/anticonvulsant
  • ECT
62
Q

Adverse effects of antipsychotics?

A

Tardive dyskinesia (TD)
Neuroleptic Malignant syndrome (NMS)
Extrapyramidal side effects (EPS)

63
Q

Agents for extrapyramidal side effects?

A

Anticholinergics (benztropine)
Dopamine facilitators (amantadine)
Beta-blockers (propranolol)

64
Q

Anxiolytic?

A

Buspirone

65
Q

Anxiety disorder treatment?

A

Anxiolytic in combination with an SSRI or SNRI

66
Q

Indications for benzodiazepines?

A

Insomnia
Parasomnias
Anxiety disorders

67
Q

Side effects of benzodiazepines?

A 
Somnolence
Cognitive deficits
Amnesia
Disinhibition
Tolerance
DEPENDENCE

Psychiatry (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions