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year three - psychiatry > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

What are the five antidepressant drug class types?

A

Selective Serotonin Reuptake Inhibitors (SSRIs)

Serotonin Noradrenaline Reuptake Inhibitors (SNRIs)

Monoamine Oxidase Inhibitors (MAOIs)

Tricyclics Antidepressants (TCAs)

Alpha2-Adrenoreceptor Antagonists

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2
Q

When do antidepressant drugs start to work?

A

2 - 4 weeks

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3
Q

What do we do when there are no improvements seen with an antidepressant after two months?

A

We switch to another antidepressant

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4
Q

How long do we prescribe antidepressants for after the first depressive episode?

A

6 months to a year

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5
Q

How long do we prescribe antidepressants for after the second depressive episode?

A

2 years

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6
Q

How long do we prescribe antidepressants for after the third depressive episode?

A

Life-long

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7
Q

When are SSRIs prescribed?

A

They are the first line drug class used to manage several psychiatric conditions, including depression and anxiety disorders

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8
Q

List five SSRI examples

A

Sertraline

Fluoxetine

Paroxetine

Citalopram

Escitalopram

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9
Q

What are the two SSRIs initially administered?

A

Sertraline

Fluoxetine

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10
Q

What SSRI is administered in individuals who have chronic illnesses? Why?

A

Sertraline

It doesn’t produce that many drug interactions

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11
Q

How do SSRIs work?

A

They work by blocking the presynaptic serotonin reuptake, thus increasing its levels within the brain

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12
Q

What syndrome can occur when SSRIs are initially administered?

A

Activation syndrome

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13
Q

What is activation syndrome? What are the four clinical features associated?

A

It is caused by increased serotonin levels, in which a state of agitation, anxiety and restlessness occurs

In some cases, suicidal ideation can occur

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14
Q

How long does it usually take for activation syndrome to self-resolve?

A

2 – 10 days

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15
Q

What syndrome can occur when SSRIs are initially stopped?

A

Discontinuation syndrome

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16
Q

What is discontinuation syndrome? What are the three clinical features associated?

A

It is caused by decreased serotonin levels

Dizziness

Paraesthesia

Anxiety

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17
Q

How long does it take for discontinuation to present after SSRIs are stopped?

A

A few days

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18
Q

How long does it usually take for discontinuation syndrome to self-resolve?

A

Three weeks

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19
Q

How can we prevent discontinuation syndrome?

A

We usually wean the drug dose gradually over a period of four weeks.

However, this period is prolonged in individuals who have been taking antidepressants for longer

We can also consider switching patients to one 20mg fluoxetine per day

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20
Q

What are the four contraindications of SSRIs?

A

Poorly Controlled Epilepsy

Manic Phase of Bipolar

Hepatic Impairment

Congenital Long QT Syndrome

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21
Q

What are the two unique side effects of SSRIs - apart from GI upset?

A

Sexual Dysfunction

Hyponatraemia

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22
Q

What are the two main side effects associated with paroxetine?

A

Sedation

Weight gain

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23
Q

Due to the increased risk of GI bleeding, which patients do we reconsider administrating SSRIs to?

A

Those taking NSAIDs, aspirin or warfarin

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24
Q

Due to the increased risk of hyponatraemia, which patients do we reconsider administrating SSRIs to?

A

Those taking diuretics and PPIs

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25
Q

Which three drugs increases the risk of serotonin syndrome?

A

Tramadol

St John’s Wort

Triptans

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26
Q

When are SNRIs prescribed?

A

They are the second line drug class used to manage several psychiatric conditions, including depression and anxiety disorders

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27
Q

List two SNRIs examples

A

Duloxetine

Venlafaxine

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28
Q

Which SNRI is prescribed in individuals who have chronic illnesses? Why

A

Venlafaxine

it doesn’t produce many drug interactions

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29
Q

Which SNRI is associated with a greater risk of mortality from overdose?

A

Venlafaxine

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30
Q

In which circumstances do we prescribe duloxetine over venlafaxine?

A

When the patient suffers from hypertension and cardiac arrhythmia

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31
Q

How do SNRIs work?

A

They work by blocking the presynaptic serotonin and noradrenaline reuptake, thus increasing their levels within the brain

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32
Q

What syndrome can occur when SNRIs are initially administered?

A

Activation syndrome

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33
Q

What syndrome can occur when SNRIs are initially stopped?

A

Discontinuation syndrome

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34
Q

What are the five contraindications of SNRIs?

