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Nerv Flashcards

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1
Q

3 ACHs used in Mild- Moderate Alzheimers

And what do you need to look out for with them?

A

Donepezil- NMS
Galantamine-SJS
Rivastigmine- GI distrubance- hold until resolves, can switch to a patch

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2
Q

Whilst most AEDs are given BD Which ones are given OD?

A 
LP3-
Lamotrigine
Phenytoin
Phenobarbital 
Primidone
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3
Q

Focal Partial Seizures?

A

Lamotrigine/Carbamazepine

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4
Q

Tonic-Clonic(Generalised)

A

Valproate/Carbamazepine

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5
Q

Absence(Generalised)

A

Ethosuximide/Valproate

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6
Q

Myoclonic
Atonic/tonic
(Generalised)

A

Valproate

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7
Q

Carmbamazepine is used in which seizures?

A

Focal and Tonic/Clonic

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8
Q

What is the Therapeutic Range for Carbamazepine?

What are the signs of tox?

A

4-12mg/L
iHANDBAG
Incoordination, Hyponatraemia, Ataxia, Nystagmus, Drowsiness, Blurred vision, Arrhythmias, and GI dist

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9
Q

Side effects of carbamazepine?

Is it an enzyme inducer or inhibitor?

A

BHHR HD
Blood dyscrasias, Hepatotoxicity, Hypersensitivity, Rash, Hyponatraemia, Dose dependent s/e

Its an inducer

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10
Q

Whats the range for Phenytoin?

Signs and symptoms of toxicity?

A

10-20mg/L
SNAtCHeD
Slurred speech , Nyastagmus,Ataxia, Confusion, Hyperglycaemia, Diplopia

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11
Q

Side effects of phenytoin?

And is Phenytoin an inhibitor or an inducer?

A

BHHR CLS
Blood dyscrasias, Hypersensitivity, Hepatoxicity, Rash, Changes in appearance, Low vitamin D (Osteomalacia/rickets), Suicidal ideation
Its an inducer

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12
Q

Side effects of SV?

A

BHP

Blood dyscrasias, Hepatoxicity, Pancreatitiis

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13
Q

How long should sodium valproate be reduced over?

A

gradually over 4 weeks

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14
Q

Tell me about category 1 and 2 AEDs and brands?

A

Category 1) CP3 -Carbamazepine, Phenytoin, Primidone, Phenobarb MUST BE ON SAME BRAND

Category 2)VLCT- Clinical judgment

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15
Q

Which AEDs Has highest and then high risk in pregnancy?

A

Highest-SV- Must not be used in women of child bearing age unless conditions of PPP are met

High-CP3L. Carbamaz, Phenytoin, Phenobarb, Primidone, and Lamotrigine

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16
Q

Which AED causes cleft pallete in first trimester?

A

Topirimate

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17
Q

Which AEDs can cause drowsiness in infants breast feeding?

A

Primidone, phenobarbital, and the benzodiazepines

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18
Q

With the AEDs Withdrawal effects can occur in babies breast feeding if the mother suddenly stops which drugs?

A

phenobarbital, primidone, or lamotrigine

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19
Q

Which AED can cause a rash?

A

Lamotrigine

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20
Q

Which AEDs cause eye problems , and what are they?

Study These Flashcards
A

Vigabatrin-Visual Field Defects

Topimirate-Glaucoma

21
Q

What drugs are used in ADHD?

Study These Flashcards
A

1) Methylphenidate(CD2)-6wk trial
2) Lisdexamphetamine(CD2)-6wk trial
alt: atomoxetine OR guanfacine

22
Q

Monitoring for methylphenidate & lisdexamphetamine

Study These Flashcards
A

pulse, BP, psychiatric symptoms, appetite, weight and height at initiation, following dose adjustment, and at least every 6 months thereafter
Seizures
Also cause Tics and Tourettes syndrome

23
Q

Drug used in acute episodes of mania?

Study These Flashcards
A

1)Benzos(eg.Lorazepam)- Short term use only
2)QOR(Quetiapine, Olanzapine, Risperidone)
If inadeaute add- lithium or valproate

24
Q

Whats the lithium range?

And acute epidoes of mania?

Study These Flashcards
A
  1. 4-1mmol/L

0. 8-1mmol/L

25
When do you do lithium monitoring?
You do it 12 hours after the dose thats why patient has dose at night time. When initiating- Monitor weekly after initiation until stable then every 3 months for a year then every 6months there after Before treatment you also measure- renal, cardiac, and thyroid function Body weight/BMI, serum electrolytes and FBC
26
Lithium symptoms of toxicity?
REVeNGe | Renal disturbance, EPS, Visual Disturbance(blurred vision), e, Nystagmus, GI disturbance(D/V)
27
Side effects of lithium | ps. Hyponatraemia pre-disposes to lithium tox
``` TRBQL Thyroid dysfunction(hypo/hyper), Renal impairment, Benign intracranial hypertension, QT prolongation, Lowers seizure threshold ```
28
Which Anti-depressant is given to children
Fluoxetine
29
Which SSRI is safe to use after MI/UA
Sertraline
30
SSRIs cause which main electrolyte disturbance?
Hyponatraemia, but can also occur to others
31
Symptoms of serotonin syndrome?
NAA Neuromuscular hyperactivity-Tremors, rigidity Altered mental state-confusion and mania Autonomic Dysfunction-diarrhoea, hyperthermia, tachycardia, sweating, shivering
32
Switching between AD drugs. | MAOIs?
Wait 2 Weeks, moclobemide does NOT need a washout period!!!
33
Switching between AD drugs | SSRI
1 week | Fluoxetine - 5 weeks
34
Switching between AD drugs. | TCAs
1-2 weeks | clomiprime/imiprimine- 3 weeks
35
Which antidepressants -have the highest risk of Withdrawal reactions?
Paroxetine and venlafaxine
36
Least seadting TCAs?
NIL | Nortrptyline, Impiramine, Lofepramine
37
Which MAOi are hepatotoxic?
pheelazine and isocarboxazid
38
Which MAOis have the greatest risk of hypertensive crises? ps it also has the greatest stimulat action
Tranylcypromine
39
Which antipsychotic has the most hyperprolactinemia?
Amisulpride, and Risperidone
40
Clozapine S/E?
AMG, | Agranulocytosis, Myocarditis & Cardiomyopathy, GI obstruction(pt to report constipation)
41
Which APS cause most EPS?
GP 3 Phenothiazine( end with perazine and phenazine) | Butyrophenones(haloperidol and Benperidol)
42
APS With most Hyperprolactinaemia?
Amisulpride and Risperidone
43
APS which cause Hyperglycaemia and diabetes?
CiROQ | Clozapine, Risperidone, Olanzapine, Quetiapine
44
APS which cause weight gain?
COW, Clozapine, Olanzapine
45
APS WIth sexual dysfunction ?
Haloperidol and Risperidone
46
APS With QT Prolongation?
Pimozide & Haloperidol
47
Anti-emetic used in PD?
Domperidone which also has Cardio s/e
48
Antiemetic used in pregnancy?
Promethazine, Prochloroperazine, metoclopramide

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