Pharmacology

Question 1

how do monoamine oxidase inhibitors work?

Answer 1

slow down degredarion of monoamines

Question 2

give examples of monoamine neurotransmitters

Answer 2

serotonin (5-HT)

dopamine

noradrenaline

Question 3

what are two monoamine oxidase inhibitors?

Answer 3

phenelzine (irrerversible)

moclobemide (reversible)

Question 4

what are some SE of monoamine oxidase inhibitors?

Answer 4

insomnia

postural hypotension

peripheral oedema

Question 5

do monoamine oxidase inhibitors have an effect on the metabloism of other drugs?

Answer 5

potentiate effects of other drugs by decreasing their metabolism

Question 6

what is the ‘cheese reaction’? (monoamine oxidase inhibitors)

Answer 6

hypertensive crisis caused by inhibtion of MO-A in gut

patietns advised to avoid tyramine rich foods- red wine/beer/game

Question 7

how do tricyclics work?

Answer 7

blocks reuptake of monoamines into presynaptic terminals

Question 8

give some examples of tricyclic antidepressants

Answer 8

imipramine

dosulepin

amitryptyline

Question 9

what are some SE’s of tricyclics?

Answer 9

sedation

wgt gain

anticholinergic- blurred vision, dry mouth, constipation

Question 10

is tricyclic overdose dangerous?

Answer 10

yes- they are cardiotoxic in overdose

Question 11

how do SSRI’s work?

Answer 11

severly inhibit reuptake of serotonin (5-HT) from synpatoc cleft

Question 12

give some examples of SSRI’s

Answer 12

fluoextine

citalopram

sertraline

Question 13

what are some SE’s of SSRI’s?

Answer 13

nausea/headaches

worsened anxiety

sweating/vivid dreams

sexual dysfunction

inc in self harm and suicidal thoughts

Question 14

what is mirtazipine?

Answer 14

antidepressant with mixed receptor effects

(SE’s- sedation nd wgt gain)

Question 15

what other monomaine reuptake inhibtor is licensed for use in chronic pain?

Answer 15

duloxetine

Question 16

what is the standard treatment for biploar disorder?

Answer 16

lithium- usually given as lithium carbonate

Question 17

lithium has a narrow therapeutic index. why is this important?

Answer 17

bloods must be done 12hrs post dose to montior levels

Question 18

what are some SE’s of lithium?

Answer 18

dry mouth/ strange taste

tremor

hypothyroidism

N&V

Question 19

give some antipsychotics

Answer 19

olanzapine

clozapine

risperidone

Question 20

which antipsychotic can be used in T2DM and why?

Answer 20

risperidone

olanzapine and clozapine are more likely to cause metablic disturbance

Question 21

what is one major side effect of clozapine?

Answer 21

agranulocytosis- FBC required if patient satrs to feel unwell

Question 22

antipsychotics are likely to cause weight gain true/false

Answer 22

true- high risk of wieght gain

Question 23

give some anticonvulsants

Answer 23

valproic acid/sodium valproate

lamotrigine

carbamazepine

Question 24

what adverse side effect has lamotrogine been linked with?

Answer 24

steven-johnson syndrome

Question 25

can anti convulsant medications be used in pregnancy?

Answer 25

no- teratogenic, should not be used in women of childbearing age

Question 26

how long should mood altering medication be trialled before swiching if no results?

Answer 26

at least 2-3 months sometimes 4

Question 27

which is mor eocmmonly prescribed olanzapien or clozapine?

Answer 27

olanzopine- should only use clozapine in those resistant to other atypicals

Question 28

what are some drugs used to treat anxiety?

Answer 28

benzos antidperessants busiprone pregabalin (anti-convulsant) B-blockers

Question 29

why are SSRI's commonly used in the treamtent of anxiety?

Answer 29

symtpoms overlap greatly w depression so can tackle both disorders

Question 30

what neurotransmitter is targetted by benzos, barbituates and alcohol?

Answer 30

GABA A,B,C

Question 31

what is the effect when benzos etc bind to GABA?

Answer 31

positive allosteric effect- neuron less likely to fire AP

Question 32

can you stop benzodiazepines suddenly?

Answer 32

no- decrease by 2-2.5mg every 2-3 weeks

Question 33

which anxiety disorder can moclobemide be used for?

Answer 33

social anxiety disorder

Question 34

which anxiety disorder can Venlaflaxine be used for?

Answer 34

GAD

Question 35

parkinsonism is a SE of which drug class?

Answer 35

anti-psychotics

Question 36

what are the main side effects of mirtazapine?

Answer 36

wgt gain and sedation

Question 37

why does clozpaine increase risk of seizures?

Answer 37

lowers the threshold making them more likely

Question 38

what can happen if someone is taking an SSRI and a NSAID?

Answer 38

increased bleeding risk co-prescribe PPI

Question 39

what drug can be used to treat tardive dyskinesia?

Answer 39

tetrabenazine

Question 40

what are some side effects of carbamazepine?

Answer 40

drowsiness ataxia induction of liver enzymes

Question 41

which receptors do antipsychotics at on?

Answer 41

dopamine D2 receptor agonists

Question 42

are typical or atypical antipsychotics more likely to cause extra-pyramidal side effects?

Answer 42

typical i.e. chlorpromazine, haloperidol, thioidazine

Question 43

which type of anti-depressant should be avoided in prostatism?

Answer 43

tricylics- due to anticholinergic effects (urinary retention)

Question 44

which is the preferred drug in treating bipolar suffering primarily w depression?

Answer 44

lamotrogine

Question 45

what is the preffered drug in treating bipolar w primarily mania/hypomania?

Answer 45

sodium valproate

Question 46

what are the first and second line treatments in ADHD?

Answer 46

methylphenidate first line atomoxetine second line

Question 47

typical or atypical antipsychotics work best in -ve symtpoms of schizophrenia?

Answer 47

atypicals

Question 48

anti-convulsants block which ion channel?

Answer 48

Na²⁺

Question 49

how long shoul danti-depressants be continued for following depressive episode?

Answer 49

at least 6 months

Question 50

which receptors does memantine act on?

Answer 50

antagonist of NDMA receptors which bind glutamate

Question 51

rapid cycling bipolar responds best ot which drug class?

Answer 51

anti-convulsants

Question 52

which drug class is assoc w hyperprolactinaemia?

Answer 52

anti-psychotics

Question 53

benzodiazepines bind to which neurotransmitter?

Answer 53

GABA A

Question 54

other than agranulocytosis which other SE can clozapine cause?

Answer 54

postural hypotension