Psychiatric Drugs

Question 1

Name some Selective-Serotonin Reuptake Inhibitors

Answer 1

Fluoxetine, Citalopram and Paroxetine

Question 2

What are SSRIs mechanism of action?

Answer 2

Reduce reuptake of serotonin from synaptic clefts, reducing symptoms of depression.

Question 3

What are SSRI ADRs?

Answer 3

Anorexia, diarrhoea, tremor, mania, extrapyramidal symptoms.

Question 4

What is an SSRI and SNRI DDI?

Answer 4

Use in combination with MAOIs can cause a risk if serotonin syndrome.

Question 5

Name some Serotonin/Noradrenaline Reuptake Inhibitors

Answer 5

Venlafaxine and Duloxetine

Question 6

What is a contraindication of SNRI use?

Answer 6

Hypertension

Question 7

What ADRs can SNRIs cause?

Answer 7

Anorexia, diarrhoea, mania, tremor, sleep disturbance, hypertension, dry mouth, hyponatraemia and extra-pyramidal symptoms

Question 8

How do SNRIs work?

Answer 8

Block serotonin reuptake at low doses, and noradrenaline reuptake at higher doses.

Question 9

Name some Tricyclic Antidepressants

Answer 9

Amitriptylline, Imipramine, Lafepramine and Clomipromine

Question 10

What are some contraindications for tryicyclic antidepressants?

Answer 10

Arrythmia, liver failure, recent MI, mania and epilepsy.

Question 11

How do tricyclic antidepressants work?

Answer 11

Inhibit noradrenaline and serotonin reuptake, as well as weakly antagonising histamine, muscarinic and alpha-1 and 2 adrenoreceptor.

Question 12

What are ADRs of tricyclic antidepressants?

Answer 12

Arrythmia, constipation, dry mouth, postural hypotension, sedation and weight gain.

Question 13

What are some Monoamine Oxidase Inhibitors?

Answer 13

Phenelzine, Isocarboxazid, Tranylcypromine

Question 14

How do MAOIs work?

Answer 14

Inhibit the MAO enzyme, responsible for serotonin and noradrenaline breakdown.

Question 15

What are some ADRs for MAOIs?

Answer 15

Hypertension, excitement, tremor, dry mouth and blurred vision.

Question 16

What DDIs exist for MAOIs?

Answer 16

Metabolism of alcohol, opioids and barbituates is reduced in MAOI use, increasing the likelihood of toxicity from these substances.

Question 17

Name 2 Typical (1st generation) anti-psychotics

Answer 17

Haloperidol, and Chlorpromazine

Question 18

How do typical anti-psychotics work?

Answer 18

Antagonise dopamine D2 receptors, reducing psychosis, and causing sedation and tranquilisation.

Question 19

Name some atypical (2nd generation) anti-psychotics

Answer 19

Olanzapine and Risperidone

Question 20

How do atypical anti-psychotics work?

Answer 20

Antagonise serotonin2A and D2 receptors, producing sedation and tranquilisation, and reducing psychosis.

Question 21

What are some ADRs of anti-psychotics?

Answer 21

Extrapyramidal symptoms, weight gain, prolactinaemia, pigmentation, neuroleptic malignant syndrome, CNS depression, cardiac toxicty, and prolonged QT.

Question 22

What are some Extrapyramidal symptoms?

Answer 22

Dystonia, akathisia, and parkonsonism.

Question 23

How do typical and atypical anti-psychotic ADRs differ?

Answer 23

Atypical anti-psychotics feature less extrapyramidal symptoms.

Question 24

Why would lithium (lithium carbonate) be used?

Answer 24

As a mood stabiliser to prevent mania or depression in bipolar disorder.

Question 25

What is a contraindication for lithium use?

Answer 25

Renal impairment

Question 26

What are symptoms of lithium toxicity?

Answer 26

Restlessness, agitation, dysarthia and coarse tremor.

Question 27

What are ADRs for lithium?

Answer 27

Memory problems/ learning new information difficulties, thirst, polyuria, fine tremor, drowsiness, weight gain, rash, diarrhoia and alopecia.

Question 28

What is a DDI of lithium?

Answer 28

NSAIDs, which raise lithium availability.

Question 29

How is lithium toxicity treated?

Answer 29

IV fluids, haemodialysis and anticonvulsants.

Question 30

What 2 classes of drugs can treat Alzheimers Disease (non-vascular dementia)?

Answer 30

Acetylcholinesterase inhibitors, and NMDA antagonists.

Question 31

What acetylcholinesterase inhibitors can be used?

Answer 31

Doneprazil, Galantamine and Rivastigmine

Question 32

How do acetylcholinesterase inhibitors work?

Answer 32

Increase levels of ACh, improving arousal, memory, mood and attention.

Question 33

What ADRs exist for acetylcholinesterase inhibitors?

Answer 33

Diarrhoea, anorexia, fatigue, insomnia, headahce and bradycardia, peptic ulceration and COPD exacerbation.

Question 34

What DDIs exist for acetylcholinesterase inhibitors?

Answer 34

Beta-blockers, which cause increased bradycardia.

Question 35

How do acetylcholinesterase inhibitors improve alzheimer's prognosis?

Answer 35

Provide an additional year for which the patient will function well enough to not require full time care.

Question 36

What is an NMDA antagonist used?

Answer 36

Memantine

Question 37

What are ADRs for NMDA antagonists?

Answer 37

Hypertension, dyspnoea, headache, dizziness and drowsiness.