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Misc Facts For Mrcpsych > Additonal Stuff Pt 3 > Flashcards

Additonal Stuff Pt 3 Flashcards

1
Q

Wad is the metabolite of

1) risperidone
2) Imipramine

A

1) Paliperidone

2) Desmipramine

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2
Q

Buspirone belongs to the chemical class

How about flupenthixol

How any thioridazine

4) bupropion?

A

Azasipirones

Thioxanthene

3) piperdine derivatives
4) aminoketone

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3
Q

Wad are the secondary amine for tricyclics

Name 3

A

Nortriplyine , Amoxapine, desmiprasine

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4
Q

Major transquilisters are known to be wadtype

A

Antipsychotics

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5
Q

Who use valproate in Mania

A

Bowden (1994)

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6
Q

Who is Janssen

A

Create haloperidol and dropidol

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7
Q

What is minacipran

A

SNRI

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8
Q

Zimeldine was wad and why it was withdrawn

A

The first SSRI

Withdrawn due to hypersensitivity syndrome and demyelination get disease

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9
Q

Rivatigmine is a wad type of drug

A

Reversible non competitive inhibitor of AchEs

Non Selective oso

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10
Q

Name two reversible MAOI

A

Moclobemide and brofaromine

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11
Q

What drug would best be used to trade mixed affective states?

A

Sodium valproate

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12
Q

Acamprosate is a wad

A

Synthetic taurine analogue

Act centrally glutamate and GABA neurotransmitter system .

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13
Q

First antidepressant is

A

Iproniazid

A MAO inhibitor

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14
Q

Wad does Kuhn does

A

Create imipramine

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15
Q

OCC can be affected by wad drugs name 4

A

Carbamazepine, St. John , topimarate, phenytoin, phenobarbitone

VALPROATE DOES NOT affect it

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16
Q

What is affected in old ppl and How

Name 4

A

1) total body fat increase
2) gastric pH increase, acidity drops
3) reduced renal clearance
4) decrease in plasma protein binding
5) decreased number of acetylene choline postsynaptic receptors

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17
Q

Comment on tricyclic’s

1) lipid solubility
2) protein binding

A

1) good, can pass easily

2) very binding

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18
Q

Half life of quietiapine?

A

6 hours

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19
Q

Fluoxetine drug effect

Can be seen for wad and wad does it do

1) propranolol
2) haloperidol
3) carbamazepine
4) oral anticoagulant
5) phenytoin

A

1) enchance
2) increases
3) increases
4) enchance
5) increases

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20
Q

Half life of nitrazepam

A

15-38 hours

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21
Q

Smoking is an enzyme inducer of inhibitor

How abt caffeine

A

Smoking : inducer

Caffeine: inhibitor

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22
Q

What kind of drugs follow zero order kinetics

A

1) depot antipsychotics
2) control realise drug
3) phenytoin
4) alcohol

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23
Q

Wad drug will be affected by moist air

A

Sodium valproate

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24
Q

Which SSRI shows the most autoinhibition

A

Paroxetine

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25
Q

Valproate can affect which drug

How carbameziene affect valproate

A

It can increase lamotrigibe, clomipramine, phenobarbitone by competitive inhibition of their metabolism

It is decreased by carbamazepine

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26
Q

Donepezil has efficacy in what domain

A

efficacy against the three major domains of Alzheimer’s disease symptoms, namely functional ability, behavior, and cognition.

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27
Q

What drugs are associated with bruxism

A

Stimulants

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28
Q

Wad drug is good to be added with MAOI

A

Amitriptyline, as it potentiates action of TCA

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29
Q

Wad antidementia drug acts on nicotinine receptors as well

A

Galatamine

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30
Q

Acamprosate is a wad

A

Glutamate antagonism

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31
Q

Sodium valproate does

A

GABA potentiation 5

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32
Q

What is the most sedative for TCA

A

Trimipramine

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33
Q

Endogenous substrate for MAO included

A

epinephrine, dopamine and serotonin

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34
Q

Chronic use of antidepressant can show

A

Downregulation of beta-adrenergic receptors

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35
Q

Which antipsychotics are better in reducing epse

A

Quetiapine

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36
Q

Barbiturates mechanism of actions

A

Increasing duration of chloride channel opening

Act on GABA

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37
Q

Clozapine hypersalivation is due to

How to treat (4)

A

Alpha 2 antagonism,
M4 agonism

Amitriptyline 
Hyoscine
Benzhexol 
Pirenzepine (M1,M4 antagonist) 
Terazoxin
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38
Q

Trazodone is wad class

A

SARI

Serotonin antagonist and reuptake inhibitor

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39
Q

Which TCA has a stimulant effect

A

Desmiprasine

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40
Q

Cyproheptadine is mechanism of action

A

Histamine h1 receptor blockage

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41
Q

Tyramine inters persona-tic neuron via what and release stored catecholamine via wad

A

Amine uptake pumps

Via Catecholamines reuptake channels

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42
Q

Which EPSE reacts best with anticholinergic

A

Dystonia

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43
Q

Drugs that are useful in tardive dyskinesia

A

Clonazepam, vitamins e, licensed is tetrabenazine (also can treat HD/tics, hemiballismus)

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44
Q

Which benzodiazepine is most toxic?

