Medication

Question 1

How do antipsychotics work?

Answer 1

dopamine receptor antagonist

Question 2

What are the two classes of antipsychotic?

Answer 2

first and second generation

Question 3

How do first generation antipsychotics work?

Answer 3

D2 receptor antagonists primarily

Question 4

What are the side-effects of first generation antipsychotics ?

Answer 4

extra-pyramidal se

elevated prolactin

Question 5

What are extra-pyramidal side effects?

Answer 5

dystonia
parkinsonism
akathisia
tardive dyskinesia

Question 6

What is dystonia?

Answer 6

involuntary muscle contraction

Question 7

What is akathisia?

Answer 7

inner restlessness

Question 8

What is tardive dyskinesia?

Answer 8

stiff jerky movements of the face eg blinking, sticking out tongue

Question 9

Are first or second generation antipsychotics better for negative symptoms?

Answer 9

second

Question 10

How do second generation anti-psychotics work?

Answer 10

Lower D2 receptor affinity.

High serotonin/dopamine binding ratio.

Question 11

What side-effects do second generation antipsychotics have?

Answer 11

inc risk of metabolic abnormality eg. obesity, inc cholesterol, inc bp, diabetes

Question 12

SE os antipsychotics

Answer 12

extrapyramidal
neurleptic malignant syndrome
prolonged QT
hyperprolactin
metabolic syndrome
anticholinergic
hyponatraemia

Question 13

What risk does clozapine have?

Answer 13

agranulocytosis

Question 14

Which types of drugs diffuse effectively over the blood brain barrier?

Answer 14

lipophilic

Question 15

What is a monoamine?

Answer 15

neurotransmitter inc dopamine, serotonin and noradrenaline

Question 16

How do antidepressants work?

Answer 16

inhibit a specific monoamine reuptake

Question 17

What is serotonin responsible for?

Answer 17

mood
sleep
feeding
pain

Question 18

What is dopamine responsible for?

Answer 18

arousal and emotion

Question 19

How do tricyclic antidepressants work?

Answer 19

block the reuptake of serotonin and noradrenaline in the presynaptic cleft

Question 20

What are the side-effects of TCA?

Answer 20

Anticholinergic: dry mouth, blurred vision, constipation, urinary retention

weight gain
postural hypotension
arrythmia

Question 21

How do SSRIs work?

Answer 21

selectively inhibit reuptake of 5ht from the presynaptic cleft

Question 22

What are the side-effects of SSRI?

Answer 22

nausea
transient inc in self harm/suicidal ideation
sweating
hyponatraemia
sexual dysfunction

Question 23

How does mirtazapine work?

Answer 23

blocks 5HT2 5HT3 and A2

Question 24

What are important side effects of mirtazapine?

Answer 24

weight gain and sedation

Question 25

What are the side-effects of lithium?

Answer 25

``` strange taste in mouth polydipsia and polyuria weight gain tremor hypothyroid dec renal function ```

Question 26

What are the signs of lithium toxicity?

Answer 26

``` vomiting, diarrhoea ataxia course tremor drowsiness convulsions ```