Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
7 Cards in this Set
- Front
- Back
|
Drug interactions
What pharmacokinetic interactions are important with psychiatric drugs? |
Kidneys - mainly lithium. Its secretion can be affected by diuretics that act on the DCT, and NSAIDs.
Hepatic - many psych drugs are metabolised by CYP450 system, and in turn affect it themselves as well. Inducers of CYP450 - carbamezapine (mood stabiliser) Inhibitors of CYP450 - SSRIs (esp fluox, parox); erythromycin; ketoconazole |
|
|
Adverse effects
The adverse effects of psychiatric drugs can be divided up into 2 big groups. These are? |
DOSE DEPENDENT vs DOSE INDEPENDENT
DOSE DEPENDENT effects are usually due to the receptor mechanisms, and include autonomic, CVS, psych, neuro, endocrine and sexual effects. As it states, the higher your dose, the worse these effects will become. DOSE INDEPENDENT effects are just that, and usually involves the immune system. This includes hepatitis, blood dyscrasias and rashes. |
|
|
Should psych drugs be prescribed in pregnancy / BF?
|
Short answer: carefully consider the risks and benefits, avoiding if you can.
Many psych meds are lipophilic and thus easily cross placenta and breast. There are risks of teratogenesis (e.g. carbamazepine), and neonatal toxicity (e.g. benzodiazepines). If possible it's best to avoid psych meds esp in early preg and near delivery, but this should be balanced with the risks. Psychotherapy may be an important option to consider. |
|
|
What about psych meds in elderly?
|
PK factors - renal, hepatic
PD factors - "less adaptable" CNS, more SEs Increased likelihood of polypharmacy and interactions Start low go slow |
|
|
How can taking medication influence a pt's perspective on psychosocial treatment?
|
In many cases it's important to make it clear to patients that meds are a PART of their treatment plan, and not a "panacea" in itself.
|
|
|
How can we increase compliance to psych meds?
|
Psych meds are in particular difficult to ensure compliance since many people don't believe they should be on them anyway!
Some strategies: Plenty of empathy. Pts must feel that they're heard Clear, frank explanations about their diagnosis and the drug Simple, easy regime |
|
|
Psych drugs fit in 4 classes which are
|
Hypnotics and anxiolytics
Antidepressants Mood stabilisers Antipsychotics |
