12.1: Drugs Used In Psychiatric Disease Flashcards
(24 cards)
What are the core symptoms of depression?
Low mood
Low energy
Lack of pleasure
Need 2 of 3 core symptoms
What are 4 examples of SSRIs?
Fluoxetine
Sertraline
Citalopram
Paroxetine
What are some side effects of SSRIs?
GI upset Nausea Anorexia Diarrhoea Citalopram prolongs QTc
Use fluoxetine if under 18
Sertraline most cardiac safe
Which type of antidepressants are reasonably safe in overdose?
SSRIs
What are some examples of TCAs?
Amitriptyline
Lofepramine
Clomipramine
Imipramine
How do TCAs work?
Inhibit NA re-uptake, hence sympathetic effect
Also block muscarinic ACh receptors, hence anticholinergic effect
What are some side effects of TCAs?
Sedation Lower seizure threshold Constipation Reduced glandular secretions Tachycardia Postural hypotension Eye accommodation block
What would the consequence be of a patient overdosing on amitriptylline versus an SSRI?
Amitriptyline is a TCA, very dangerous in overdose and can lead to sudden cardiac death
Whereas SSRIs are reasonably safe in overdose
(So better for lots of patients)
What are some examples of SNRIs?
Duloxetine
Venlafaxine
What are some examples of typical antipsychotics?
Haloperidol
Chlorpromazine
What are 3 examples of atypical antipsychotics?
Olanzapine
Risperidone
Quetiapine
Sulpiride
What pathways in the brain are affected by D2 antagonist antipsychotics which are responsible for the side effects?
Nigrostriatal
Tubero infundiblar
What is the 3rd line antipsychotic agent?
Clozapine
What is akathisia?
Movement disorder characterised by feeling of restlessness and inability to stay still
Type of EPSE
How do benzodiazepines exert their action?
Act as agonists at BDZ receptors
Leads to enhancement of GABA
(Chief inhibitory neurotransmitter in the brain)
Why are benzodiazepines generally avoided long term and in pregnancy?
Px will build up tolerance so need increasing dose
Px can build a dependence and have withdrawals symptoms if discontinued
In pregnancy can cause cleft lip and palate, and respiratory distress in foetus
What are some side effects of benzodiazepines?
Dizziness Drowsiness Blurred vision Psychomotor impairment Headache GI upset Dry mouth Low BP
Why are antidepressants avoided in bipolar disorder?
As they can induce mania
What are some examples of mood stabilisers?
Lithium
Sodium valproate
Carbamazepine
Lamotrigine
What checks needs to be done before commencing lithium and every 6 months, and why?
Renal function, as it is renally excreted
Thyroid function as it can cause hypothyroidism
What is memantine used in?
Alzheimer’s dementia
How does memantine work?
NMDA antagonist
What class of drugs is first line in dementia?
AChE inhibitors
Eg rivastigmine, galantamine, donepezil
What are some side effects of AChE inhibitors used in dementia?
Nausea Vomiting Worsen COPD Diarrhoea Headache Anorexia Bradycardia Insomnia Peptic ulcers
