Neuro

Question 1

Opioid analgesic indications

Answer 1

Moderate pain - codeine
Severe pain - morphine
Treatment of opioid dependence - methadone
Obstetric pain - pethidine
Biliary colic - pethidine

Question 2

Opioid analgesic SEs

Answer 2

Sedation
Coma
Respiratory depression
Constipation
QT prolongation (methadone)
Hyperprolactinaemia

Question 3

Antiemetic indications

Answer 3

Post-operative nausea and vomiting
Treatment or prophylaxis of chemotherapy or radiotherapy associated nausea and vomiting
Treatment of migraine associated nausea and vomiting (metoclopramide)
Treatment of motion sickness (cyclizine)

Question 4

Antiemetic SEs

Answer 4

Antihistamines: sedation and antimuscarinic SEs
Metoclopramide: risk of occulogyric crisis or extrapyramidal SEs
Ondansetron: constipation and flushing

Question 5

Antiepileptic drug types and indications

Answer 5

Sodium Valproate - generalised seizures
Carbamazepine - focal seizures
Lamotrigine - focal and generalised

Question 6

Antiepileptics SEs

Answer 6

Carbamazepine: sedation, leukopenia, hepatotoxicity

Sodium valproate: alopecia, weight gain, teratogenic

Lamotrigine: sedation, rash, dizziness

Question 7

Sumatriptan indications

Answer 7

Migraine and cluster headaches

Question 8

Sumatriptan SEs

Answer 8

Vasoconstriction
Sedation
Dysrhythmias
Raynaud’s

Question 9

Drugs used to treat Parkinson’s disease

Answer 9

Levodopa + co-careldopa
Dopamine receptor agonists - Ropinirole
Monoamine-oxidase-B inhibitors (Selegiline)

Question 10

Levodopa side effects

Answer 10

Psychosis and dementia
Postural hypotension
Dysrhythmias
Dry mouth

Question 11

Ropinirole side effects

Answer 11

Impulse disorders
Confusion
Hallucinations

Question 12

Selegiline SEs

Answer 12

Ulcers
Hypotension
Sedation
Confusion

Question 13

Acetylecholinesterase inhibitors - examples and indications

Answer 13

Mild to moderate dementia

Donepazil, Galantamine, Rivastigmine

Question 14

Acetylcholinesterase-inhibitor SEs

Answer 14

Cholinergic effects
- Syncope
- Hallucinations
- Aggression
- Incontinence
Heart block and dizziness

Question 15

Memantine indication

Answer 15

Moderate to severe dementia

Question 16

Memantine SEs

Answer 16

Hypertension
Heart failure
Thrombosis 
Psychosis 
Suicidal intent

Question 17

Anxiolytics examples and indication

Answer 17

Diazepam and lorazepam 
Acute alcohol withdrawal
Acute drug induced dystonic reactions 
Status epilepticus
Short term use in anxiety or insomnia

Question 18

Anxiolytics SEs

Answer 18

Drowsiness
Confusion
Ataxia
Dependence
Paradoxical aggression
Side effects may be enhanced with alcohol

Question 19

1st generation Antipsychotic example and indication

Answer 19

Haloperidol

Used to treat schizophrenia, psychosis and aggression in organic brain disorders

Question 20

Haloperidol SEs

Answer 20

Extrapyramidal SEs - Parkinsonism, dystonia, akathesis, tardive dyskinesia
Hypotension
QT-prolongation

Question 21

Atypical/Second generation antipsychotic examples and indication

Answer 21

Clozapine and Olanzapine

Question 22

Atypical antipsychotic SEs

Answer 22

Hyperlipidaemia
Glucose intolerance
Weight gain
Bone marrow suppression esp with Clozapine

Question 23

Lithium indication

Answer 23

Treatment and prophylaxis of mania or bipolar disorder

Question 24

Lithium SEs

Answer 24

Narrow therapeutic index
GI disturbance 
QT prolongation
AV block
Tremor
Cognitive impairment
Extra-pyramidal features
Seizures
Thyroid abnormalities
Renal impairment (beware of concurrent ACE-I, NSAIDs, diuretics)

Question 25

SSRI SEs

Answer 25

Hyponatraemia esp in the elderly
Serotonin syndrome 
Suicidal ideation esp in young people 
Low libido 
Weight gain
N/V

Question 26

TCA example and indications

Answer 26

Amitriptyline

Unlicensed use for neuropathic pain and migraine prophylaxis

Question 27

TCA SEs

Answer 27

Think of anticholinergic SEs
Drowsiness
Blurred vision
Dry mouth
Constipation 
Weight gain
Drowsiness 
Dizziness
Hypotension 
Arrhythmias