Brainscape's Knowledge GenomeTM

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


See full index

Psychiatry > Therapeutics > Flashcards

Therapeutics Flashcards

1
Q

SSRI’s mechanism

A

increase serotonin activity by reducing pre-synaptic reuptake of serotonin after release
…so more serotonin…down regulation of post synaptic receptors

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

SSRI’s s/e

A

agitation
nausea
GI disturbance
headache
weight change
sexual dysfunction
suicidal idealation - younger

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

sertraline safest in

A

CVD

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

citalopram s/e

A

QT prolong

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

fluoxetine switching

A

risk of serotonin syndrome

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

paroxetine stop

A

discontinuation syndrome

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

SNRI mechanism

A

same as SSRI but bind to NA reuptake receptors as well

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

SNRI s/e

A

sedation
nausea
sexual dysfunction

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

mirtazapine mechanism

A

noradrenergic and specific serotonergic antidepressant - 5HT-2 and 5HT-3 antagonist and H1 activity

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

mirtazepine

A

sedation (histamine)
weight gain

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

TCA uses and examples

A

if not respond to SSRI’S
newer - lofepramine
older - amitriptyline

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

TCA s/e

A

muscarinic and histaminic side effects
QT prolong and arrhythmias

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

MAOI mechanism

A

MAOI-A - work on serotonin
MAOI-B - work on dopamine
…both can increase adrenaline

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

MAOI types

A

irreversible (more dangerous) - phenelzine, isocarboxazid
reversible (less dangerous) - moclobamide, tranylcypromine

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

MAOI cautions

A

potential for significant drug interactions
tyramine reaction leading to hypertensive crisis - avoid cheese, pickled meats, wine and other tyramine products
if changed to another antidepressant, need a washout period (up to 6 weeks)

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

vortioxetine mechanism

A

serotonergic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

vortioxetine s/e

A

nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when use mirtazapine not SSRI

A

if major weight loss or major sleep difficulty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Anxiety and OCD dose changes

A

If no initial change, consider increasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Discontinuation syndrome

A

Sweating, shakes, agitation, insomnia, headaches, irritability, N+V
…worse if shorter half life (paroxetine and venlafaxine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Stop paroxetine and venlafaxine

A

Alternate days of taking or snap in half
Or switch to fluoxetine and then reduce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Serotonin syndrome sx

A

Headaches, agitation, hypomania, coma, shiver, sweat, hyperthermia, tachycardia, N+V, myoclonus, hyperreflexia, tenor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Serotonin syndrome tx

A

Fluids and monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Antipsychotics mechanism

A

Reduce levels of dopamine activity at D2 receptors at mesocortical and Mesolimbic pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Antipsychotics general s/e

A

Nigostriatal - movement
Tuberoinfundibular - hypothalamic-pituitary-adrenal axis
Sedation
Extrapyramidal
Weight gain
Acute dystopia - ocuolgyric crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Typical v atypical antipsychotics mechanism

A

Typical - muscarinic and hustaminic receptors
Atypical - serotonergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Typical antipsychotics examples

A

Haloperidol
Chlorpromazine

28
Q

Atypical antipsychotics examples

A

Clozapine
Olanzapime
Riperidone

29
Q

Anomaly atypical antipsychotic

A

Aripiprazole - D2 partial agonist not antagonist so fewer side effects

30
Q

Typical antipsychotics s/e

A

Extra pyramidal - bradykinesia, muscle stiffness, tremor, tardive dyskinesia, akathisia
Dizziness
Sexual dysfunction

31
Q

Atypical antipsychotics s/e

A

Weight gain
Dyslipidaemia and diabetes

32
Q

Antipsychotic generally monitoring

A

FBC, LIPID, LFT, HBA1C, WEIGHT, ECG, BP, PULSE,

33
Q

Neuroleptic malignant syndrome what and risks

A

Life threatening reaction to antipsychotics - fever, confusion, muscle rigidity, sweating, autonomic instability
Risk of death due to rhabdomyolysis, renal failure, seizures

34
Q

Neuroleptic malignant syndrome risk factors

A

High potency dopamine antagonist ie typical ones, high doses, young men

35
Q

Neuroleptic malignant syndrome tx

A

EMERGENCY
stop antipsychotics
Give benzo acutely due to behaviour change
Fluid resuscitation
Reduce temp
Oxygen
Fluids and sodium bicarbonate
Relax muscles with Dantrolene or lorazepam

36
Q

Extra pyramidal and acute dystonia treatment

A

Too much acetylcholine in relation to dopamine….reduce by antagonising with procyclidine

37
Q

Most efficacious antipsychotic

A

Clozapine
D2 antagonist, 5HT2 antagonist
Used after trying two other ones

38
Q

Clozapine s/e

A

Leukopenia
Constipation and fatal bowel obstruction
Hypersalivation
Urinary incontinence

39
Q

Clozapine agranulocytosis tx

A

Stop any myelosuppresive drugs
Avoid antipsychotics for a couple of weeks
Consultant haematologist
Avoid infection
Lithium or G-CSF

40
Q

Beta blocker mechanism

A

Reducing autonomic activity

41
Q

Beta blockers c/i

A

Asthma

42
Q

Benzodiazepines mechanism

A

Bind to GABA receptors to potentiate effects of GABA and reduce excitability of neurones

43
Q

Benzo how long use

A

Tolerance, dependence
Misuse
<6 weeks

44
Q

Pregablin mechanism

A

Binds ro voltage gated calcium channels on neurones reducing neuronal activity

45
Q

Pregablin indications

A

Anxiety
Neuropathic pain
Epilepsy

46
Q

Pregablin s/e

A

Sedation
Weight gain

47
Q

Hypnotics types

A

Benzodiazepines - temazepam, lormatazepam
Non Benzo - zopiclone
< 2 weeks

48
Q

Mood stabilisers indications

A

Bipolar

49
Q

Lithium mechanism

A

Lowers noradrenaline release and increase serotonin synthesis

50
Q

Lithium monitoring

A

Regular serum lithium levels - narrow gap between effective and toxic dose

51
Q

Lithium other indications

A

Self harm
Augment antidepressant

52
Q

Lithium s/e

A

GI disturbance, metallic taste, dry mouth, fine tremor, polydipsia, polyuria, weight gain

53
Q

Lithium long term effects

A

Hypothyroidism
Renal impairment

54
Q

Lithium toxicity

A

Confusion, coarse tremor, NAND V, ataxia, seizures
Tx with stop lithium and supportive fluids

55
Q

Lithium interactions

A

NSAIDS
loop diuretics
ACEi

56
Q

1st line tx for bipolar

A

Quetiapine
Second generation antipsychotics in bipolar

57
Q

Anticonvulsants in bipolar examples

A

Sodium valproate
Carbamazepine
Lamotrigine

58
Q

Anticonvulsants s/e

A

Sedation
Weight gain
Thrombocytopenia

59
Q

Drugs for ADD and ADHD

A

Methylphenidate - CNS stimulants
Atomoxetine - NA re uptake inhibitor

60
Q

antipsychotics in elderly pts

A

increased risk of stroke and VTE

61
Q

mirtazapine

A

blocks alpha 2 adrenergic receptors - increases release of neurotransmitters
fewer side effects - sedation and increased appetitie

62
Q

SSRI +NSAID

A

require PPI

63
Q

citalopram

A

QT prolongation

64
Q

SSRI interactions

A

warfarin
heparin
NSAIDS
aspirin
tritptans

65
Q
A

Psychiatry (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions