Psychiatry - Drugs + Mental Health Acts

Question 1

what does an emergency detention allow in the MHA 2015?

Answer 1

72hrs of detention

Question 2

who needs to allow a emergency detention?

Answer 2

doctor

mental health officer

Question 3

who can put a short term detention in place?

Answer 3

psychiatrist

mental health officer

Question 4

how long can a short term detention last?

Answer 4

28 days

Question 5

what is a CTO?

Answer 5

sets out conditions for complicance during treatment

Question 6

what powers do the police have?

Answer 6

sections 297/8 police can take a person to a safe place (if mentally disordered/need Tx) for 24 hours

Question 7

what form is used to treat physical disorders?

Answer 7

AWI

section 47

Question 8

can you get treatment under an emergency detention?

Answer 8

nope

Question 9

how do SSRIs work?

Answer 9

selectively inhibit 5-HT reuptake

Question 10

side effects of SSRI?

Answer 10

anti cholinergic
decrease libido
tremor
palps
insomnia (take in morning)

Question 11

which of the SSRIs, are best in
post MI
epilepsy
<18yrs?

Answer 11

post MI - sertraline
epilepsy - citalopram
<18yrs - fluoxetine

Question 12

what SSRIs are safe in pregnancy? what one is not and why?

Answer 12

citalopram
sertraline

paroxetine has risk of PHt/CVS abnormalities

Question 13

what drugs to avoid when on SSRIs?

Answer 13

NSAID (GI bleeds)
triptans
warfarin/heparin (switch to mirtazipine)

Question 14

how do tricyclics work?

Answer 14

bock NA/5HT reuptake in the synaptic cleft

Question 15

side effects of tricyclics?

Answer 15

anti cholinergic
decrease libido
drowsy (take at night)

Question 16

adverse effects of tricyclics?

Answer 16

long QT
increased potency by alcohol
cardiotoxic in overdose

Question 17

how do MAOis work?

Answer 17

inhibits MAO which increased NA/5-HT availability

Question 18

side effects of MAOis ?

Answer 18

anti cholinergic
jaundice
increase wt
insomnia (take in morning)

Question 19

what adverse effect can occur on MAOis? Tx?

Answer 19

hypertensive crisis
due to eating lots of foods high in tyramine

phentolamine infusion

Question 20

what adverse effects do SNRIs have?

Answer 20

worse withdrawal (than SSRIs)

Question 21

what do NaSSA cause?

Answer 21

wt gain

sedative (take at night)

Question 22

what bloods should be checked when on a NaSSA?

Answer 22

FBC

Question 23

what anti depressant is safe in overdose?

Answer 23

SARI

Question 24

example of a NaSSA?

Answer 24

mirtazapine

Question 25

example of a SARI?

Answer 25

trazodone

Question 26

example of a SNRI?

Answer 26

duloxetine | venlaflaxine

Question 27

example of MAOis?

Answer 27

phenelzine | moblenclamide

Question 28

example of a tricyclic?

Answer 28

amitryptilline | dosuleptin

Question 29

how do benzos work? what do they cause?

Answer 29

enhance GABA anticonvulsant sedate anterograde amnesia

Question 30

what can use of benzos during pregnancy cause?

Answer 30

1st trim - cleft palate | 3rd - floppy baby

Question 31

how does sodium valp work? what should be checked before starting?

Answer 31

blocks Na channels to increase GABA BMI FBC LFTs

Question 32

side effects of sodium valp?

Answer 32

``` Vomiting Anorexia L liver toxicity P pancreatits R wt gain O oedema A alopecia T teratogenic/tremor E enzyme inhibition ```

Question 33

how does lamotrigine work?

Answer 33

binds to Na to stop glutamate release

Question 34

side effects of lamotrigine?

Answer 34

rashes headache GI upset

Question 35

what should be checked before starting lamotrigine?

Answer 35

FBC U+Es LFTs

Question 36

side effects of Li?

Answer 36

``` arrythmias dry mouth wt gain headache hypothyroid nephropathy ```

Question 37

what signs are there of lithium toxicity?

Answer 37

``` D+V tremor sedation seizure arrythmia ```

Question 38

what should be done before starting Li, then every 6 months?

Answer 38

ECG U+Es, eGFR LFTs, FBC, TFTs BMI TFT U+Es, eGFR BMI

Question 39

what is the difference in side effect profile of atypical vs typical antipsychotics?

Answer 39

typical - worse parkinsonism | atypical - worse metabolic

Question 40

what adverse effects of antipsychotics are there?

Answer 40

BM increase prolong QT increase PRL

Question 41

what should be checked before starting anti psychotics?

Answer 41

``` ECG PRL BMI BM lipids FBC ```

Question 42

what does clozapine carry the risk of?

Answer 42

agranulocytosis

Question 43

is lithium safe in breastfeeding?

Answer 43

no

Question 44

what are the risks associated with taking lamotrigine while pregnant?

Answer 44

oral cleft defect | SJS (breastfeeding)

Question 45

what are the risks associated with taking antipsychotic while pregnant?

Answer 45

growth defects | IUGR

Question 46

can antipsychotics be taken while breastfeeding?

Answer 46

yes but monitor fetus for lethargy

Question 47

what are the risks associated with taking carbamazepine while pregnant?

Answer 47

NTD facial dysmorphia fingernail hypoplasia