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Phase 2- Mental Health > Psychiatric Drugs > Flashcards

Psychiatric Drugs Flashcards

1
Q

Give 4 generic side effects of adrenergic receptor drugs

A

Sweating, tremor, headaches, nausea, dizziness

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2
Q

Give 4 generic side effects of muscarinic receptor drugs

A

Dry mouth, dysphagia, thirst, urinary retention, hot and flushed skin

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3
Q

Give 4 generic side effects of histamine receptor drugs

A

Dry mouth, drowsiness, dizziness, nausea, vomiting

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4
Q

Give the 4 main extrapyramidal side effects

A

Parkinsonism (cogwheel rigidity, bradykinesia, tremor)
Akathisia (restlessness, inability to stay still)
Dystonia (muscle spasms)
Tardive dyskinesia (involuntary movements of the tongue lips and face)

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5
Q

What are antidepressants?

A

Medications used to treat depression. They mainly work on increasing the activity of serotonin at postsynaptic receptors.

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6
Q

Give 4 examples of SSRIs

A

Sertraline
Citalopram
Fluoxetine
Paroxetine

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7
Q

How do SSRIs work?

A

Reduce the presynaptic reuptake of serotonin after its release

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8
Q

Give 5 side effects of SSRIs

A

Restlessness, agitation, increased anxiety, nausea, GI disturbance, headaches, weight changes, sexual dysfunction, GI bleeding, suicidal ideation

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9
Q

Give examples of 3 DDIs with SSRIs

A

Aspirin
Warfarin
NSAIDs
Triptans

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10
Q

Which SSRI is given in paediatric depression?

A

Fluoxitine

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11
Q

Which SSRI is given as 1st line treatment?

A

Sertraline

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12
Q

Which SSRI is the safest in cardiac disease?

A

Sertraline

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13
Q

How do TCAs work?

A

Inhibiting the reuptake of adrenaline and serotonin in the synaptic cleft

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14
Q

Give 4 potential side effects from TCAs

A

Tachycardia, hypotension, fine tremor, weight gain, dry mouth, urinary retention, dizziness, thirst, N&V

Fatal in overdose (QTc elongation)

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15
Q

Give 3 examples of TCAs

A

Amitriptyline
Dosulepin
Clomipramine
Lofepramine

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16
Q

Give the only example of an NaSSAntidepressant

A

Mirtazapine

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17
Q

Give 2 side effects of Mirtazapine

A

Sedation, weight gain, dry mouth

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18
Q

What is the mechanism of action of Reboxetine?

A

Prevents the reuptake of noradrenaline (NARI)

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19
Q

What is a SNRI?

A

Serotonin and noradrenaline reuptake inhibitor –> stops serotonin and noradrenaline from re-entering the presynaptic membrane.

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20
Q

Give 2 examples of SNRIs

A

Duloxetine

Venlafaxine

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21
Q

Give 4 potential side effects of SNRIs

A

Nausea, dry mouth, headache, dizziness, sexual dysfunction

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22
Q

When should Venlafaxine be used cautiously?

A

Heart disease patients –> changes in blood pressure

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23
Q

When might a MAOI be prescribed?

A

Atypical depression

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24
Q

What foods must a person on an MAOI avoid?

A

Foods high in tyramine

Cheese, wine, pickled meats

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25
Q

Give 2 examples of MAOIs

A

Phenelzine
Isocarboxazid
Moclobemide
Tranylcypromine

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26
Q

How long should a patient stay on an antidepressant?

A

6 months after they feel better

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27
Q

What is discontinuation syndrome?

A

When a patient comes off antidepressants very quickly

Symptoms include sweating, shakes, agitation, insomnia, headaches, irritability, nausea, vomiting, paraesthesia, clonus

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28
Q

What is serotonin syndrome?

A

Too much serotonin in the body from antidepressant use

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29
Q

What are the symptoms of serotonin syndrome?

A

Headaches, agitation, hypomania, confusion, shivering, sweating, hyperthermia, tachycardia, nausea, myoclonus, hyperreflexia, tremor

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30
Q

What are antipsychotics?

A

Drugs given to patients who have psychotic symptoms such as in schizophrenia and psychotic depression.

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31
Q

What is the main aim of antipsychotics?

A

Reduce dopamine activity in the mesocortical and mesolimbic brain pathways

32
Q

Which receptors do typical antipsychotics work on?

A

Muscarinic and histamine

33
Q

Give 5 common side effects of typical antipsychotics

A 
Bradycardia
Muscle stiffness 
Parkinsonism 
Tardive dyskinesia
Akathisia
Dizziness
Sexual dysfunction 
Acute dystonia (torticollis, oculogyric crisis)
34
Q

Give 2 examples of typical antipsychotics

A 
Haloperidol 
Flupenthixol 
Zuclopenthixol 
Chlorpromazine 
Sulpiride
35
Q

Give 3 side effects of atypical antipsychotics

A

Weight gain
Dyslipidemia
Diabetes
Increased risk of VTE

36
Q

Give 4 examples of atypical antipsychotics

A 
Clozapine 
Olanzapine 
Risperidone 
Quetiapine 
Amisulpride
Aripiprazole
37
Q

When should Clozapine be prescribed?

