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What type of drugs are haloperidol/chlorpromazine?
Typical/first generation antipsychotics
Use of haloperidol/chlorpromazine?
Common & serious side effects?
What advice would you give the patient?
- 1. schizophrenia, psychosis, delirium
- 2. sedation, tardive dyskinesia, anticholinergic effects.
- NMS, cardiac (long QT)
- 3. Baseline ECG reqd. Avoid alcohol, careful when driving
What are antimuscarinic effects?
Dry mouth, constipation, blurred vision, dizziness
Name 3 atypical antipsychotics?
Quetiapine, Olanzapine, Clozapine
Common & serious SEs of atypical antipsychotics?
- Common: sedation, weight gain, [antimusc]
- dry mouth, constipation, blurred vision
- Serious: DM/DKA, NMS causing high fever, heart, kidney probs
- Clozapine --> clozapenia (neutropinia)
What is respiridone?
Atypical antipsychotic, "watered down haloperidol" (maintains some dyskinesia)
Name 3 benzodiazepines?
Diazepam, lorazepam, clozapam
What are benzos used for?
short term for anxiety, insomnia also seizures, alcohol withdrawal
Common & serious SEs of benzos?
- Common: sedation/drowsy, can muddle
- thinking, mess with memory
- Serious: cause dependence, decrease breathing
Name 3 SSRIs
Fluoxetine, Paroxetine, Citalopram
Common & serious side effects of SSRIs?
- Common – FINISH (fat, insomnia, nausea,
- irrit/anxiety, sex func dec, headaches)
- Serious – initial inc in suicidal thoughs
What advice would you give pt starting SSRIs?
- 4-6 wks for people to notice effect
- Initial increase in anxiety/suicide thoughts so need follow up after 1-2 wks.
- Withdrawal slowly
- Will need to be on it for 6 months after feeling better (2-3y if recurrent)
What are amitryptiline & nortryptiline & how does it work?
- seratonin & NA reuptake inhibition
- Has effects on histamine receptor, a receptor and anticholinergic
Common & serious SEs of TCAs?
- Common – [antichol] dry mouth, blurred vision, constipation, sedation [antihist], hT, dizzy [a recep], weight gain
- Serious – seizures, coma, arrythmias
Order of prescribing antidepressants?
- 1. SSRIs
- 2. (try diff SSRI)
- 3. TCA
- 4. SNRI
- 5. MAOI
What is venlafaxine?
SNRI (seratonin, noradrealine reuptake inhib)
What might a patient switch to SNRIs from TCAs?
Less sedative & antimuscarinic effects
Common & serious SEs of venlafaxine?
- Common: rash, [HTN] which if sustained has effects on your body, headaches, tummy upset
- Serious: Heart effects if stopped suddenly
Example of a MAOI & major SE?
- Hypertensive crisis - special diet required
What is lithium & what is it used for?
- Mood stabiliser
- Mania, bipolar
Common & serious SEs of Lithium?
- Common = 4T’s: tremor, terrible kidney (pee lots),
- tummy upset, thyroid inc
- Serious – teratogenic, kidney and heart arrythmias, seizures, coma if too much
What is lamotragine?
Common/serious - cerebellar sx, blood dx (bleeding, infection)
What are sodium valproate/Carbamazepine? When are they used in psychiartry?
- Antiepileptics/mood stabilisers
- Used as mood stabilisers when unresponsive/can't use Li
Common & serious SEs of sodium valproate/carbamazepine?
- Common: Sedation, headache, cerebellar
- Serious: Blood dx (bleeding, infec)
- (NaVal) – teratogen
- (Carba) – Increase suicidal thoughts