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3MB Psych > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

give an example of an irriversible and reversible monoamine oxidase inhibitor

A

phenelzine and moclobemide respectively

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2
Q

what is the main side effect of MAO inhibitors

A

cheese reaction- hypertensive crisis

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3
Q

give and example of a tricyclic antidepressant

A

amitriptyline, imipramine, lofepramine

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4
Q

what is the mechanism of action of a tricyclic antidepressant

A

block the reuptake of monoamines such as noradrenaline and 5-HT/serotonin

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5
Q

under which conditions should imipramine be avoided

A

if the patient has cardiac conditions

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6
Q

giva an example of SSRI

A

fluoxitine, citalopram, sertraline

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7
Q

what is the mechanism of action of SSRI

A

block reuptake of serotonin

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8
Q

what are the side effects of SSRI

A

vivid dreams, nausea, sweating, sexual dysfunction and hyponatraemia (in the elderly)

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9
Q

give an example of SNRI

A

venlafaxine and duloxetine

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10
Q

what is the mechanism of mirtazapine

A

block of alpha 2, 5-HT2 and 3

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11
Q

give an example of a dopamine uptake inhibitor

A

bupropion

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12
Q

what special precautions are taken with lithium

A

12hr post dose blood levels due to narrow theraputic index

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13
Q

what is the mechanism of action of lithium

A

block second messenger system or inhibit glycogen synthase kinase 3beta or modulate NO signalling

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14
Q

what are the toxic effects of lithium

A

vomiting, diarrhoea, ataxia, altered consiousness

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15
Q

give and example of anticonvulsant (mood stabalisers)

A

carbamazepine, lamotrigine

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16
Q

side effects of valproate

A

teratogenicity

17
Q

lamotrigine side effects

A

small risk of Stevens-Johnson syndrome

18
Q

what are side effects shared by valproate and carbamazepine

A

ataxia, drowsiness, CV affects and induced liver enzymes

19
Q

give examples of antipsychotics

A

aripiprazole, olanzipine

20
Q

what is a risk of olanzipine use

A

higher risk of metabolic syndrome

21
Q

what are the side effects of aripiprazole

A

extrapyramidal- motor

22
Q

which classes of drugs can be used to treat anxiety

A

benzodiazepines, pregabalin, antidepressants, buspirone

23
Q

what is the mechanism of action of benzodiazepines

A

enhance the activity of the neurotransmitter GABA, particuarly affecting the amygdala

24
Q

give an example of a benzodiazepine used for rapid tranquilisation

A

lorazepam

25
Q

what are the pharmacological effects of benzodiazepines

A

reduced anxiety and aggression
hypnosis and sedation
muscle relaxation
anticonvulsant effects

26
Q

what are the 2 biggest side effects or problems with benzodiazepines

A

can cause anterograde amnesia

withdrawal and additction upon long term usage

27
Q

what are the clinical uses of benzodiazepines

A

acute treatment of extreme anxiety and mania

rapid tranqulisation, status epilepticus

28
Q

how do you withdraw a patient from benzodiazepines

A

transfer to equvalent dose of diazepam/chlordiazepoxide

reduce dose 2-3 weeks by 2-2.5mg

29
Q

treatment pathway for anxiety (pharmacologically)

A

SSRI first then tricyclics (imipramine) then venalfaxine (also very useful in GAD)

30
Q

what is the management pathway for GAD (generalised anxiety disorder)

A 
1st- psychoeducation
2nd- self help and social groups
3rd- CBT or SSRI
4th- SNRI
5th- pregabalin
31
Q

what are some of the clinical uses of SSRIs

A

panic disorder, PTSD, OCD and phobias

32
Q

what is the management of panic disorder

A

1st- self help
2nd-CBT or SSRI if longstanding symptoms
3rd-tricyclics (clomipramine, imipramine)
continue treatment for 6 months

33
Q

what is the management of OCD

A

1st- CBT or self help
2nd- more intense psychological intervention or SSRI (sertrline, citalopram)
3rd- consider increase in dose after 4-6 weeks
4th- SSRI plus CBT and ERP
5th- clomipramine

34
Q

what is the management of PTSD

A 
1st- watchful waiting for 4 weeks
2nd- within 3 months of trauma then CBT
         after 3 months of trauma then forcused CBT or 
         EMRD
4th- mirtazepine
35
Q

what is the management of social anxiety

A 
1st- CBT
2nd- SSRI reviewed at 12 weeks
3rd- SSRI plus CBT
4th- alternative SSRI (fluoxitine or paroxetine)
5th- MAOI (moclobemide)

3MB Psych (7 decks)

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