A

Cardiac Arrythmias

Uncontrolled Hypertension

Hepatic Impairment

Renal Impairment

Congenital Long QT Syndrome

Monoamine Oxidase Inhibitors

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35
Q

Why should SSRIs not be combiend with MAOIs?

A

There is a risk of serotonin syndrome

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36
Q

What are the eight clinical features of serotonin syndrome?

A

Fever

Confusion

Seizures

Renal impairment

Hepatic impairment

Arrhythmia

Increased muscle tone

Hypersecretion of sweat

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37
Q

How do we prevent serotonin syndrome?

A

There should be a 14 day washout period between SSRIs and MAOIs

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38
Q

What are the two unique side effects of SNRIs - apart from GI upset?

A

Hypertension

Sexual Dysfunction

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39
Q

When are MAOIs prescribed?

A

They are the second/third line drug class used to manage several psychiatric conditions, including depression and anxiety disorders

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40
Q

Who usually prescribes MAOIs?

A

Psychiatrists

GPs tend to continue this prescription, however it tends to be initiated in secondary care

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41
Q

List four MAOIs examples

A

Isocarboxazid

Phenelzine

Selegiline

Tranylcypromine

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42
Q

What should phenelzine not be prescribed with? Why?

A

Fluoxetine

An increased risk of central serotonin syndrome

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43
Q

How do MAOIs work?

A

They work by binding irreversibly to monoamine oxidase on the presynaptic membrane thereby preventing the inactivation of amines, such as serotonin, dopamine and noradrenaline

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44
Q

What are the four contraindications of MAOIs?

A

Cerebrovascular Disease

Manic Phase of Bipolar

Phaeochromocytoma

Severe Cardiovascular Disease

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45
Q

What are the three unique side effects of MAOIs - apart from GI upset?

A

Weight Gain

Postural Hypotension

Hypertensive Crisis

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46
Q

How do MAOIs lead to a hypertensive crisis?

A

When they are administered with tyramine-rich foods, such as cheese

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47
Q

When are TCAs prescribed?

A

They are the second/third line drug class used to manage several psychiatric conditions, including depression and anxiety disorders

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48
Q

Who usually prescribes TCAs?

A

Psychiatrists

GPs tend to continue this prescription, however it tends to be initiated in secondary care

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49
Q

What do all TCAs end in?

A

“ine”

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50
Q

List seven TCAs examples

A

Amitriptyline

Clomipramine

Doxepin

Desipramine

Imipramine

Nortriptyline

Trimipramine

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51
Q

Which TCA is used to manage anxiety?

A

Clompiramine

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52
Q

How do TCAs work?

A

They work by blocking the re-uptake of serotonin, noradrenaline and dopamine, thus increasing their levels within the brain

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53
Q

What are the two subtype classifications of TCAs?

A

Tertiary TCAs

Secondary TCAs

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54
Q

What are tertiary TCAs?

A

They are molecules composed of a three-ring structure, with two methyl groups on the nitrogen atom of the side chain

This means that they have tertiary amine side chains

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55
Q

What TCA subtype is associated with more side effects? Why?

A

Tertiary TCAs

The side chains are prone to cross react with other types of receptors

Tertiary TCAs have tertiary amine side chain

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56
Q

List four tertiary TCAs examples

A

Imipramine

Amitriptyline

Doxepin

Clomipramine

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57
Q

What are the two active metabolites of tertiary TCAs?

A

Desipramine

Nortriptyline

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58
Q

What are secondary TCAs?

A

They result from the metabolism of tertiary TCAs, during which there is loss of one methyl group on the nitrogen side chain

This means that they have secondary amine side chains

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59
Q

List two secondary TCAs examples

A

Desipramine

Nortriptyline

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60
Q

What is the main difference between tertiary and secondary TCAs?

A

Tertiary TCAs - They are more potent in blocking reuptake of serotonin

Secondary TCAs - They are more potent in blocking the reuptake of noradrenaline

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61
Q

What are the six contraindications of TCAs?

A

Arrythmias

Heart Block

Severe Hepatic Impairment

Severe Renal Impairment

Manic Phase of Bipolar

Congenital Long QT Syndrome

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62
Q

What are the two unique side effects of TCAs - apart from GI upset?

A

Weight Gain

Eye Accommodation

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63
Q

Which antidepressant has the greatest risk of mortality related to overdose? What does this mean?

A

TCAs

They should be carefully prescribed to individuals who experience suicidal ideation

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64
Q

When are alpha2-adrenoreceptor antagonists prescribed?

A

They are the second/third line drug class used to manage several psychiatric conditions

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65
Q

What condition do alpha2-adrenoreceptor antagonists treat?

A

Depression

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66
Q

List an alpha2-adrenoreceptor antagonist

A

Mirtazapine

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67
Q

How do alpha2-adrenoreceptor antagonists work?

A

They work by antagonising the adrenergic alpha2-autoreceptors and alpha2-heteroreceptors as well as blocking 5-HT2 and 5-HT3 receptors

This blocks reuptake of serotonin and noradrenaline, thus increasing their levels within the brain

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68
Q

What are the five contraindications of mirtazapine?

A

Cardiac Disorders

Diabetes Mellitus

Manic Phase of Bipolar

Hypotension

Psychosis

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69
Q

What are the two unique side effects of mirtazapine - apart from GI upset?

A

Weight Gain

Postural Hypotension

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70
Q

What are two mood stabiliser drug class types?

A

Lithium salts

Anticonvulsants

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71
Q

When are lithium salts prescribed?

A

They are the first line drug class used to manage psychiatric conditions, including bipolar disorder and schizophrenia

They can be used for the treatment of acute episodes of mania associated with bipolar disorder or the long-term management of bipolar disorder to prevent recurrence of acute episodes

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72
Q

List two lithium salt examples

A

Lithium carbonate

Lithium citrate

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73
Q

How do lithium salts work?

A

They work by increasing GABA levels, which is an inhibitory transmitter that also plays a role in modulating glutamate and dopamine

In bipolar disorder, individua’s have diminished GABA neurotransmission. Thus, low GABA levels can result in excitatory toxicity

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74
Q

What two investigations should be conducted prior to the administration of lithium?

A

Baseline bloods (U&Es, TSH)

Pregnancy test

75
Q

How long post-dose should we measure lithium blood levels?

A

12 hours

76
Q

Why do we conduct a pregnancy test prior to the administration of lithium?

A

This is due to the associated teratogenic risk of Ebstein’s anomaly

77
Q

How do we administer lithium?

A

An initial dose of lithium (400mg, twice daily) is administered, which after 5-7 days is reviewed

The dose is gradually titrated up until a stable therapeutic level of 0.6 – 1.2 is achieved

78
Q

What investigations should be conducted when administrating lithium? Why?

A

LFTs every 3 months

TFTs and U&Es every six months

To monitor for lithium toxicity

79
Q

At what serum lithium concentration does lithium toxicity occur?

A

> 1.5mmol/L

80
Q

What are the eight clinical features of lithium toxicity?

A

Diarrhoea

Vomiting

Dizziness

Coarse tremor

Blurred vision

Ataxia

Clonic limb movements

Convulsions

81
Q

Which endocrine disorder is most commonly associated with chronic lithium toxicity?

A

Hypothyroidism

82
Q

In which patients is lithium toxicity risk the greatest?

A

Those with chronic illnesses

83
Q

How do we manage patients with suspected lithium toxicity?

A

It is recommended that an urgent lithium level is conducted immediately, and specialist advice is obtained

84
Q

What are the eight contraindications of lithium?

A

Cardiac Arrythmias

Severe Renal Impairment

Hypothyroidism

Brugada Syndrome

Addison’s Disease

Diabetes Insipidus

Breastfeeding

Pregnancy

85
Q

What are the five unique side effects of lithium?

A

Urinary Frequency

Weight Gain

Fine Tremor

Altered Taste Sensation

Thyroid Abnormalities

86
Q

Which drugs are avoided when prescribing lithium?

A

Nephrotoxic drugs, such as ACEI, NSAIDs and diuretics

87
Q

When are anticonvulsants prescribed?

A

They are the second line drug class used to manage psychiatric conditions, including bipolar disorder and schizophrenia

It can be used in individuals in which lithium is contraindicated or not tolerated

They can be used for the treatment of acute episodes of mania associated with bipolar disorder or the long-term management of bipolar disorder to prevent recurrence of acute episodes

88
Q

List three anticonvulsant examples

A

Sodium valproate

Carbamazepine

Lamotrigine

89
Q

How do anticonvulsants work?

A

They work by increasing GABA levels, which is an inhibitory transmitter that also plays a role in modulating glutamate and dopamine

In bipolar disorder, individua’s have diminished GABA neurotransmission. Thus, low GABA levels can result in excitatory toxicity

90
Q

When do we prescribe sodium valproate?

