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37 Cards in this Set
- Front
- Back
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Name mood stabilizers |
-Lithium- the best one !!
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What pathways do DA act on ? |
Mesolimbic --> psychotic symptoms
Tuberofundibular --> Hyperprolactinemia --> osteoporosis & sexual dysfunction |
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What are the side effects of atypical antipsychotics ? |
weight gain, sedation
Metabolic syndrome |
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What are the side effects of SSRIs? |
-N&V -insomnia Sexual dysfunction -Suicidal ideation + anxiety ( in short-term)
Serotonin syndrome (small risk) |
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Give examples of TCA's
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Amitriptylline Imipramine Clomipramine |
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What are the side effects of TCA's
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-Anti-muscarinic (dry eyes/mouth, constipation, urinary incontinence)
-Anti-histamine ( sedation + weight gain)
-Cardiac arrhythmias ( if OD) -->
CONTRAINDICATED IF SUICIDAL IDEATION PRESENT |
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Give examples of MAOi |
Meclobemide (reversible inhibitor) Phenelzine Isocarboxazid Tranylcypromide |
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What are the side effects of MAOi
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-Cheese RXN/HTN crisis --> malignant HTN, raised ICP, palpitations, headache (due to tyramine foods -e.g cheese/wine)
-risk of serotonin syndrome |
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What are the symptoms of serotonin syndrome & how is it Rx?
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CVS collapse seizure/myoclonus Hyperthermia
Rx- cyproheptadine |
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Give an example of an SNRI & their side effects
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-Venlafaxine -Duloxetine
Side effect: Discontinuation syndrome (parasthesia, N&V, sweats, insominia, anxiety) |
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Give an example of an NaSSA & their side effects
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Mirtazapine
Side effect : Sedation + weight gain |
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Give examples of mood stabilisers for BPAD
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-Lithium- the best one !!
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When using lithium, what do you need to monitor?
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-U&E -TFT's -Serum lithium levels |
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Side effects of lithium |
-N&V + diarrhoea -Anorexia -Renal - polydipsia/polyuria (due to ADH inhibition) --> renal impairment
Hypothyroidism
-Teratogenic (Ebstein's anomaly) |
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What are the S/S of lithium toxicity |
Ataxia + fusion + coarse tremor
Rx - Stop Lithium + hydrate + Dialysis |
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Side effects of carbamazepine
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-N&V + Diarrhoea -Sedation -Ataxia -SiADH -Leucopenia -SJS
Contraindicated for - Generalized epilepsy , OCP |
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Side effects of sodium valproate
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ALPROATE -appetite increased -Liver failure -Pancreatitis -Reversible alopecia -Oedema -Ataxia -teratogenic/tremor/thrombocytopenia -Encephalopathy |
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Side effects of lamotrigine
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SJS |
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Give examples of anxiolytics
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-BDZ -Antidepressants -Buspirone ( slower onset) -Beta-blockers (for symptomatic relief) |
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Give examples of BDZ
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-Midazolam< lorazepam
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How do BDZ work ?
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Increase sensitivity of GABA channels Similar to ethanol/barbituates
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When are BDZ indicated?
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Aggression ( if PD/Lewy body dementia) BDZ/Alcohol withdrawal Sedation (e.g surgery) Status epilepticus |
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Which BDZ is used for alcohol withdrawal ?
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Diazepam OR chlodiazepoxide |
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Which BDZ is used for status epilepticus
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-If community - Buccal midazolam/rectal diazepam
-If hospital - IV lorazepam x2 --> phenytoin |
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Why are BDZ used in short-term only?
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-tolerance -Dependence/Withdrawal symptoms (similar to delirium tremens) |
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What are the side effects of BDZ ? |
Confusion paradoxical aggression Resp. depression
Rx OD if RR <10 |
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What is the reversal agent for BDZ? |
Flumazenil ( a GABA antagonist)
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What are the benefits of buspirone ?
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No sedation, incoordination or withdrawal BUT slower onset (2 weeks) & weaker |
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Identify/describe the 3 DA pathways |
Mesolimbic --> psychotic symptoms
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What can antipsychotics also be used for ?
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Mood stabilizer ( quetiapine)
Anti emetic (prochloperazine) |
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What are the general side effects of antipsychotics?
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-risk of Stroke/VTE
-Hyperprolactinemia -EPS -Prolonged QT -Neuroleptic malignant syndrome |
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What is neuroleptic malignant syndrome ?
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-Rare -S/S (muscle rigidity + hyperthermia + confusion)
-Rx -stop causative agent + bromocriptine |
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Give examples of typical antipsychotics
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Haloperidol Prochloperazine Chlorpromazine |
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What are the side effects of typical antipsychotics?
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-Hyperprolactinemia (e.g gynecomastia)
-EPS ( dystonia --> parkinsonism -> akathisia -> tardive dyskinesia)
-antihistamine effects
-Antimuscarinic effects
Haloperidol = worst EPS effect + prolonged QT BUT no antihistamine/antimuscarinic effects
Chlorpromazine = obstructive jaundice |
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Give examples of atypical antipsychotics
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Olanzapine risperidone Quetiapine Aripripazole Amisulpride Clozapine
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What are the side effects of atypical antipsychotics ? |
- Metabolic syndrome -Sedation -Muscarinic effects (e.g Hypersalivation)
Clozapine = agranulocytosis & decreases seizure threshold
Risperidone (for pregnancy) = insomnia
Quetiapine = sedation |
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What is zopiclone ? |
a hypnotic commonly used for insomnia |
