Psychotropics In Clinical Setting Flashcards
Mechanism of action of antipsychotics
to block (or partially
block) dopamine
receptors in the
mesolimbic area of the
brain
Side effects of the 1st gen antipsychotics
Extrapyramidal manifestations due to block of dopamine in nigrostriatal pathway
Mechanism of action of 2nd generation antipsychotics
5HT2A and D2 antagonists;
Mechanism of action of 3rd gen antipsychotics
dopamine partial agonists
1st line treatment of Antidepressants
SSRI (citalopram)
What are the labs required for use of SSRI
CBC, U&E (hyponatremia), ECG (long QTC)
2nd line Antidepressants
Another SSRI
Mood stabilizers are used to treat….
Bipolar
Most commonly used mood stabilizer
Lithium
Mechanism of action of Lithium (mood stabilizers)
inhibition of
secondary messenger
enzymes
• By modulation of G proteins
• By interaction at various sites
within the downstream signal
transduction cascades (eg
inhibition of GSK
3)
1st line tx of bipolar affetive disorder
Na valproate
Mechanism of action of Na valproate
• It blocks voltage-sensitive sodium channels and
increases brain concentrations of gammaaminobutyric acid (GABA)
Drug used for tx of acute mania and prophylaxis of bipolar
Carbamazepine
Mec. Of action of carbamazepine
• It blocks voltage sensitive Na+ channels to reduce
glutamate release and decreases turnover of
norepinephrine and dopamine.
How is Lithium excreted
By kidney
Buspirone is used to treat…..
Generalised anxiety disorder
1st line tx for mild depression in children and adolescents
Psychological support
Tx for mod/ severe depression in young people
psychological therapy, either alone or in
combination with antidepressant medication
1st kine Antidepressants in children and young people
Fluoxetine
TriFluoPerazine is a drug of which category of the following;
. 1st gen antipsychotics
. 2nd gen antipsychotics
. 3rd gen antipsychotics
1st gen antipsychotics
A pregnant woman takes haloperidol for her psychosis, what are the complications that might happen to the baby due to Haloperidol use?
Limb defects
Low birth weight
Preterm birth
A patient with renal impairment is taking haloperidol for psychotic symptoms, do you recommend we change something about the dose of haloperidol?
. Reduce dose
. Increase dose
. No Change required
No change required
A patient has been taking haloperidol for his psychosis, after a while of use the patient developed neuroleptic malignant syndrome,
what is the treatment of this case?
. Muscle relaxants
. Dopamine agonists: Bromocriptine
What is the 2nd Gen antipsychotic used in resistant cases of psychosis? (last line)
Clozapine
A schizophrenia patient takes an antipsychotic, in the past two days he becomes feverish, the dr suspects an infection, lab reports show neutropenia and agranulocytosis,
What is the most likely drug that has caused this clinical picture?
. Haloperidol
. Olanzapine
. Clozapine
. Aripiprazole
What are other side effects of this drug?
Clozapine,
Other side effects :
. Metabolic syndrome
. Myocarditis
. Sedation
True or false
Clozapine is contraindicated in liver impairment
True
Patient taking clozapine with another drug, the drug interaction has caused an increase in incidents of seizures due to CYP 2D6 inhibition, what is the other drug used?
Fluoxetine
A pregnant woman delivers her baby and starts breastfeeding him, her doctor prescribed her an antipsychotic for mild psychosis,
what is the first line post-partum antipsychotic?
Olanzapine Or Quetiapine
What is the agent of choice for Non cognitive symptoms associated with dememtia
Risperidone
1st line SSRI in elderly depression
Sertraline
1st line SSRI in Adolescent and child depression
Fluoxetine
What is the safest SSRI in pregnancy?
. Sertraline
. Citalopram
. Escitalopram
. Fluoxetine
Fluoxetine
Mention 4 SSRIs you know
Sertraline
Citalopram
ESCITALOPRAM
FLUOXETINE
FLUROXAMINE
Paroxetine
A pregnant lady is taking an SSRI for her depression, on her follow up with the obstetrician, he told her that her baby has a cardiac malformation.
What is the SSRI that she is using and caused the cardiac malformation?
Paroxetine
Venlafaxine, Duloxetine are two antidepressants of which subtype (class of drugs)
SNRI
Mechanism of action of mirtazapine
Antidepressant (Noradrenergic and specific serotonergic antidepressant) (NaSSA)
Which anticonvulsant of yhe follwing causes Steven johnson syndrome?
. Valproate
. Carbamazepine
. Lamotrigine
Lamotrigine
Indication of buspirone (anxiolytics)
Generalized anxiety disorder