Mental Health Drugs

Question 1

Tricyclic Antidepressant Examples

Answer 1

Amitriptyline, Lofepramine

Question 2

How do Tricyclic Antidepressant work?

Answer 2

Inhibit neuronal reuptake of serotonin AND noradrenaline (also block a wide range of receptors = side effects)

Question 3

Tricyclic Antidepressant Indications

Answer 3

Second-line treatment of Depression, Neuropathic pain

Question 4

Tricyclic Antidepressant Contra-indications

Answer 4

Elderly, CVD, Epilepsy, Constipation, BPH, High intraocular pressure

Question 5

Tricyclic Antidepressant Side Effects

Answer 5

Blurred vision, Dry mouth, Hypotension, Arrhythmias, Convulsions, Hallucinations, Tremor (many)

Question 6

What drug class shouldn’t you give with TCAs and SSRIs?

Answer 6

Monoamine Oxidase Inhibitors

Question 7

Selective Serotonin Reuptake Inhibitor Examples

Answer 7

Citalopram, Fluoxetine, Sertraline

Question 8

Why do SSRIs have fewer side effects than TCAs?

Answer 8

Do not inhibit noradrenaline uptake or cause blockade of other receptors

Question 9

SSRI Indications

Answer 9

First-line for depression, Panic disorder, OCD

Question 10

Who are SSRIs not that good in?

Answer 10

Young people

Question 11

SSRI Side Effects

Answer 11

Hyponatraemia, Confusion, Suicidal thoughts, Prolonged QT interval, Bleeding

Question 12

What should you prescribe with SSRIs if also taking Aspirin/NSAIDS?

Answer 12

Gastroprotection due to an increased risk of bleeding

Question 13

Benzodiazepine Examples

Answer 13

Diazepam, Lorazepam, Midazolam

Question 14

How do Benzodiazepines Work?

Answer 14

Target GABAA receptor and upregulate it - increases chloride flow into cell and thus more resistance to depolarisation (depresses synaptic transmission)

Question 15

Benzodiazepine Indications

Answer 15

Seizures, Alcohol withdrawal, Sedation, Severe anxiety/Insomnia

Question 16

Benzodiazepine Contra-Indications

Answer 16

Elderly, Respiratory impairment, Myasthenia Gravis, Liver failure

Question 17

Benzodiazepine Side Effects

Answer 17

Drowsiness, Sedation, Addiction

Question 18

What are Benzodiazepines metabolised by?

Answer 18

CYP450 system

Question 19

Acetylcholinesterase Inhibitor Examples

Answer 19

Donepezil, Carbamates, Caffeine

Question 20

How do Acetylcholinesterase Inhibitor work?

Answer 20

Inhibit break down of acetylcholine = increases level and duration of the neurotransmitter

Question 21

Acetylcholinesterase Inhibitors Indications

Answer 21

Myasthenia gravis, Parkinson’s, Alzheimer’s, Schizophrenia, Autism, Postural tachycardia

Question 22

Acetylcholinesterase Inhibitor Side Effects

Answer 22

Parasympathetic nervous system action = hypotension, Bronchoconstriction, Decreased Intraocular pressure etc. // Prolonged muscle contraction