A

It is recommended in individuals who suffer from several manic/depressive episodes a year

It is recommended in individuals who suffer from comorbid alcohol/substance use

91
Q

How do we administer and monitor sodium valporate?

A

An initial dose of sodium valproate (500mg daily) is administered, which after 4-5 days is reviewed

The dose is gradually titrated up until a stable therapeutic level of 50– 125 is achieved, after which annual blood checks are conducted

92
Q

What are the four contraindications of sodium valproate?

A

Acute Porphyria

Severe Hepatic Impairment

Urea Abnormalities

Mitochondrial Disorders

93
Q

What are the three unique side effects of sodium valproate - apart from GI upset?

A

Weight Gain

Tremors

Hair Loss

94
Q

How do we administer and monitor carbamazepine?

A

An initial dose of carbamazepine (100mg-200mg, 1-2 times daily) is administered, which after 5 days is reviewed

The dose is gradually titrated up until a stable therapeutic level of 4– 12 is achieved, after which monthly blood checks are conducted

95
Q

What are the three contraindications of carbamazepine?

A

Acute Porphyria

AV Conduction Abnormalities

Bone Marrow Depression

96
Q

What are the three unique side effects of carbamazepine - apart from GI upset?

A

Weight Gain

Rash

Fluid Imbalance

97
Q

How do we administer and monitor lamotrigine?

A

An initial dose of lamotrigine (25mg daily on alternate days) is administered. The dose is gradually titrated up to 50mg daily after two weeks, and then 100mg daily after a further two weeks

In cases where patients experience compliance issues and stop administrating lamotrigine for 5 days, it is recommended that they start back at the initial dose

98
Q

What are the three contraindications of lamotrigine?

A

Myoclonic Seizures

Parkinson’s Disease

Brugada Syndrome

99
Q

What are the two unique side effects of lamotrigine - apart from GI upset?

A

Rash

Irritability

100
Q

It is normal for individuals on anticonvulsants to experience deranged LFTS. When should we raise concerns?

A

If LFTs are increased three times greater than the baseline

101
Q

When are anti-psychotics prescribed?

A

They are indicated in the management of psychotic disorders, including schizophrenia, bipolar disorder and psychotic depression

102
Q

What two medications are antipsychotics commonly administered in conjunction with?

A

Lithium

Sodium valproate

103
Q

How do antipsychotics work?

A

They work by inhibiting dopaminergic neurotransmission via four dopaminergic pathways

104
Q

What are the four dopaminergic pathways?

A

Mesocortical Pathway

Mesolimbic Pathway

Nigrostriatal Pathway

Tuberoinfundibular Pathway

105
Q

Where does the mesocortical pathway extend?

A

It connects the ventral tegmentum to the prefrontal cortex

106
Q

What is the function of the mesocortical pathway?

A

It is thought to be involved in cognitive control, motivation and emotional response

107
Q

What abnormalities in the mesocortical pathway results in psychotic disorders?

A

There are reduced levels of dopamine

108
Q

What psychotic clinical features arise as a result of mesocortical pathway abnormalities?

A

Negative clinical features, such as anergia, anhedonia, lack of motivation, etc

109
Q

Where does the mesolimbic pathway extend?

A

It connects the ventral tegmentum to the ventral striatum in the forebrain

110
Q

What is the function of the mesolimbic pathway?

A

It is involved in reinforcement and reward-related motor function learning

111
Q

What is another term of mesolimbic pathway?

A

Reward pathway

112
Q

What abnormalities in the mesolimbic pathway results in psychotic disorders?

A

There are increased levels of dopamine

113
Q

What psychotic clinical features arise as a result of mesolimbic pathway abnormalities?

A

Positive clinical features, such as hallucinations, delusions and thought disorders

114
Q

Where does the nigrostriatal pathway extend?

A

It connects the substantia nigra in the midbrain to the basal ganglia in the forebrain

115
Q

What is the function of the nigrostriatal pathway?

A

It is thought to be involved in movement regulation, by suppressing acetylcholine activity

116
Q

What abnormalities in the nigrostriatal pathway results in psychotic disorders?

A

There are reduced levels of dopamine

117
Q

What psychotic clinical features arise as a result of nigrostriatal pathway abnormalities?

A

Sympathetic motor deficits, such as bradykinesia, dyskinesia, tremors, rigidity, akathisia and dystonia

118
Q

Where does the tuberoinfundibular pathway extend?

A

It connects the infundibular nucleus in the hypothalamus to the anterior pituitary gland

119
Q

What is the function of the tuberoinfundibular pathway?

