Brainscape's Knowledge GenomeTM

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


See full index

Psychiatry > Psychopharmacology - Part 2 > Flashcards

Psychopharmacology - Part 2 Flashcards

1
Q

What are the indications for mood stabilizers?

A

Bipolar, cyclothymia and schizoaffective disorder

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

What are the classes of mood stabilizers?

A

Lithium
Anticonvulsants
Antipsychotics

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

Describe lithium

A

Only medication to reduce suicide rate
Effective long term prophylaxis of both mania and depressive episodes
Positive factors - FH with good response, classic pure mania and mania following depression

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

What is checked before starting lithium?

A

Get baseline U+Es and TSH
Check pregnancy - first trimester is associated with Ebstein’s anomaly

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

What is the monitoring on lithium?

A

Steady state achieved after 5 days
Once stable check 3 months and TSH + creatinine 6 months
Goal is 0.6-1.2

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

What are the lithium side effects?

A

GI distress - reduced appetite, N/V and diarrhoea
Thyroid abnormalities
Polyuria/ polydipsia secondary to ADH antagonism
Hair loss and acne
Reduced seizure threshold, cognitive slowing and intention tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are mild levels of lithium toxicity?

A

1.5 - 2
Vomiting, diarrhoea, ataxia, dizziness, slurred speech and nystagmus

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

What is moderate lithium toxicity?

A

2-2.5
N/V, anorexia, blurred vision, clonic limb movements, convulsant, delirium and syncope

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

What is severe lithium toxicity?

A

> 2.5
Generalised convulsions, oliguria and renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe valproic acid (Depakote) - anticonvulsant

A

Effective as lithium in mania prophylaxis but not in depression
Positive response - rapid cycling patients, comorbid substance issues, mixed patients and comorbid anxiety disorders
Better tolerated than lithium

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

What is checked in valproic acid?

A

LFTS, pregnancy test and FBC
Avoid in women of child bearing age - neural tube defects
Goal is between 50-125

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

What are side effects of valproic acid?

A

Thrombocytopenia and platelet dysfunction
N/V, weight gain, sedation, tremor and hair loss

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

When is carbamazepine (Tegretol) used - anticonvulsant?

A

First line agent for acute mania and mania prophylaxis
Indicated for rapid cycles and mixed patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is checked before going on carbamazepine?

A

Baseline LFTS, FBC and ECG
Target is 4-12mcg/ml
Need to check level and adjust dosing after a month because induces own metabolism

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

What are the side effects f carbamazepine?

A

Rash, N/V, diarrhoea, sedation, dizziness, ataxia, confusion, AV conduction delays, aplastic anaemia, agranulocytosis and water retention
Drug - drug interaction

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

Describe lamotrigine (Lamictal) - anticonvulsant

A

Also use for neuropathic/ chronic pain
Baseline LFTS before starting
Start on 25mg for 2 weeks then 50mg for 2 weeks when 100mg (rash if too fast) and if stopped then have to start again

17
Q

What are the side effects of lamotrigine?

A

N/V, sedation, dizziness, ataxia and confusion
Severe - toxic epidermal necrolysis and SJS
Blood dyscrasias
Drug interactions - VPA and sertraline

18
Q

What are the indications for antipsychotics?

A

Schizophrenia, schizoaffective disorder, bipolar for mood stabilization or psychotic features and psychotic depression

19
Q

Describe typical antipsychotics

A

D2 dopamine receptor antagonists
High potency bind to D2 receptor in high affinity - higher risk of extrapyramidal side effects
Fluphenazine, Haloperidol and Pimozide

20
Q

Describe low potency typical antipsychotics

A

Have less affinity for the D2 receptors but tend to interact with non-dopaminergic receptors - more cardiotoxic and anticholinergic effects (sedation and hypotension)
Chlorpromazine and Thioridazine

21
Q

What are the adverse effects of antipsychotics?

A

Tardive dyskinesia - involuntary muscle movements that may not resolve
Neuroleptic malignant syndrome
Extrapyramidal side effects - Acute dystonia and Parkinson’s
Akathisia

22
Q

What are the symptoms in neuroleptic malignant syndrome?

A

Severe muscle rigidity, fever, altered mental status, autonomic instability, elevated WBC and CPK

23
Q

What are agents for extrapyramidal symptoms?

A

Anticholinergics - benztropine, trihexyphenidyl and procyclidine (watch for side effects esp. with TCAs)
BB for akathisia

24
Q

Describe antipsychotics atypicals

A

Serotonin dopamine 2 antagonists
Tend to effect dopamine 1,3,4 and 5 so less EPS
Atypical in the way they affect dopamine and serotonin neurotransmission

25
Q

Describe risperidone (Risperdal) - antipsychotic

A

Regular tablets, IM and rapidly dissolving tablet
Function more like a typical at doses greater than 6mg
Increased EPS
Weight gain and sedation
Atypical to induce hyperprolactinemia

26
Q

Describe olanzapine (Zyprexa) - antipsychotic

A

Regular tablets, IM, rapidly dissolving tablet and depo form
Weight gain, hypertriglyceridemia, hypercholesterolemia, hyperprolactinemia and hyperglycaemia
May cause abnormal LFTs

27
Q

Describe Quetiapine (Seroquel) - antipsychotic

A

Regular tablet
May cause abnormal LFTs
Weight gain, hypertriglyceridemia, hypercholesterolemia and hyperglycaemia
Orthostatic hypotension

28
Q

Describe Aripiprazole (Abilify) - antipsychotic

A

Regular tablets, immediate release IM and depo form
Unique mechanism of action as D2 partial agonist
Low EPS, no QT prolongation, low sedation and low weight gain

29
Q

Describe Lurasidone - antipsychotic

A

Newer
Similar side effects to aripiprazole
Potential weight gain and increased rate akathisia

30
Q

Describe treatment resistance for schizophrenia

A

Poor prognosis to 2 first line antipsychotics at adequate dose for 8 weeks
Clozapine used in this case

31
Q

When is clozapine used?

A

Treatment resistant patients as side effect profile
Regular tablet form

32
Q

What are the side effects of clozapine?

A

Agranulocytosis, seizures, sedation, weight gain, abnormal LFTs, hypertriglyceridemia, hypercholesterolemia, hyperglycaemia, non-ketotic hyperosmolar coma and death

33
Q

Describe prophylaxis in psychotic disorder

A

Relapse more commonly due to non-compliance

34
Q

Describe anxiolytics

A

Used to treat panic disorder, generalised anxiety disorder (in combo. with SSRIs and SNRIs), substance related disorder and their withdrawal, insomnias and parasomnias

35
Q

What are the pros of buspirone - anxiolytics?

A

Good augmentation strategy in anxiety
5HT1A agonist
No sedation

36
Q

What are the cons of buspirone?

A

Takes about 2 weeks before notice results
Will not reduce anxiety in patients that are used to taking BZDs as no sedation effect

37
Q

Describe benzodiazapines

A

Used to treat insomnia, parasomnias and anxiety disorders
Also in CNS depressant withdrawal protocols

38
Q

What are the side effects of benzodiazepines?

A

Somnolence, cognitive deficits, amnesia, disinhibition, tolerance and dependence

Psychiatry (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions