year5 Flashcards
moa of benzos
Enhances the effect of gamma-aminobutyric acid
leading to hyperpolarisation of neurons and ultimately decreased neuronal excitability.
feature of benzo withdrawl syndrome
insomnia
irritability
anxiety
tremor
loss of appetite
tinnitus
perspiration
perceptual disturbances
seizures
similar to alcohol withdrawal
happens 3 weeks after withdrawing from drug
in which condition are ssri needed to be giving for a longer period of time
ocd or depression
ocd as higher dose
continue ssri for 12months to prevent relapse and also allow for improvement
After discussing management options, she expresses a desire to switch to sertraline in hopes of better tolerability. from fluxoetine what is the most appropraite advice
Switching from fluoxetine to another SSRI - withdraw then leave a gap of 4-7 days (as it has a long half-life) before starting a low dose of the alternative SSRI
What type of urinary incontinence is the most associated with amitriptyline?
overflow
What should be monitored at initiation and dose titration of venlafaxine
BP
what should you hceck before starting an SSRI
U&E
how long should you conitnue SSRI for after deciding to stop
Antidepressants should be continued for at least 6 months after remission of symptoms to decrease risk of relapse
A 30-year-old police constable sees you in a routine GP surgery. The patient feels her life is falling apart, barely keeping it all together, but never taken a day off work. She has no history of mental illness. Her spouse noticed her cleaning the house more than usual and the constable is irritated by the apparent lack of cleanliness at home. The patient becomes irritated with others’ inability to perform tasks to her personal standards. She has a long history of perfectionism and never spends her money on frivolities.
What is the most likely diagnosis?
Patients with obsessive-compulsive personality can be rigid with respect to morals, ethics and values and often are reluctant to surrender work to others
Important for meLess important
OCD with mild impairment: low-intensity psychological treatments:
cognitive behavioural therapy (CBT) including exposure and response prevention (ERP) is first-line
finesteride cause waht problem
gynaecomastia
