Psych Drugs

Question 1

Nephrogenic diabetes insipidus

Answer 1

Lithium

Question 2

Fine tremor

Answer 2

Lithium at therapeutic level

Question 3

Causes of hypothyroidism

Answer 3

Lithium

Anorexia Nervosa

Question 4

ECG changes associated with lithium use?

Answer 4

T wave flattening or inversion

Question 5

Hyperparathyroidism and resultant hypercalcaemia

Answer 5

Lithium

Question 6

What is the therapeutic range for lithium?

Answer 6

0.4-1.0

Question 7

When should lithium samples be taken for monitoring purposes?

Answer 7

12 hours post-dose

Question 8

How often should lithium levels be measured?

Answer 8

weekly after dose change until stable, 3 monthly following

Question 9

Monitoring requirements for lithium use

Answer 9

Lithium level

Thyroid and renal function - 6 monthly

Question 10

Monitoring requirements for venlafaxine

Answer 10

Blood pressure and ECG

Question 11

List extrapyramidal side effects

Answer 11

Akathisia
Dystonia
Tardive dyskinesia
Parkinsonism

Question 12

Examples of acute dystonia

Answer 12

Torticollis

Oculogyric crisis

Question 13

Examples of tardive dyskinesia

Answer 13

Pouting

Chewing

Question 14

What is akathisia?

Answer 14

Restlessness

Question 15

Drugs causing EPSE

Answer 15

Antipsychotics - first generation > second generation

Question 16

Side effects of second-generation antipsychotics?

Answer 16

Increased appetite 
Weight gain 
Metabolic syndrome
Sexual dysfunction 
Postural hypotension 
Reflex tachycardia 
antimuscarinic SEs

Question 17

Drug most associated with hyperprolactinaemia

Answer 17

Risperidone

Question 18

Drug most commonly associated with metabolic syndrome

Answer 18

Olanzapine

Question 19

Signs of lithium toxicity

Answer 19

Vision changes 
Diarrhoea 
Vomiting 
Hypokalaemia 
Tremor 
Dysarhtria 
Coma

Question 20

Side effects of Lithium

Answer 20

LITHIUM 
Lethargy
Insipidus
Tremor
Hypothyroidism
Intestinal symptoms
Urine output increased
Metallic taste

Question 21

Which drug family increase risk of VTE and stroke when used in the elderly?

Answer 21

Antipsychotics

Question 22

Flu-like symptoms
Shock sensations
Vivid dreams
Irritabilty

Answer 22

SSRI discontinue symptoms

Question 23

Which drug family causes hyponatraemia, GIT symptoms and bleeding risk?

Answer 23

SSRI

Question 24

Which SSRI should be used if there is a PMH of CVD?

Answer 24

Sertraline

Question 25

Side effects of mirtazepine?

Answer 25

Appetite increase, weight gain, and sedation

Question 26

Discontinuation of tricyclic antidepressants?

Answer 26

GIT upset, agitation, vivid dreams

Question 27

Which antipsychotic is associated with long QT?

Answer 27

Haloperidol

Question 28

Which SSRI is most associated with ECG changes such as torsade de pointes?

Answer 28

Citalopram

Question 29

When does neuroleptic malignant syndrome usually start?

Answer 29

Within hours to days of commencement of antipsychotic

Question 30

``` Pyrexia Muscle rigidity Tachycardia Increased blood pressure Hyporeflexia Pupils normal ```

Answer 30

Neuroleptic malignant syndrome

Question 31

Abnormal blood results in neuroleptic malignant syndrome

Answer 31

Raised CK Leukocytosis May develop AKI

Question 32

St John's Wart may interact with what?

Answer 32

SSRI -> serotonin syndrome

Question 33

``` Pyrexia Rigidity Tachycardia Hypertension Hyperreflexia Dilated pupils ```

Answer 33

Serotonin Syndrome