Psych Vivas · Psychopharmacology — organ impairment
Psychotropics in renal and hepatic disease — consultant viva
Fellowship viva covering renal/hepatic PK, agent selection, depression-in-CKD trials, lithium toxicity, cirrhosis sedation, and DILI/HAE.
On this page
Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner places cards: CAST, ASCEND, eGFR 35, paliperidone, Child–Pugh C, LOT benzodiazepines, lithium + NSAID, EXTRIP, valproate ammonia, free fraction.
Station structure
Time: 8–10 minutes. Depth: consultant teaching registrar. Expect named trials (CAST, ASCEND), renally cleared antipsychotic traps, Child–Pugh thinking, LOT benzodiazepines, free-fraction concept, lithium EXTRIP, and valproate HAE without inventing product-label milligrams as universal law.[1][2][3][4]
References10ShowHide
- [1]Baghdady NT, Banik S, Swartz SA, et al. Psychotropic drugs and renal failure: translating the evidence for clinical practice Adv Ther, 2009.PMID 19444657
- [2]Hedayati SS, Gregg LP, Carmody T, et al. Effect of Sertraline on Depressive Symptoms in Patients With Chronic Kidney Disease Without Dialysis Dependence: The CAST Randomized Clinical Trial JAMA, 2017.PMID 29101402
- [3]Mehrotra R, Cukor D, Unruh M, et al. Comparative Efficacy of Therapies for Treatment of Depression for Patients Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial Ann Intern Med, 2019.PMID 30802897
- [4]Decker BS, Goldfarb DS, Dargan PI, et al. Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup Clin J Am Soc Nephrol, 2015.PMID 25583292
- [5]Grønbæk L, Watson H, Vilstrup H, et al. Benzodiazepines and risk for hepatic encephalopathy in patients with cirrhosis and ascites United European Gastroenterol J, 2018.PMID 29774154
- [6]Telles-Correia D, Barbosa A, Cortez-Pinto H, et al. Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity World J Gastrointest Pharmacol Ther, 2017.PMID 28217372
- [7]Segura-Bruna N, Rodriguez-Campello A, Puente V, et al. Valproate-induced hyperammonemic encephalopathy Acta Neurol Scand, 2006.PMID 16774619
- [8]McKnight RF, Adida M, Budge K, et al. Lithium toxicity profile: a systematic review and meta-analysis Lancet, 2012.PMID 22265699
- [9]Hiemke C, Bergemann N, Clement HW, et al. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017 Pharmacopsychiatry, 2018.PMID 29390205
- [10]Lewis JH, Stine JG Review article: prescribing medications in patients with cirrhosis - a practical guide Aliment Pharmacol Ther, 2013.PMID 23638982