Psychotropic Drugs Flashcards
What are the common adverse effects of antidepressants?
GIT symptoms, sedation, dizziness, weight gain, sexual dysfunction, headaches, insomnia, anxiety
What are the adverse effects of clozapine?
Specific: agranulocytosis, myocarditis
General: weight gain, sedation, EPSE, tardive dyskinesia, prolactinaemia
What are the adverse effects of benzodiazepines?
Sedation, poor coordination, decreased libido, hypotension, suppressed breathing, memory loss, tolerance, dependence, addiction
What are the features of neuroleptic malignant syndrome and how is it treated?
F - Fever A - Autonomic Dysfunction R - Rigidity M - Mental State Change Treatment: cessation of antipsychotics +/- admission to ICU
What are the features of serotonin syndrome and how is it treated?
Cognitive: confusion, hypomania, hallucinations
Autonomic: hyperthermia, sweating/shivering, increased HR, dilated pupils, dry mouth
Neuromuscular: tremor, hypertonia, hyperreflexia, ataxia, seizures
Which commonly used atypical antipsychotic is associated with high rates of hyperprolactinaemia?
Risperidone, Paliperidone
Which commonly used atypical antipsychotic is unlikely to cause weight gain?
Aripiprazole
Which commonly used atypical antipsychotics are associated with a high risk of weight gain?
Olanzapine + Clozapine
Which commonly used atypical antipsychotics are non-sedating?
Aripiprazole
Risperidone
What is the difference between MOAIs used in Parkinson’s Disease and those used to treat depression?
MOAI Type B (e.g. selegeline) used in PD to increased DA levels
Nonselective MAOI used in depression to increase DA and serotonin (e.g. tranylcypromine)
Which medication is used to treat serotonin syndrome?
Cyproheptadine (serotonin antagonist)
What are EPSEs?
A - Akasthesia (restlesssness)
A - Acute dystonias
P - Parkinsonism (tremor, rigidity, bradykinesia, apathy)
T - Tardive dyskinesia
How can akasthesia be treated?
Benzodiazepine, beta-blocker
Reduce dose
Change agent
How can antipsychotic-induced Parkinsonism be treated?
Benztropine (anticholinergic)
Amantadine (MAOI-A + NMDA blocker)
Reduce dose
Change agent
How do serotonin syndrome and NMS present differently?
SS (<24 hours): dilated pupils, hyperreflexia, myoclonus, tremor, hyperactive bowel sounds
NMS (days-weeks): hyporeflexia, rigidity (sluggish)
What is the treatment for alcohol withdrawal?
Diazepam
Which benzodiazepine can be given to treat acute aggression or anxiety?
Lorazepam (oxazepam if hepatic impairment present)
Which benzodiazepine can be used for chemical restraint?
Midazolam
Which benzodiazepam can be used to aid sleep?
Tamazepam
What medications can be used to treat Alzheimer’s Disease?
Cholinesterase Inhibitors (donepezil, galantine, rivastigmine) for MMSE >10 NMDA Antagonists (memantine) for MMSE 10-14
What are the adverse effects of lithium?
L - Leg swelling (secondary to renal problems)
I - Indigestion / GI complaints
T - Tremor, toxicity, thirst
H - Hypothyroidism
I - Interactions (diuretics, NSAIDs, ACEI, ARB)
U - Urinary excess (polyuria)
M - Metallic taste, mums-to-be (teratogenic)
What are the clinical features of lithium toxicity?
(similar to alcohol intoxication) F - Fatigue A - Ataxia S - Slurred speech T - Tremor, thirst C - Confusion N - Nausea + vomiting S - Seizurea
What medications can be used as an adjunct in alcohol dependence?
Naltrexone: opioid receptor antagonist
Acamprosate (campral): NMDA blocker, GABA A antagonist
Disulfiram (antabuse): inhibits acetaldehyde dehydrogenase
What medications can be given to reduce nicotine dependence?
- Nicotine replacement therapy
- Verenicline (champix): blocks nicotine receptors
- Bupropion
- TCAs (nortryptiline)
What are the physical effects of cocaine intoxication?
Fever (up to 41 degrees) Dilated pupils Tachycardia and hypertension Agitation and aggression Muscle twitches and tremors Muscle rigidity and hyperreflexia Cardiac arrhythmias
Which antidepressants may also improve insomnia?
Mirtazepine
Venlafaxine
Clomipramine (TCA)
