Week 2.10 Drugs Case Hx

Question 1

What is the role of an antidepressant

Answer 1

To prolong the effect of NT by inhibiting reuptake and breakdown

Question 2

3 main types of antidepressants

Answer 2

SSRI’S
SNRIs
Tricyclics

Question 3

SSRIs

Answer 3

Considered first line tx
Commonly used forms include
- citalopram
- fluoxetine
- sertraline
Less likely than tricyclics to cause anticholinergic effect
Ocular side effects: photosensitivity, pupil dilation, ACG, reports of raised iop

Question 4

SNRIs

Answer 4

Increases both seretonin and noradrenaline levels
Ocular side effects cause mydriasis

Question 5

Tricyclic antidepressants

Answer 5

• Inhibit the reuptake of seretonin and noradrenaline
  Side effects: dry mouth, urinary retention, constipation, blurred vision, pupil dilation, disturbance of accomodation, raised IOP

Question 6

Examples of tricyclic antidepressants

Answer 6

Amitrptyline
Clomipramine
Imipramine

Question 7

Monoamine oxidase inhibitors

Answer 7

Inhibit the enzyme which breaks down the nt as opposed to drugs that stop the reuptake
Do not use phenylephrine to dilate in these px who are taking or have just stopped taking the drug
Ocular side effects: drowsiness, nystagmus, blurred vision, dizzy when standing up, HAs

Question 8

Two main types of contraceptive pill

Answer 8

Combination pill: progesterone and oestrogen, reversible and reliable method of contraception. Take for 21 days of 28 day cycle

Mini pill: progesterone only. Does not always prevent ovulation but make difficult for sperm to enter womb

Question 9

What are ocular side effects of contraceptives

Answer 9

Dry eyes
Contact lens intolerance
Increased risk of conjunctivitis in recent users
Central retinal artery occlusions reported - sudden painless loss of vision
Macular oedema

Question 10

What are non opiod analgesics

Answer 10

NSAIDs - ibuprofen, aspirin
Paracetamol

Question 11

What are the ocular side effects of ibuprofen

Answer 11

Blurred vision
Diplopia
CV changes
Dry eye
Ocular effects resolve when drug is stopped

GI bleeding occurs less frequently than with aspirin

Question 12

NSAIDs: aspirin

Answer 12

Acetylsalicylic acid
Mild moderate pain
More likely to cause side effects than paracetamol
Interacts with other dugs, such as SSRIs
Minimal ocular side effects

Question 13

Paracetamol

Answer 13

Analgesic
Not anti inflammatory
Not NSAID
Is a non opiod analgesic
Mild to moderate pain
Less irritant to stomach
Minimal side effects

Question 14

Opiods

Answer 14

Used if non opiods fail to work
Opiod for mild to moderate pain - codeine, tramadol
Opiod for moderate to severe pain - morphine, fentanyl
Very powerful so can produce mood changes
Inhibit nt release
Side effects: sedation, depression, pupil miosis

Question 15

What’s the main job of thyroid gland

Answer 15

Regulate metabolism

Question 16

Hyperthyroidism/hypothyroidism

Answer 16

Hyper - excessive thyroid, high metabolic rate, nervousness, weight loss

Hypo - decrease in activity, weight gain

Question 17

Drug treatment for nausea

Answer 17

• Prochlorperazine and chlorpromazine are two examples of drugs used as antiemetic drugs – antagonists at dopamine receptors
• Metoclorpramide – dopamine antagonist used as antiemetic – nausea and vomiting