questions Flashcards
what is the risk of using fluoxetine in the 3rd trimester of pregnancy?
persistent pulmnonary hypertension
what additional medication needs to be given & why
patient on SSRI & NSAID
give PPI due to risk of GI bleed
medication to manage the side effect of antipsychotic ‘tardive dyskinesia’
tetrabenzine
medication to manage side effect antipsychotis; of acute dystonia
procyclidine
mechanism of mirtazapine
noradrenergic and specific serotonergic antidepressants
2 side effects of mirtazapine
- sedation
- increased apetitie
examples of typical antipsychotics and the common side effects
haloperidol
chlopromazine
extrapyramidal side efffets
hyperprolactinaemia
common side effects of TCAs
- dry mouth
- constipation
- urinary retention
- blurred vision
- drowsiness
examples of serotonin-noradrenaline reuptake inhibitor (2)
duloxetine or venlafaxine
common side efffects of atypical antipsychotics & example
olanzapine
weight gain
the only atypical antipsychotic to reduce seizure threshold
clozapine
name 5 atypical antipsychoticS
- olanzapine
- clozapine
- risperidone
- apiprazole
- quitietepine
what 2 side effects do all atyipcal antipsychotics cause
- hyperprolactinaemia
- weight gain
which atypical antipsychotic is less likely to causes hyperprolactinaemia
apiprazole
which atypical antipsychotic is notorious for its associations with dyslipidaemia & weight gain?
olanzapine
its also associated with diabetes and sedation. It is for this reason that some patients are purposefully given olanzapine if they are underweight and cannot sleep.
most notable side effect of quitiepine
postural hypotension
rare serious side effect of clozapine
agranulocytosis
which medication can cause a mild increased WCC
lithium
whren does delerium tremens peak after alcohol withdrawal
72 hours
first line for delerium tremens
Chlordiazepoxide
urinary problem in TCA
overflow incontinence
SSRI electrolyte abnormality
hyponatraemia
common side effect of clozapine
constipation
antidepressant of choice post MI
sertraline
what can chronic lithiium toxicty cause?
hypothroidism
the only absolute contraindication for ECT?
raised intracranial pressure
factors suggesting depression rather than dementis?
- depression has a short history and rapid onset
- global memory loss ( as in dementia there is recent memory loss)
- depression is associated with biological symptoims such as sleep disturbance & weight loss
pattern of onset for depression & dementia
depression has a short history and a rapid onset
whereas dementia has a more gradual onset
what are the 4 categories for schniders first rank symptoms of schizophrenia?
1) auditory hallucinations
2) thought disorders
3) passivity phenomena
4) delusional perceptions
what is Erotmania
specific form of delusional disorder that is characterised here by the patient’s belief that a famous actor is in love with her, alongside no other symptoms suggesting psychosis or mood disturbance.
poor prognostic factors for schizophrenia
- gradual onset
- pre morbid social withdrawal
- strong family history
- low IQ
- lack of obvious precipitant
what scale can be used to assess severity of alcohol withdrawal?
revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale
malingering?
Lying or exaggerating
fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain
atypical antipsychotics in the elderly - increased risk of?
VTE & stroke
venlafaxine mechanism
serotonin and noradrenaline reuptake inhibitor (SNRI)
most likely antidepressant to cause QT prolongation and Torsades de pointes
citalopraom (SSRI)
Charles-Bonnet syndrome (CBS)
persistent or recurrent complex hallucinations (usually visual or auditory), occurring in clear consciousness. This is generally against a background of visual impairment (although visual impairment is not mandatory for a diagnosis). Insight is usually preserved. This must occur in the absence of any other significant neuropsychiatric disturbance.Charles-Bonnet syndrome (CBS)
which patients should be on antidepressants for at least 2 years following a depressive episode?
High risk patients:
- > 5 lifetime episodes
- or 2 or more episodes in last few years
common initial adverse effects of SSRI
- mild nausea
- dry mouth
- sexual dysfunction
- GI upset
questionaire to assess patients mood in postnatal period?
EPDS (Edinburgh postnatal depression scale)
which section should be used to detail patients when the diagnosis is unclear?
section 2
medication used to deter a patient from drinking alcohol
Disulfiram
medication for acute treatment of mania?
Olanzapine
medication CI in lithium
Naproxen - as can reduce renal function when both taken
what is the maximum duration of restriction that DoLS can place?
12 months, however can be extended
2 medications that can be given for cognitive symptoms in lewy body dementia?
Donepezil & Rivastigmine
what medication can cause exacerbation of neuropsychiatric and cognitive symptoms so should not be given in lewy body dementia
levadopa
ACE 3 screening test
Addenbrooke’s cognitive examination III is a screening test that is composed of tests of attention, orientation, memory, language, visual perceptual and visuospatial skills. It is useful in the detection of cognitive impairment, especially in the detection of Alzheimer’s disease and fronto-temporal dementia
medication to manage REM sleep disorder
clonazepam
questionairre to assess ADHD
Connors
what is the ONLY licensed pharmacological trx for aggressive behaviour in children?
Risperidone
according to ICD 10, symptoms of ADHD should be present by when and for how long for diagnosis?
and DSM 5?
by age 6
with symptoms present for at least 6 months
DSM 5 = symptoms before age 12
1st line for ADHD?
methyphenidate
2nd line for AHDH & usuallly why?
atomoxetine
if the child has significant apetite suppression from the first line medx
symptoms relating to innatention in ADHD
- daydreaming
- forgetfulness
- appears not to lilsten
- making mistakes
side effects of methyphenidate
- weight loss
- hypertension
- growth restruction
- anxiety
- tachycardia
