Pharmacology Flashcards
(31 cards)
Symptoms of lithium toxicity
blurred vision poor concentration D/V tinnitus anorexia ataxia nystagmus
Can lithium toxicity cause first degree heart block
YES!!
How to treat lithium toxicity?
Stop lithium
Dialysis
Rehydrate with IV fluids
Symptoms of NMS
Fever Postural Hypotension Stiffness Coma Seizures Hyperthermia Urinary incontinence
Investigations for NMS
metabolic acidosis
increased CK
leucocytosis
prolonged QT
Treatment of NMS
stop anti-psychotics
IV fluids
Benzos
Cause of serotonin syndrome
An overdose of multiple different antidepressants or the use of an antidepressant + tramadol or amphetamines
Symptoms of serotonin syndrome
Hyper-reflexia Clonus Coma Shaking Tachycardia Tachypnoea Dilated pupils Increased temperature Hallucinations Seizures Sweating
Investigations for serotonin syndrome
VBG, FBC, U and Es, CT head
Treatment for serotonin syndrome
supportive care through cooling
Benzos for seizures
Cyproheptadine is a serotonin antagonist
How do antipsychotics work
Dopamine D2 receptors as part of the mesolimbic system
Typical antipsychotics
haloperidol and chlorpromazine
Side effects of typical antipsychotics
Extrapyramidal
Atypical antipsychotics
olanzapine, quetiapine, clozapine
Side effects of atypical antipsychotics
Weight gain
What are extrapyrimdal side effects?
parkinsonism tardive dyskinesia (chewing motion. tongue protrusion) acute dystonia (facial grimacing, arching of head back)
Other side effects of antipsychotics
DM Hypercholesterolaemia Blurred vision urinary retention Dry mouth
How do antidepressants work?
Increase the levels of the monoamines: serotonin, dopamine and norepinephrine
SSRI examples
sertraline, fluoxetine, citalopram, paroxetine
SEs of SSRIs?
increased risk of suicide initially
GI SEs - n+v, reflux
Examples of SNRIs
duloxetine, venlafaxine
When are SNRIs CI
heart disease
MAOIs examples
isocarboxazid
SE of MAOIs
risk of hypertension with tyramine which is found in cheese