A

It is thought to be inhibit the secretion of prolactin from the anterior pituitary lactotrophs by binding to D2 receptors

120
Q

What is a common complication when administering antipsychotics that bock the tuberoinfundibular pathway?

A

Hyperprolactinemia

121
Q

What are the four main clinical features of hyperprolactinaemia?

A

Gynaecomastia

Galactorrhoea

Decreased libido

Menstrual dysfunction

122
Q

What are the two classifications of antipsychotics?

A

Typical Antipsychotics

Atypical Antipsychotics

123
Q

What is the mechanism of typical antipsychotics?

A

D2 dopamine receptor antagonists

124
Q

When do we prescribe typical antipsychotics? Why?

A

They are used to manage severe psychotic conditions, which are resistant to newer medications

Due to the high risk of extrapyramidal and cardiotoxic/anticholinergic side effects

125
Q

What type of typical antipsychotics are associated with extrapyramidal side effects?

A

High potency

126
Q

List three high potency typical antipsychotics

A

Fluphenazine

Haloperidol

Pimozide

127
Q

What are five extra-pyramidal features?

A

Parkinsonism

Acute dystonia

Sustained muscle contraction

Akathisia

Tardive dyskinesia

128
Q

What are the two types of extra-pyramidal sustained muscle contractions?

A

Oculogyric crisis

Torticollis

129
Q

What is oculogyric crisis?

A

It is a dystonic reaction that occurs shortly after initiation of anti-psychotics, resulting in an upward deviation of both eyes.

130
Q

What are the two management options for oculogyric crisis?

A

Drug cessation

Anti-muscarinic administration - procyclidine

131
Q

What are the three features of an acute dystonic reaction?

A

Oculogyric crisis

Tongue protrusion

Jaw spasm

These all occur suddenly

132
Q

What is akasthesia?

A

Restlessness

133
Q

What is tardive dyskinesia?

A

It is late onset of choreoathetoid movements, abnormal, involuntary - chewing and pouting of jaw

134
Q

What is the cause of tardive dyskinesia?

A

The blockade of the dopamine receptor promotes hypersensitivity of the D2 receptor in the nigrostriatal pathway, thus giving rise to excessive movements.

135
Q

What increases the risk of tardive dyskinesia?

A

Long-term use of antipsychotic drugs

136
Q

How do we treat extra-pyramidal side effects?

A

We administer anti-cholinergics and beta-blockers

137
Q

What three anticholinergics are used to treat extra-pyramidal features?

A

Benxtropine

Trihexyphenidly

Diphenhydramine

138
Q

What beta-blocker is used to treat extra-pyramidal side effects?

A

Propanolol

139
Q

What should we be cautious about when treating extra-pyramidal side effects?

A

If the patient is taking other meds with anticholinergic activity, such as TCAs

140
Q

What type of typical antipsychotics are associated with cardiotoxic, anticholinergic side effects?

A

Low potency

141
Q

List two low potency typical antidepressants

A

Chlorpromazine

Thioridazine

142
Q

Why do the low potency typical antipsychotics cause cardiotoxic and anticholinergic adverse effects?

A

They have a lower affinity for the D2 receptors and tent to interact with nondopaminergic receptors

143
Q

What are the four common side effects associated with typical antipsychotics?

A

Extrapyramidal features

Neuroleptic malignant syndrome

Hyperprolactinaemia

Prolonged QT interval

Metabolic syndrome

144
Q

What is neuroleptic malignant syndrome?

A

It is a life threatening condition which can occur in individuals taking antipsychotic and dopaminergic medications

145
Q

How soon after starting an antipsychotic can neuroleptic malignant syndrome occur?

A

Hours to days

146
Q

What are the six clinical features of neuroleptic malignant syndrome?

A

Fever

Muscle rigidity

Hypertension

Tachycardia

Tachypnoea

Delirium

147
Q

What are the two blood test results indicative of neuroleptic malignant syndrome?

A

Increased creatinine kinase levels

Increased leucocyte levels

148
Q

What are the five management options of neuroleptic malignant syndrome?

A

Stop antipsychotic

IV fluids

Dantrolene

Bromcriptine

Dopamine agonist

149
Q

What is the advantage of typical antipsychotics?

A

There is no weight gain

150
Q

What is a contraindication of typical antipsychotics? What is administered instead?

A

Parkinson’s disease

IM Lorazepam

151
Q

What is the mechanism of atypical antipsychotics?

