Psychopharmacology 115

You are asked to review a man on a hospital ward with hemochromatosis who has been observed to be low in mood. On review of his blood results you note significant hepatic impairment. You history and examination confirms that he is depressed. Which of the following medications would be indicated to manage his depression?  Amitriptyline23%Mirtazapine17%Fluoxetine20%Moclobemide9%Paroxetine30% Haemochromatosis is an inherited disorder in which iron levels in the body slowly build up over many years. If left untreated, the extra iron is deposited in the body, usually around organs, such as the heart and liver and can lead to both liver and heart...

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Psychopharmacology 114

Which of the following metabolic changes is associated with QTc prolongation? Hyponatraemia7%Hypokalaemia65%Hypophosphatemia6%Hypermagnesaemia8%Hypercalcaemia14% QTc prolongation In addition to psychotropic drugs, there are a number of additional risk factors for QTc prolongation to consider.QTc prolongation is an indicator of risk of torsade de pointes and increased cardiac mortality. Risk factors for QTc prolongation Long QT syndromeBradycardiaIschaemic heart diseaseMyocarditisMyocardial infarctionLeft ventricular hypertrophyHypokalaemiaHypomagnesaemiaHypocalcaemiaExtreme physical exertionStress or shockAnorexia nervosaExtremes of age...

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Psychopharmacology 113

Which of the following relates to theta rhythms? Seen when concentrating10%Seen in stage 0 sleep16%Seen in meditative practice45%Decreased in antidepressants20%Dominant rhythm when alert8% Electroencephalography Electroencephalography is the recording of electrical activity along the scalp produced by the firing of neurons within the brain. In clinical contexts, EEG refers to the recording of the brain's spontaneous electrical activity over a short period of time, usually 20-40 minutes, as recorded from multiple electrodes placed on the scalp. It is mainly used as a test to rule out organic conditions. Research has showed it to...

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Psychopharmacology 112

Which of the following is true regarding the distribution of administered medication in the elderly? There is a relative reduction of body fat to body water12%A reduced unbound free fraction of administered drugs is typical seen in the elderly11%Older people have higher amounts of albumin when compared to younger adults5%Water soluble drugs tend to have lower levels in the elderly21%As people age, the half-life of a lipid soluble drug increases51% Prescribing in the elderly Older people's bodies are different to those of younger adults and this affects how they handle medication. Additionally they are often on a range of other drugs so interactions...

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Psychopharmacology 111

Which of the following is the method of choice for detecting alcohol dependence and hazardous drinking in primary care settings? AUDIT55%MAST5%CAGE20%FAST11%PAT8% Exam Question Aug 2008AUDIT is used in primary care settings as it accurately detects both alcohol dependence and hazardous drinking. CAGE is good at detecting dependence only. Alcohol screening tools A variety of tools have been devised to assist in the diagnosis of alcohol problems.AUDIT (Alcohol Use Disorders Identification Test), was developed by the WHO as a simple method of screening for excessive drinking. The test consists of 10 questions and attempts to cover the...

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Psychopharmacology 110

Which of the following medications is affected by moisture and so cannot be included in a compliance aid? Citalopram7%Fluoxetine6%Donepezil8%Sodium valproate60%Hyoscine Hydrobromide19% Drug stability The stability of drugs varies considerably (Church 2006). Some medications cannot be included in compliance aids as they can be affected by their environment. Some drugs tend to absorb moisture from the air which renders them ineffective. Light is known to accelerate this process.Examples of drugs effected this way and so unsuitable for compliance aids include:- Sodium valproate Zopiclone Venlafaxine Topiramate Methylphenidate Mirtazapine Olanzapine Amisulpride Aripiprazole Church...

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Psychopharmacology 109

A 46-year-old man is seen by an occupation health doctor due to long-term sickness leave. He states chronic lower back pain prevents him from working but examination findings are inconsistent and the doctor suspects a non-organic cause of his symptoms. This is an example of a: Conversion disorder8%Munchausen's syndrome8%Malingering60%Hypochondrial disorder7%Somatisation disorder17% Somatoform and Dissociative disorders Somatoform disordersThe somatoform disorders are a group of disorders characterised by physical symptoms that are presumed to have a psychiatric origin.They are classified slightly differently by the ICD-10 and DSM-IV, see...

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