A

After 2 antipsychotics have been tried

38
Q

What is the main risk of being on Clozapine?

A

Agranulocytosis

39
Q

Give 4 side effects of Clozapine (not agranulocytosis)

A

GI hypomotility, bowel obstruction, hypersalivation, urinary incontinence

40
Q

What is Neuroleptic Malignant Syndrome?

A

Rare, life-threatening reaction to antipsychotics causing fever, confusion, muscle rigidity, sweating and autonomic instability.

41
Q

Why are anticholinergics sometimes taken alongside antipsychotics?

A

To reduce the extrapyramidal side effects

42
Q

Give an example of an anticholinergic

A

Procyclidine

43
Q

What are anxiolytics?

A

Drugs which are used to help reduce anxiety.

44
Q

Why are beta blockers used as anxiolytics?

A

Reduce autonomic nervous system activation so relieve autonomic symptoms of anxiety.

45
Q

What receptors do Benzodiazepines work on?

A

GABA-A receptors to potentiate the effect of GABA and reduce the excitability of neurons.

46
Q

Give 4 side effects of Benzodiazepines

A

Drowsiness, lightheadedness, ataxia, confusion, amnesia

47
Q

Give 4 effects of a Benzodiazepine overdose

A

Ataxia, dysarthria, nystagmus, coma, respiratory depression

48
Q

Give 3 examples of benzodiazepines

A

Diazepam
Lorazepam
Temazepam
Zopiclone

49
Q

What is the mechanism of action of Pregabalin?

A

Inhibitor of glutamate, noradrenaline and substance P

50
Q

Give 3 side effects of Pregabalin

A 
Dizziness 
Blurred vision 
Diplopia
Confusion 
Vivid dreams
51
Q

Give examples of drugs which can work as hypnotics

A

Benzodiazepines
Trazodone
Low dose amitriptyline
Z drugs

52
Q

What are the Z drugs?

A

Zopiclone, Zolpidem, Zaleplon

Used as hypnotics and act like benzodiazepines

53
Q

What are acetylcholinesterase inhibitors?

A

Drugs used in Alzheimers Disease to inhibit the breakdown of acetylcholine and therefore increase the amount of acetylcholine in the brain.

54
Q

Give 4 side effects of ACh-esterase inhibitors

A

Nausea, vomiting, insomnia, fatigue, muscle cramps, syncope

55
Q

Who are ACh-esterase inhibitors contraindicated in?

A 
Patients with a heart rate less than 50 
Supraventricular arrhythmias
Peptic ulcers
Asthma 
COPD
56
Q

Give 3 examples of ACh-esterase inhibitors

A

Donepezil
Galantamine
Rivastigmine

57
Q

What is Memantine?

A

Glutamine receptor agonist which leads to lower neuronal excitability. It is mainly given to patients with dementia behavioural issues.

58
Q

What medications can be given in alcohol dependence?

A

Acamprosate and Naltrexone to reduce cravings

Disulfiram to induce severe hangovers

59
Q

What are mood stabilising drugs?

A

Drugs used to treat bipolar disorder

60
Q

Which 3 antipsychotics are commonly used in psychotic bipolar?

A

Haloperidol
Olanzapine
Quetiapine

61
Q

Why should bipolar patients not be given an antidepressant when they are in a low episode?

A

They can induce a manic episode

62
Q

Why must bloods be taken every week when a patient is initially started on Lithium?

A

Narrow therapeutic window

63
Q

Which bloods should be done every 6 months for patients on long term lithium?

A

U&Es

TFT

64
Q

What ECG changes may be seen in a patient on Lithium?

A

T wave flattening

Widening of the QRS

65
Q

Give 5 side effects of lithium

A

Polyuria, polydipsia, nausea, metallic taste, GI disturbance, weight gain, renal impairment, fine tremor, hypothyroidism, leukocytosis, oedema

66
Q

Give 5 effects of lithium toxicity

A

Coarse tremor, ataxia, dysarthria, reduced consciousness, convulsions, coma, death

67
Q

Give 3 types of drugs which interact with lithium

A

NSAIDs, Loop diuretics, ACE inhibitors

68
Q

Which 2 antiepileptic drugs can also be used as mood stabilisers?

A

Sodium valproate

Carbamazepine

69
Q

What blood checks need to be done when a patient is taking sodium valproate?

A

LFTs, FBC every 6 months, TFTs every year

70
Q

Give 5 side effects of sodium valproate

A

Tremor, sedation, anorexia, nausea, vomiting, diarrhoea, headache, sedation, thrombocytopenia, hair loss

71
Q

What blood checks need to be done when a patient is taking carbamazepine?

A

Serum levels, LFTs, U&Es, FBC every 6 months

TFTs every year

72
Q

When is carbamazepine most effective in bipolar?

A

When the mood cycles are very rapid

73
Q

What are the side effects of carbamazepine?

A

Dizziness, drowsiness, ataxia, headache, hyponatraemia, oedema, anorexia, constipation, leukopenia, agranulocytosis, rash

74
Q

What is the main drug used in treatment of ADHD?

A

Methylphenidate

75
Q

Give 4 side effects of methyphenidate

A 
GI disturbance
Hypertension 
Tachycardia
Palpitations
Insomnia 
Nervousness

Phase 2- Mental Health (16 decks)

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