A

Serotonin-dopamine 2 antagonists (SDAs)

152
Q

Why are atypical antipsychotics considered atypical?

A

They affect dopamine and serotonin neurotransmission in the four dopaminergic pathways of the brain

153
Q

When do we prescribe atypical antipsychotics? Why?

A

They are the first line antipsychotics administered

They are associated with fewer side effects

154
Q

List five atypical antidepressants

A

Risperidone

Olanzapine

Quetiapine

Aripiprazole

Clozapine

155
Q

What is the first line antipsychotic prescribed?

A

Risperidone

156
Q

What is the maximum dose of risperidone? Why?

A

6mg

A greater dose can result in adverse side effects

157
Q

What are the five side effects commonly associated with risperidone?

A

Weight gain

Sedation

Hyperprolactinaemia

Extra-pyramidal features

Sexual dysfunction***

158
Q

When is risperidone prescribed?

A

It is the first line antipsychotic used to treat manic and mixed bipolar episodes

It is also used in terms of long term maintenance of bipolar disorder

159
Q

When is olanzapine prescribed?

A

It is used to treat manic, depressive and mixed bipolar episodes

160
Q

What are the four side effects associated with olanzapine?

A

Weight gain***

Sedation

Hyperlipidaemia

Deranged LFTs

161
Q

When is quetiapine prescribed?

A

It is used to treat manic and depressive bipolar episodes

It is also used in terms of long term maintenance of bipolar disorder

162
Q

What are the four side effects associated with quetiapine?

A

Weight gain

Hyperlipidaemia

Deranged LFTs

Hypotension

163
Q

When is aripiprazole prescribed?

A

It is used to treat manic and mixed bipolar episodes

It is also used in term of long term maintenance of bipolar disorder

164
Q

What are the two side effects associated with aripiprazole?

A

Akathisia

Activation

However, there are generally fewer side effects compared to the other atypical antipsychotics

165
Q

Which antipsychotic has the fewest side effects compared to to other typical antipsychotics?

A

Aripiprazole

It is particularly good for managing prolactin elevation

166
Q

When is clozapine prescribed?

A

It is used to treat resistant psychotic disorders, in which two antipsychotics have been ineffectively trialled for a period of eight weeks respectively

167
Q

What are the six side effects associated with clozapine?

A

Agranulocytosis**

Seizures

Sedation

Weight gain

Hyperlipidaemia

Deranged LFTs

168
Q

Which blood test is used to work out if olanzapine has caused agranulocytosis?

A

FBC

169
Q

What are the six contraindications of antipsychotics?

A

Cardiovascular Disease

Diabetes

Epilepsy

Myasthenia Gravis

Parkinson’s Disease

Prostatic Hypertrophy

170
Q

What are the two administration methods for antipsychotics?

A

Oral route

Intramuscular route

171
Q

What administration route is opted for after the third episode of schizophrenia? Why?

A

Intramuscular

This is due to reduced functioning and lower IQ symptoms resulting in compliance issues

172
Q

What four blood tests are conducted prior to antipsychotic administration?

A

Fasting lipid profiles

Fasting blood sugars

LFTs

FBC

173
Q

What ongoing monitoring is conducted when patients are administered antipsychotics? Why?

A

ECG

Due to the risk of QT prolongation

174
Q

How long do we prescribe antipsychotics for? Why?

A

Life-long

This is due to the inevitable relapse of psychotic disorders

175
Q

What four drugs are used to treat insomnia?

A

Melatonin

Benzodiazepines

Zopiclone

Temazepam

176
Q

What is the main side effect of benzodiazepines?

A

Respiratory depression

177
Q

What is the mechanism of action of zopiclone?

A

It is a non-benzodiazepine hypnotic acting on the α2-subunit of the GABA receptor

178
Q

What are the two indications for melatonin administration in insomnia patients?

A

Patient - > 55 years old

Short term use - < 13 weeks use

179
Q

How long does it take for insomnia patients to fall asleep after pharmacological intervention?

A

22 minutes

It doesn’t maintain sleep!!!

180
Q

What two drugs are used to manage ADHD?

A

Atomoxetine

Methylphenidate

181
Q

What is the mechanism of atomoxetine?

A

It is a norepinephrine reuptake inhibitor

182
Q

What is the mechanism of action of methylphenidate?

A

It is a dopamine/norepinephrine reuptake inhibitor

183
Q

Which high potency typical antidepressant?

A

x

year three - psychiatry (23 decks)

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