Psychiatry Flashcards
(34 cards)
Raised 『3G’s and 3C’s』 of anorexia
3G’s : GH, glucose, salivary glands, 3C’s : cortisol, cholesterol, Carotinaemia
Cardiac SE of citalopram and escitalopram
dose-dependent QT interval prolongation
SSRI drug interactions
- NSAIDs: NICE dont combined but if need co-prescribe a PPI
- Warfarin / heparin: NICE guidelines recommend avoiding SSRIs and considering mirtazapine
- aspirin
- triptans - increased risk of serotonin syndrome
- MAOIs- increased risk of serotonin syndrome
How to stop SSRI?
dose should be gradually reduced over a 4 week period
-this is not necessary with fluoxetine
oculogyric crisis rx
Procyclidine, an anticholinergic drug, is used in the management of extrapyramidal symptoms caused by antipsychotics.
It works by blocking the action of acetylcholine in the central nervous system, which helps to reduce muscle stiffness and spasms.
Adverse effects of clozapine
agranulocytosis (1%), neutropaenia (3%)
reduced seizure threshold - can induce seizures in up to 3% of patients
constipation
myocarditis: a baseline ECG should be taken before starting treatment
hypersalivation
Dose adjustment of clozapine might be necessary if smoking is started or stopped during treatment.
Typical antipsychotics (-azine)
examples
Mechanism of action
SE
Haloperidol
Chlorpromazine
Dopamine D2 receptor antagonists, blocking dopaminergic transmission in the mesolimbic pathways
Extrapyramidal side-effects and hyperprolactinaemia common
Atypical antipsychotics (-idone)(-apine)
examples
Mechanism of action
SE
Clozapine
Risperidone
Olanzapine
Act on a variety of receptors (D2, D3, D4, 5-HT)
Extrapyramidal side-effects and hyperprolactinaemia less common
Metabolic effects
Tricyclic antidepressants (More sedative)
[ACT Dumb] -
Amitriptyline
Clomipramine
Dosulepin
Trazodone*
Tricyclic antidepressants (Less sedative)
Imipramine
Lofepramine
Nortriptyline
Tricyclic antidepressants
mechanism of action
inhibition of the reuptake of neurotransmitters
Noradrenaline (NA) & Serotonin (5-HT)
SSRI of choice post myocardial infarction
Sertraline
What type of drug is venlafaxine and duloxetine
Serotonin and noradrenaline reuptake inhibitors
what is Erotomania (De Clerambault’s syndrome)
色情狂Presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms
Capgras syndrome
This is the delusion that a person closely related to the patient has been replaced by an impostor冒充耆.
most common ophthalmological conditions assoc with Charles Bonnet syndrome?
Age related macular degeneration >(glaucoma/ cataracts)
how often should lithium blood levels be monitored?
every 3 months
how long should patients be continued on antidepressant therapy for after remission?
at least 6 mo after remission as this reduces the risk of relapse
which SSRI has highest incidence of discontinuation symptoms?
paroxetine
peak incidence of seizures following alcohol withdrawal?
36h
what drugs are used in PTSD?
Venlafaxine of SSRI e.g. sertraline.
- in severe cases: risperidone may be used
which tricyclic has the lowest incidence of toxicity in overdose?
lofepramine
which tricyclic antidepressants are considered the most dangerous in overdose?
Amitriptyline and dosulepsin
mx of mild OCD?
CBT including exposure and response prevention (ERP)
OR SSRI
