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Revision > Nevrous System > Flashcards

Nevrous System Flashcards

1
Q

Carbamazepine therapeutic range

A

10-20mg/L or 40-80 micromol/L

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2
Q

What types of seizures does carbamazepine exacerbate

A

Atonic, clonic and myoclonic

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3
Q

Signs of carbamazepine toxicity (I Handbag)

A 
In coordination
Hyponatraemia
Ataxia
Nystamus- uncontrolled eye movements
Drowsiness
Blurred vision and double vision
Arrhythmias
Gastrointestinal disturbance
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4
Q

Carbamazepine side effects

A

Leucopenia or thrombocytopenia
Hepatotoxicity
Hypersensitivity- anti epileptic syndrome
Rashes- Han Chinese and Thai patient are at increased risk of Steven Johnson syndrome

Hyponatraemia

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5
Q

How can you reduce some side effects of carbamazepine

A

Use MR preparations

Side effects: headache, ataxia, jazziness, nausea, vomiting, blurred vision, unsteadiness and allergic skin reactions

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6
Q

What drugs reduce seizure threshold with carbamazepine

A

Quinolones SSRIs antipsychotics, TCAs and related antidepressants

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7
Q

What drugs increase the risk of hepatotoxicity with carbamazepine

A

Tetracyclines sulphasalazine sodium valproate, methotrexate iron aside statins fluconazole and alcohol

Think what drugs affect the liver

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8
Q

What is the dose of citalopram in the elderly?

A

Max 20mg

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9
Q

What should you consider adding to citalopram

A

PPI as there is an increased risk of bleeding

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10
Q

When should a drug sample to check lithium is in range after initation

A

12 hours after first dose

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11
Q

Elderly patient comes in with a shaky tongue. What drug do you think it could be due to

Morphine
Furosemide
Haloperidol
Ramipril

A

Haleperiodol is a first gen antipsychotic

Thats are most likely to cause eps

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12
Q

Which medication is QT interval prolongation not a concern

Haloperidol
Citalopram
Alteplase
Sotalol
Amiodarone
A

Alteplase

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13
Q

Patient is due risperidone depot and has the following: muscle rigidity, tachycardia, sweating all day, times that they lose conciousness. What should you do?

Reduce dose
Stop medicine
Switch to oral
Continue but monitor

A

Stop
May have neuroleptic malignant syndrome which is fatal
May last 5-7 days after stopping oral but longer after stopping depot

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14
Q

Which of the following antipsychotic side effects are irreversible?

A. Tremors
B. Tardive dyskinesia
C. Dystonia
D. Akthsia

A

B. Tardive dyskinesia

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15
Q

A patient has been experiencing tremors, tongue wagging and a twitch in their check and they are on haloperidol? Which should you switch to?
Olanzapine, prochloperazine, flupentixol or citalopram

A

Olanzapine- 2nd gen are less likely to cause EPSEs

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16
Q 
How often should FBCs be monitored for a patient taking quetiapine?
3 monthly
6 monthly
Yearly
At the start only
A

Yearly

17
Q 
Which of the following do not need to be monitored in patients taking antipyschotics?
Blood pressure
Lipids
Weight
ECG
TSH
A

TSH

18
Q 
A patient is taking olanzapine which of the following medication is appropriate to prescribe the patient?
Ciprofloxacin
Ramipril
Metoclopramide
Domperidone
Citalopram
A

Domperidone
Assess clinical need but SSRIs, metoclopramide and SSRIs interact
SSRIs- prolong QT
Metoclopramide- EPS

19
Q

A patient is unhappy because they have being gaining weight they are taking the following…
Metformin
Glizide
Quetiapine

A

Metformin is weight neutral

20
Q

A patient has been taking clozapine for 32 weeks how often are they going in clozapine monitoring?

A

2 weekly

Every week for 18 weeks, then fortnightly up to one year then monthly

21
Q

A patient asks you for Senna as they have not open their bowels for 3 days. You ask and found out that they are on paracetamol, clozapine and cyclizine. What should you do?

A

Tell them to get medical attention asap as faecal impaction can be a fatal side effect from clozapine

22
Q 
A 82 year old is starting on olanzapine and the doctor wants some advise on the starting dose. Which one should it be?
5mg
10mg
15mg
20mg
A

5mg as elderly patients should be started on half or lower than the usual dose. 20mg is the max dose dose. 10mg is the typically starting dose.

23
Q

Which of the following are most likely to cause hyperprolactinemia?
Amisulpride
Aripiprazole
Quetiapine

A

Amisulpride as does risperidone

Apripiprazole does not cause this side effect

24
Q

Patient is experiencing nausea and vomiting and can not swallow. They can not have medicines rectally. What would you give?

A

Prochlorperazine can be given as a buccal tablet

25
Q

What are the contraindications of codeine? (3)

A

Ultra rapid metabolisers of CYP2D6
Kids that have undergone tonsils removal or adenoids for obstructive sleep aponea
Kids with breathing problems

26
Q

Which of the following routes can codeine not be given?
IM
PO
IV

A

IV as it can cause a severe reaction

27
Q 
Which of the following can tramadol be given with?
Warfarin
Amitriptyline
Citalopram
Phenytoin
Ramipril
A

Tramadol increases bleeding risk so not with warfarin
it lowers seizure threshold
Used with serotonergic drugs, there is a risk of serotonin syndrome

28
Q

Which of these are less likely to cause GI effects?

Morphine
Fentanyl
Tapentadol
Oxycodone 
Methadone
A

Tapentadol

29
Q 
Which of these are used for analgesia in labour?
Pethidine
Morphine 
Diamorphine
Codeine
A

Pethidine

Morphine and diamorphine is used for obstetric pain

30
Q

A mother is breastfeeding and has a prescription for tramadol 50mg. What should you do?

A

Ask for an alternative like paracetamol or NSAID. Tramadol is not recommended for breastfeeding mums

31
Q

What age range is sumatriptan indicated for OTC?

A

18-65

Revision (10 decks)

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