Pharma In Psychiatry Flashcards Preview

Jason's MD3 Psychiatry Rot > Pharma In Psychiatry > Flashcards

Flashcards in Pharma In Psychiatry Deck (63):
1

Important issue in psychiatry pharma? What is %

Non-compliance, partial or complete

50% discontinue

2

Antidepressants used in what disorders?

Major depression
Panic disorder
OCD (SSRIs)
Generalized anxiety disorder (venlafaxine)
PTSD
Narcolepsy

Neuropathic pain states (TCAs)

3

How long antidepressants take to work?

2-4 weeks

4

Any difference in response rates between members of same class? Or between classes?

No if you're doing group studies.

Can make a difference in individuals.

5

What improves in first week for antidepressants?

Sleep disturbance

6

Side effects of antidepressants? Antimuscarinics/anticholinergic?

Dry mouth
Blurred vision
Constitution
Urinary hesitancy
Glaucoma
Delirium
Cog disturbance
Cardiovascular effects

7

H1 receptor SFx? Antihistaminergic

Sedation
Weight gain
Drowsiness
Metabolic syndrome

8

SFx of a1/2 receptor, antiadrenergics

Hypotonia

9

Inhibition of noradrenaline reuptake SFx?

Tremor
Tachy cardia
Restless

10

SSRI SFx?

Gastro upset
Nausea
Less appetite
Weight loss
Headache
Motor restlessness
Serotonin syndrome
Sexual dysfunction
SIADH (older patients)
Risk of bleeding (on warfarin)

11

When are SSRIs given?

During day to prevent sleep disturbance

12

How to treat SFx sexual dysfunction from SSRI drugs?

Adjust dose
Change drug

13

Important rare SFx of antidepressants ?

change in Electrical conduction of heart.
Esp. In ppl with preexisting heart condition
Withdrawal syndrome

14

What drug is Citalopram?

SSRIs

15

What drug is paroxetine?

SSRIs

16

What drug is sertraline?

SSRI

17

Which SSRI drug most likely to cause withdrawal?

Paroxetine

18

What drug is Prozac?

Fluoxetine

19

How many half-lives take to leave body?

7 half-lives

20

Which SSRI can be used in paeds?

Fluvoxamine

21

risk of SSRIs in adolescents?

Increased risk of suicide

22

3 SNRIs?

Venlafaxine
Duloxetine
Desvenlafaxine

23

What dose needed in SNRIs to get actual noradrenergic effects?

150-225mg that you get noradrenergic

24

SNRI has what SFx?

Withdrawal effect
Sweating - dose dependednt

25

Name an alpha - 2 antagonist.

Mirtazepine

indirect effects on: 5HT, noradrenaline,

H1, 5HT2C receptors - weight gain

26

Mirtazepine Sfx?

Very sedative

27

Mirtazepine used for what?

Anti-anxiety effect

28

Effects on which receptors cause weight gain?

H1
5TH2C

29

Mirtazepine risk on blood?

Blood dyscrasias

30

What is Agomelatine? How does it work?
Used for?
When given?

Multimodal agents
Melatonin agonist
5HT2C antagonist

Used for sleep disturbance

Given at night

31

What is reboxetine?

NA reuptake inhibitor
Not used. Much

32

What is vortioxetine?

5HT reuptake inhibitor
5HT1A agonist
5HT3 antagonist actions

33

Indications for anxiolytics?4 things

Generalized anxiety disorder
Phobias
Sleep disturbance
Anxiety from med disorder

34

4 classes of anxiolytics

Benzos
Buspirone
Antidepressants
Beta blockers

35

Main use of benzos? Chloride ion

Sleep disturbance
Panic attacks
Phobias

36

Main SFx prob with benzos?

bad Withdrawal
Addictive

37

Benzos NOT used in 3 things:

Simple phobias
PTSD
OCD

38

Most important benzos SFx?

1. Behavioural disinhibition (rage, hostility, aggressiveness)

2. Psychomotor impairment
3. Cognitive impairment
4. Abrupt Withdrawal phenomena (seizures)
5. Rebound insomnia

39

Suffix for benzos?

-pam
-lam


40

Most used benzo hypnotic?

Temazepam

41

Flunitrazepam important how?

'Date rape' drug
Long half life
Short duration of action

42

What are zopiclone and zolpidem? How long to use?

Hypnotic agents for sedation

Short term use (Max 10 days)

43

Benzos work on what receptor?

GABA-A

44

Buspirone works on what?
Takes how long?

5HT-1A partial agonist

Take weeks to work

45

When is Busiprone used for?

PTSD
Social phobia

46

Important SFx with Buspirone?

Dysphoria on initiation
Not useful for benzo withdrawal

47

Indications for antipsychotics?

Schizophrenia (Psychotic symptoms only)
Bipolar disorder manic psychotic
Brief psychosis
Depression (psychotic)
Delirium

Methamphetamine overdose

48

When use haloperidol?

Delirium in ICU

49

Haloperidol risk?

Extrapyramidal symptoms

50

When use intramuscular injection for antipsychotics?

Non-compliance

51

When use atypical antipsychotics?

First line
Positive
Negative
Relapse
Restablisation
Maintenance

52

3 most important drugs of atypical antipsychotics

Olanzipine
Risperidone


Then clozapine if failed

53

Clozapine serious SFX?

Agranular cytosis
Cardiomyopathy, myocarditis

54

Quetiapine in low dose used for what

Hypnotic agent.

55

Quetiapine indicated for

Bipolar
Depression
Schizo
PTSD
Generalized anxiety disorder
Sleep disturbances

56

Notable SFx of atypical antipsychotics?

Weight gain (Olanzapine and clozapine)

T2DM

57

main Risperodone side effects?

Extrapyramidal SFx
Increase prolactin
QTc

58

2 classes for mood stabilizing for bipolar?

Lithium
Anticonvulsants

59

Name 4 anticonvulsants

Sodium valproate
Carbamazepine
Lamotrigine
Topiramate

60

Lithium needs two things before starting:

Need
thyroid/FBE, ECG, renal function

Baseline
Checked every 6 months

61

Why is renal function important in lithium?

Lithium not metabolized, only removed by kidneys

62

When take bloods for lithium?

12 hours after dose to get trough 0.4-0.8

63

Optimal dose in psychiatry?

Titration to dose response
Dose that gets them better