Pharmacology

Question 1

Symptoms of lithium toxicity

Answer 1

blurred vision 
poor concentration 
D/V
tinnitus 
anorexia 
ataxia 
nystagmus

Question 2

Can lithium toxicity cause first degree heart block

Answer 2

YES!!

Question 3

How to treat lithium toxicity?

Answer 3

Stop lithium
Dialysis
Rehydrate with IV fluids

Question 4

Symptoms of NMS

Answer 4

Fever
Postural Hypotension 
Stiffness
Coma
Seizures 
Hyperthermia
Urinary incontinence

Question 5

Investigations for NMS

Answer 5

metabolic acidosis
increased CK
leucocytosis
prolonged QT

Question 6

Treatment of NMS

Answer 6

stop anti-psychotics
IV fluids
Benzos

Question 7

Cause of serotonin syndrome

Answer 7

An overdose of multiple different antidepressants or the use of an antidepressant + tramadol or amphetamines

Question 8

Symptoms of serotonin syndrome

Answer 8

Hyper-reflexia 
Clonus 
Coma
Shaking
Tachycardia
Tachypnoea
Dilated pupils
Increased temperature
Hallucinations
Seizures
Sweating

Question 9

Investigations for serotonin syndrome

Answer 9

VBG, FBC, U and Es, CT head

Question 10

Treatment for serotonin syndrome

Answer 10

supportive care through cooling
Benzos for seizures
Cyproheptadine is a serotonin antagonist

Question 11

How do antipsychotics work

Answer 11

Dopamine D2 receptors as part of the mesolimbic system

Question 12

Typical antipsychotics

Answer 12

haloperidol and chlorpromazine

Question 13

Side effects of typical antipsychotics

Answer 13

Extrapyramidal

Question 14

Atypical antipsychotics

Answer 14

olanzapine, quetiapine, clozapine

Question 15

Side effects of atypical antipsychotics

Answer 15

Weight gain

Question 16

What are extrapyrimdal side effects?

Answer 16

parkinsonism 
tardive dyskinesia (chewing motion. tongue protrusion)
acute dystonia (facial grimacing, arching of head back)

Question 17

Other side effects of antipsychotics

Answer 17

DM
Hypercholesterolaemia
Blurred vision 
urinary retention 
Dry mouth

Question 18

How do antidepressants work?

Answer 18

Increase the levels of the monoamines: serotonin, dopamine and norepinephrine

Question 19

SSRI examples

Answer 19

sertraline, fluoxetine, citalopram, paroxetine

Question 20

SEs of SSRIs?

Answer 20

increased risk of suicide initially

GI SEs - n+v, reflux

Question 21

Examples of SNRIs

Answer 21

duloxetine, venlafaxine

Question 22

When are SNRIs CI

Answer 22

heart disease

Question 23

MAOIs examples

Answer 23

isocarboxazid

Question 24

SE of MAOIs

Answer 24

risk of hypertension with tyramine which is found in cheese

Question 25

Example of a TCA

Answer 25

``` Amitriptyline Amoxapine Desipramine Doxepin Imipramine ```

Question 26

SE of TCAs

Answer 26

dry mouth | blurred vision

Question 27

Atypical antidepressants

Answer 27

mirtazepine

Question 28

SE of mirtazapine

Answer 28

increased appetite | increased fatigue

Question 29

SEs of ECt

Answer 29

headache Cardiac arrythmias short term memory loss

Question 30

When is ECT recommeneded?

Answer 30

medication failure mania severe depression catatonic schizophrenia

Question 31

What is dependence syndrome?

Answer 31

Craving, tolerance, continued use despite negative effects, withdrawal, use causing social, occupational, personal dysfunction, increase time looking for substance