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BNKN601 > Psychopharmacology (medications) > Flashcards

Psychopharmacology (medications) Flashcards

1
Q

What are the five main classes of drugs?

A

Antipsychotics, antidepressants, Benzodiazepine anxiolytics, Mood stabilisers, and hypnotics

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2
Q

What are antipsychotic medications used for?

A

Primarily used for schizophrenia, BPAD, emergency sedation, ASD, OCD, PTSD, and MSS.

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3
Q

What are the two types of antipsychotics?

A

Typical and atypical

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4
Q

What are examples of typical antipsychotics?

A
  • Haloperidol (oral/depo/IM)
  • Zuclopenthixol (oral/depo/IM)
  • Flupenthixol (depo only)
  • Levomepromazine
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5
Q

What are examples of atypical antipsychotics?

A
  • Olanzapine (oral/depo/IM)
  • Rideridone/paliperidone (oral/depo)
  • Clozapine
  • Quetiapine
  • Ziprasidone
  • Aripiprazole
  • Amisulpride
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6
Q

Is typical or atypical more likely to cause extrapyramidal side effects?

A

Typical is more likely to cause extrapyramidal side effects, however atypical is more likely to cause metabolic side effects.

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7
Q

What are the extrapyramidal side effects?

A

Parkinsonism, dystonia, akathisia, tardive dyskinesia

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8
Q

What is Neuroleptic malignant syndrome?

A

a life-threatening neurologic emergency associated with the use of antipsychotic (neuroleptic) agents and characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia

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9
Q

What are the symptoms of Neuroleptic malignant syndrome?

A

Fever
Encephalopathy
Vitals (tachycardia, BP changes)
Elevated enzymes (CK, WBCs)
Rigidity

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10
Q

What is Hyperprolactinaemia

A

Hyperprolactinemia is a condition characterized by excess prolactin, the hormone responsible for milk production in a woman’s breasts.
typical antipsychotics can cause this. It can affect 40% of patients on typical antipsychotics.

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11
Q

What are the signs and symptoms of Hyperprolactinemia?

A

Galactorrhoea (milk discharge from breasts)
Amenorrhoea
Gynocomastia (breast development in males)
Hypogonadism
Sexual dysfunction (eg impotence)
Decreased fertility
Increased risk of hip fracture
Increased risk of breast cancer

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12
Q

Is Clozapine the most effective antipsyhotic?

A

Yes

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13
Q

What are the side effects of Clozapine?

A

constipation/bowel obstruction, myocarditis, cardiomyopathy, sedation, hypersalivation, weight gain, rise lipids/hyperglycaemia, and seizures

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14
Q

What are the significant risks when on Clozapine?

A

Neutropenia and agranulocytosis, constipation, myocarditis and cardiomyopathy

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15
Q

What are some advantages of a depot antipsychotic?

A

Compliance, reasonable stability, potentially less risk of relapse, less possibility of overdose.

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16
Q

What are some disadvantages of a depot antipsychotic?

A

Little empowerment, baring backwards= subservience, side effects not easily reversed by immediate reduction in dose, setting on right dose may take some time, limited flexibility in dosing.

17
Q

What are the ‘common’ side effects of typical antipsychotics?

A

Dry mouth, increased salvia, constipation, nausea, blank facial expression, unusual/slowed/uncontrolled body movements.

18
Q

What are the ‘common’ side effects of atypical antipsychotics?

A

Increased salvia, constipation, nausea, blank facial expression, unusual/slowed/uncontrolled body movements, increased appetite, weight gain, drop in BP.

19
Q

What are the ‘common’ side effects of depot antipsychotics?

A

Rigidity, muscle spasms, tremors and drowsiness.

20
Q

What are the types of antidepressants?

A

SSRI’s - selective serotonin reuptake inhibitors.
SNRI - serotonin and noradrenaline reuptake inhibitors
NaSSA - Noradrenergic and specific serotonergic
NDRI - Noradrenaline/dopamine reuptake inhibitors
TCA’s - tricyclic antidepressants
MAOI - mono amine oxidasr inhibitors
Reversible MAOI

21
Q

What medications are SSRI’s?

A

citalopram, escitalopram fluoxetine, paroxetine, setraline.

22
Q

What medications are SNRI?

A

venlafaxine

23
Q

What medications are NaSSa?

A

Mirtazapine

24
Q

What medications are NDRI?

A

bupropion

25
Q

What medications are TCA’s?

A

amitriptyline, clomipramine, desipramine, dothiepin, doxepin, imipramine, norteiptyline

26
Q

What medications are MAOI?

A

phenelzine, tranylcypromine

27
Q

What medications are Reversible MAOI?

A

moclobemide

28
Q

What are ‘common’ side effects of SSRI’s?

A

dry mouth, loss of appetite, indigestion, nausea, diarrhoa or constipation, dizziness

29
Q

What are ‘common’ side effects of TCA’s?

A

Dry mouth, excessive sweating at night, drowsiness, difficulty passing urine, constipation

30
Q

What are mood stabiliser medications?

A

Lithium, sodium valproate, and carbamazepine

31
Q

What are the adverse effects of lithium?

A

Tremor, hypothyroidism, acne like lesions, psoriasis, pregnancy; ebstein’s anomaly

31
Q

What are the adverse effects of lithium?

A

Tremor, hypothyroidism, acne like lesions, psoriasis, pregnancy; ebstein’s anomaly

32
Q

what is the lithium therapeutic index?

A

Normal range; o.6 to 1 mmol/L
1.3 to 2.0 mmol/L = slurred speech, unbalanced gait, confusion, irritable, restless, vomiting, muscle twitching, disorientation, cognitive impairment
2.0 to 2.5 mmol/L = frank ataxia, choreiform movements, seizures, coma, renal failure, electrolyte imbalances, dehydration, hypotension

33
Q

What are the ‘common’ side effects for mood stablisers?

A

Dry mouth, excessive thirst, changes to heart rate, frequent urination, slurred speech.

34
Q

Can sodium valproate be used during pregnancy?

A

Valproate should not be used routinely for woman who may become pregnant. It may;
20-30% of babies are born with foetal abnormalities
50 % of new borns have a developmental delay
If prescribed, ensure adequate contraception.

35
Q

What are benzodiazepines used for?

A

Anxiety disorders
Insomnia
Agitation
Alcohol withdrawal
EPSE’s
Pre procedure sedation
Status epilepticus

36
Q

What are the different types of benzodiazepines and the medications?

A

Short acting; Triazolam (6h), midazlolam (6-12h), Temazepam (<12h)

Mid acting; Lorazepam (12-24h)

Long acting; Clonazepam (24-36h), Diazepam (36-48h), clobazam (36-40h)

37
Q

What are adverse effects of benzodiazepines?

A

Cognitive- sedations, anterograde amnesia, psychomotor slowing, learning impairment, longer term cognitive impairment
Dependence
Withdrawal
Tolerance

BNKN601 (33 decks)

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