Pyschopharmacology

Question 1

what are general pharmacology principles

Answer 1

indication
try use lowest dose possible
choose a drug for least drug-drug interaction
adjust dose for optimum benefit and compliance

Question 2

what are the indications for antidepressants

Answer 2

bipolar
depression
anxiety disorders
typically a delay of 3-6 weeks before they work
if no improvement after 2 weeks at optimal dose, switch or add lithium or mirtrazapine

Question 3

what are tricyclics

Answer 3

very effective
lethal at overdose
can cause QT lengthening
amitriptyline, desipramine

Question 4

what are monoamine oxidase inhibitors

Answer 4

prevent activation of dopamine and serotonin leading to increase synaptic levels
side effects- dry mouth, weight gain, cant have cheese or red wine
can lead to seritonin syndrome
wait 2 weeks for switching from SSRI to MOI

Question 5

what are selective serotonin reuptake inhibitors

Answer 5

block synaptic serotonin uptake
increase serotonin in the brain
GI upset, sexual dysfunction

Question 6

explain paroxetine

Answer 6

short half life
sedating
weight hain

Question 7

explain sertraline

Answer 7

short half life

requires full stomach

Question 8

explain fluoxetine

Answer 8

long half life

can induce mania

Question 9

explain citalopram

Answer 9

short half life

can be sedating

Question 10

what are SNRIs

Answer 10

inhibit both serotonin and noadrengic reuptake

duloxetine good for neuropathic pain , venlafaxine

Question 11

hot to treat 1 episode of depression

Answer 11

for 6 months

Question 12

how to treat 2 episodes of depression

Answer 12

for 2 years

Question 13

how to treat 3 episodes

Answer 13

for life

Question 14

what are indications for mood stabilisers

Answer 14

bipolar

schizophrenia

Question 15

what is lithium used for

Answer 15

effective long term prophylaxis
blood levels 0.5-1.2
over this can lead to lithium toxicity

Question 16

what tests to do before giving lithium

Answer 16

baseline U and E
TSH
pregnancy test

Question 17

what are the side effects of lithium

Answer 17

GI distress
thyroid abnormalities
acne
hair loss

Question 18

what are anticonvulsants

Answer 18

vampiric acid:
not in depression
effective in mania 
folic acid supplement in women
thrombocytopenia

Question 19

what is the first line for acute mania

Answer 19

carbamazepine
basle line liver function
rash and nausea

Question 20

what are atypical antipsychotics

Answer 20

are serotonin dopamine 2 antagonists
pimozide
affect dopamine and serotonin
risperadone, olanzapine

Question 21

what are antipsychotic adverse affects

Answer 21

tardive dyskinesia-involuntary muscle movements
neuropletic malignant syndorme
extrapyramidal effects

Question 22

what to do before prescirbing

Answer 22

fasting lipid profile
fasting blood sugar
LFT

Question 23

what are anxiolytics

Answer 23

used to treat anxiety usually in combination with SSRI
buspar
benzodiazepines