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5 - Pharmacology > Psychiatric Drugs > Flashcards

Psychiatric Drugs Flashcards

(39 cards)

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1
Q

Give some examples of typical antipsychotics

A

Haloperidol

Chloropromazide

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2
Q

Mechanism for typical antipsychotics

A

Antagonist dopamine D2 receptor

  • Sedation occurs with hours
  • Tranquillisation within hours
  • Acts as an antipsychotic within weeks
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3
Q

Give some ADRs for typical antipsychotics

A 
Extrapyramidal effects
Anti-adrenergic effects 
- sedation and postural hypotension
Anticholinergic effects 
Cardiac arrhythmias
Weight gain, diabetes & metabolic syndrome
Amennorhoea
Galactorrhoea 
Hypothermia 
Neuroleptic malignant syndrome
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4
Q

Give the toxicities associates with typical antipsychotics

A

CNS depression
Cardiac toxicity
Sudden death with high dose - prolonged QT syndrome and torsades de points

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5
Q

Give some atypical antipsychotics

A

Olanzapine
Risperidone
Clozapine
Quetiapine

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6
Q

Give the mechanism for atypical antipsychotics

A

Antagonists 5HT receptors but also D2 receptors, but have a higher affinity for 5HT
- Sedation occurs with hours
- Tranquillisation within hours
Acts as an antipsychotic within weeks

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7
Q

Give some ADRs of atypical antipsychotics

A

Olanzapine = significant weight gain
Risperidone = increased prolactin
Sedation
Extrapyramidal side effects

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8
Q

Give some toxicities associated with atypical antipsychotics

A

Cardiac toxicity

Risk of sudden death - prolonged QT leading to torsades de points

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9
Q

What is the first line treatment for schizophrenia?

A

Atypical antipsychotics

  • have better tolerated side effects
  • less extrapyramidal side effects
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10
Q

What kind of treatment would you give to someone with an anxiety disorder?

A

Cognitive behavioural therapy

- save the medications for the severe cases of anxiety

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11
Q

What type of medication can be used to treat anxiety?

A 
Antidepressants
Benzodiazepines
Antipsychotics
Beta blockers
Busiprone
Barbituates
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12
Q

Mechanism for benzodiazepines

A

Enhance the action of GABA-A receptors

  • positive allosteric modulation
  • increase Cl current into the nerve, causing hyper polarisation, increasing AP threshold
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13
Q

ADRs for benzodiazepines

A 
Sedation
Withdrawal
Tolerance (develops within weeks)
Confusion, impaired coordination
Aggression
Seizures can be triggered with an abrupt withdrawal
Respiratory and CNS depression
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14
Q

Give an antagonist for benzodiazepines

A

Flumazenil

- IV, can reverse overdose effects

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15
Q

Give some contraindications for benzodiazepines

A

Pregnancy - is teratogenic

Don’t use in someone with respiratory depression

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16
Q

Give some mood stabilisers

Study These Flashcards
A

Lithium
Sodium valproate
Carbamezepine
Lamotrigine

17
Q

Describe lithium

Study These Flashcards
A

Administered as lithium carbonate

  • mood stabiliser
  • prophylaxis of mania and depression in bipolar disorder
  • augments antidepressant action in unipolar depression
18
Q

Give some theories as to how lithium works

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A
  • competes with Mg2+ and Ca2+
  • increases 5HT levels
  • antagonises effects of neurotransmitters without altering receptor density
    Good for preventing relapse into mania
19
Q

Lithium ADRs

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A 
Memory problems - learning new info
Thirst
Polyuria
Tremor
Drowsiness
Weight gain
Hair loss 
Rashes
20
Q

Toxic effects of lithium

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A 
Coarse tremor
Ataxia
Dysarthria
Reduced levels of consciousness
Convulsions
Coma
Death
21
Q

Give some characteristics of managing someone who is taking lithium

Study These Flashcards
A

Good evidence that it reduces suicides
Need to monitor plasma levels as it has a narrow therapeutic window (0.5-1.0 mmol/L)
- need to check TFTs and U+Es

22
Q

How would you treat lithium toxicity?

Study These Flashcards
A

Supportive treatment

  • Anticonvulsants
  • IV fluids
  • Haemodialysis
23
Q

Give some drugs used to treat Alzheimer’s disease

Study These Flashcards
A

Acetylcholinesterase inhibitors

NMDA antagonists

24
Q

Give some examples of acetylcholinesterase inhibitors

Study These Flashcards
A

Donepezil
Galantamine
Rivastigmine

25
Give some ADRs of acetylcholinesterase inhibitors
``` Nausea Vomiting Diarrhoea Fatigue Insomnia Headache Muscle cramps Bradycardia Syncope ```
26
What is the first line treatment for alzheimer's?
Acetylcholinesterase inhibitors
27
Give an example of an NMDA antagonist
Memantine
28
Give some ADRs of NMDA antagonists
``` Hypertension Dyspnoea Headache Dizziness Drowsiness ```
29
What are extra-pyramidal side effects?
``` Parkinsonian side effects Akathisia Tardive dyskinesia - choreo-athetoid movements in tongue, lips and face Dystonia - muscle/muscle groups go into spasm ```
30
What is neuroleptic malignant syndrome?
Life-threatening reaction to medications which causes: - Extreme EPSE - Autonomic dysfunction Complications include renal failure, pneumonia and thrombo-embolism. Get increased creatine phosphokinase
31
What is the pathophysiology of neuroleptic malignant syndrome?
Decrease dopamine function due to: - Dopamine blockade - reduced function of D2 receptor
32
What is one of the side effects of clozapine?
Causes agranulocytosis and neutropenia - Regular FBC monitoring is needed - Drug should be discontinued if there are any concerns
33
Give the half lives for varying bezodiazepines
``` Diazepam = 20-100 hrs Lorazepam = 8-24 hrs Temazepam = 5-11 hrs Zopiclone = 4-6 hrs ```
34
What are the equivalent doses of lorazepam or temazepam to diazepam 10mg?
``` Lorazepam = 1mg Temazepam = 20mg ```
35
How do acetyl cholinesterase inhibitors work?
Increase the amount of acetylcholine in the synaptic cleft. This improves the brain function by improving the strength of nerve transmission.
36
When should you take caution in prescribing acetyl cholinesterase inhibitors?
COPD patients Peptic ulcers Hx of convulsions
37
What are central nervous system stimulants?
Act to improve concentration in children who have ADHD.
38
Give some examples of CNS stimulants
Methylphenidate | Dexamphetemine
39
Give some side effects of methylphenidate
``` GI disturbance Hypertension Tachycardia Palpitations Insomnia Nervousness ```

5 - Pharmacology (17 decks)

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