Psychiatry

Question 1

What class of drugs for anxiety

Answer 1

Benzodiazepines

Question 2

Duration of action for BZD

Answer 2

Short (midazolam), Intermediate (Alprazolam, lorazepam), Long (Diazepam)

Question 3

MoA of BZD

Answer 3

Binds to BZD sites in CNS –> increase the frequency of Cl channel opening –> potentiate GABA actions

Question 4

SE of BZD

Answer 4

CNS (increased drowsiness, anterograde amnesia), CVS (decreased BP, respiration), neonatal (floppy child syndrome), tolerance/dependence/withdrawal

Question 5

What class of drugs for insomnia?

Answer 5

BZD and non-BZD hypnotics

Question 6

Non-BZD hypnotics

Answer 6

Zolpidem, zopiclone

Question 7

BZD-induced sleep

Answer 7

Reduced REM and deep sleep

Question 8

Non-BZD side effects

Answer 8

Withdrawal anxiety, abuse potential

Question 9

Classes of antidepressants

Answer 9

SSRI (selective serotonin reuptake inhibitor)
TCA (tricyclic antidepressant)
SNRI (serotonin & norepinephrine reuptake inhibitor)
NaSSA (Noradrenergic & Selective Serotonergic Antidepressants)

Question 10

SSRI

Answer 10

Fluoxetine, Escitalopram, Sertraline

Question 11

MoA of SSRI

Answer 11

Block serotonin reuptake –> increase availability at synaptic cleft –> increase post-synaptic reaction –> increase BDNF –> mood elevation

Question 12

SSRI DDI

Answer 12

P450 inhibition

Question 13

SE of SSRI

Answer 13

Anxiety, weight loss, no fatality in overdose***

Question 14

TCAs

Answer 14

Amitriptyline, Imipramine

Question 15

MoA of TCA

Answer 15

Block reuptake of serotonin and noradrenaline and increases availability at synaptic cleft

Question 16

SE of TCA

Answer 16

FATALITY in overdose, sedation & fatigue, tachycardia, anticholinergic effects (dry mouth, BoV, urinary retention)

Question 17

SNRI MoA

Answer 17

Inhibit reuptake of serotonin and noradrenaline

Question 18

NaSSA

Answer 18

Mirtazapine

Question 19

MoA of NaSSA

Answer 19

Blocks presynaptic a2-adrenergic autoreceptors on noradrenergic & serotonergic pre-synaptic terminals –> loss of inhibition –> increase NA release –> improvement of symptoms

Question 20

SE of NaSSA

Answer 20

Anticholinergic effects, agranulocytosis, sedation

Question 21

Classes of antipsychotics

Answer 21

Typical: chlorpromazine, haloperidol (Ty CHa)
Atypical: quetiapine, olanzapine, risperidone, clozapine, aripipazole (A QuORCA)

Question 22

MoA of antipsychotics

Answer 22

Blockade of dopamine receptors –> reduce dopamine transmission (opposite of dopamine hypothesis for Psychosis)

Question 23

Pharmacodynamics of antipsychotics

Answer 23

Typical: Blockade of D2 > 5-HT2
Atypical: Blockade of 5-HT2 > D2

Question 24

SE of typical vs atypical

Answer 24

Atypicals have less EPSE than typicals but have dose-dependent weight gain

Question 25

SE of atypicals

Answer 25

Agranulocytosis (clozapine), sedation (clozapine, olanzapine), weight gain (olanzapine >> riseperidone), dose-dependent EPSE (risperidone)