A

Alprazolam

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45
Q

3 mechanism of weight gain due to drugs

A

5ht2c antagonism
H1 antagonism
Hyperprolactinemia
Increased serum leptin

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46
Q

Risk of NMS

A

0.5 -1%

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47
Q

Wad atypical can increase prolactin

Name 3

A

Risperidone, Amisulpride and Zotepine

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48
Q

Tca potentiates 4 types of drug

A

alcohol, hypnotics, anxiolytics and antipsychotics n anticoagulant

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49
Q

Name 4 tat causes high effect on QTC

A

sertindole, thioridazine, pimozide and droperidol

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50
Q

Rare side effect of MAOI name 4

A

hepatocellular jaundice, Peripheral neuropathy, bone marrow suppression, and cardiac arrhythmia

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51
Q

Which SSRI has more problems of erectile dysfunction

Which has least

A

Paroxetine

Fluvoxamine

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52
Q

Which antidepressant can hav urinary hesitancy and how to treat

A

Reboxetine

Can use alpha 1 antagonist such as doxazosin or Tamsulosin

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53
Q

Wad antibiotic will cause serotonin syndrome if add with MAOI

A

Linezoid a oxazolidone family

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54
Q

Percentage of patient developing

1) tardive dyskinesia
2) Dystonia
3) Pseudoparkinsonism
4) akathesia

A

1) 2-5%
2) 2-10%
3) 20%
4) 25%

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55
Q

What can be used for self injurious behaviour of ID peeps

A

Naltrexone

56
Q

Give three medication that can be sued to treat NMS

A

Bromocriptine, Dantrolene, amantadine

57
Q

Who belongs to the seven transmembrane receptor

A

Dopamine

58
Q

Mirtazapine mechanism

A

5HT2A antagonism
Alpha 2 antagonism
Antihistamine
Anti 5HT3

59
Q

Agomelatine mechanism

A

Norepinephrine and dopamine neurotransmission through 5-HT2C antagonism

Direct agonist at melatonin receptors

60
Q

How SSRI can cause tolerance to hallucinogic drug

A

Down regulation of 5HT 2A

61
Q

Lower incidence of EPSEs of newer atypical antipsychotics is due to

A

5-HT2 receptor blockage

62
Q

Who create the first benzodiazepine

What is it

A

chlordiazepoxide

Hugo sternbach

63
Q

Lithium cannot be combine with which TCA because

A

Clomipramine

Serotonin syndrome

64
Q

Wad can cause atropine psychosis

A

Amitriptyline

65
Q

Serotonin syndrome is due to hyperstimulation of wad

A

5HT 1A/5HT 2A

66
Q

Most common side effect of

1) amisulpride and clozapine
2) imipramine and chlorpromazine

A

1) hypersalivation

2) dry cough

67
Q

Which antidementia drugs are non selective

A

Rivastigmine

68
Q

Special side effect of topimarate

A

Word finding difficulty
Wight loss
Renal stone

69
Q

Special side effect of galatamine

A

Bradycardia

70
Q

Phencyclidine mechanism

Ketamine mechanism

A

Phencyclidine: competitive

Ketamine
Non competitive NMDA receptor s

71
Q

Tell me three types if phenothiazine

A

1) aliphatic: chlorpromazine, trifluoperazine, promazine

Piperidine: thioridazine

Piperazine: trifluoperazine, perphenazine, fluphenazine

72
Q

Sinadefil made by

A

Osterloh

73
Q

Who made carbamazepine

A

Takezaki and Hanoka with okuma

To treat mania

74
Q

How does sodium valproate react

A

Enhances GABAergic function and inhibits GABA aminotransferase, increase GABA binding

75
Q

Lamotrigine

A

Neuronal membrane stabiliser and blocks voltage-dependent sodium channels hence reducing release of excitatory amino acid

76
Q

Topimarate how does it function

A

enhances GABA and blocks glutamate at NMDA receptors

77
Q

What is the first depot injection and is introduced byyyyyy

A

Fluphenazine

By G.R. Daniels

78
Q

Irreversible retinal pigmentation is associated with

A

use of high dose thioridazine (above 1000 mg a day)

79
Q

Which SSRI has weakly blocking reuptake of dopamine

Which SSRI stimulate 5-HT2C receptors

A

1) setraline so good for psychomotor reduction

2) Fluoxetine-hence does not cause weight gain

80
Q

Which antidepressant has a safe cardiovascular profile

A

Ribose Tien

81
Q

Wad ssri can have potent effect ion the pain receptors (which site)

How abt zopidem
Or zopiclone
Zaleplon

A

Fluvoxamine on sigma

Both z affect omega receptor-1 in GABA
All omega receptors in GABA

82
Q

Why these drugs are withdrawn

1) sertindole
2) mianserin’
3) Thalidomide
4) Zimeldine

A

1) sudden cardiac death
2) blood dyscrasias
3) teratogenic effect of phocomelia
4) GB and hypersensitive reaction

83
Q

Lithium might made wad cardiac issue even worse

A

Brugada

RBBB and ST elevation in right precordial leads

84
Q

Wad blood stuff can sodium valproate do

A

Leukopenia, thrombocytopenia, red cell hypoplasia

85
Q

Which antidepressent can cause dependence

A

Tranylcypromine cuz it has an amphetamine like structure

86
Q

Antidepressant related QTC prolongation is

A

Trazodone

87
Q

Which TCA has the least effect in cardiac arrhythmia

A

Lofepramide

88
Q

Which antidementia drug has no hepatic involvement

A

Rivastigmine

89
Q

Phenelzine has been shown to be superior to placebo in the treatment of

A

Social phobia

90
Q

Which of the following medications used to treat depression can directly influence gene transcription via nuclear receptors

A

Tri-iodothyronine

91
Q

GABApentin binds to

A

: Voltage-dependent calcium channel

92
Q

Lithium tremors can be helped by

A

Smaller, more frequent dose, or/and propranolol

93
Q

ST johns wort might do what two these two things

1) contraceptive pills
2) warfarin

A

1) decrease

2) inhibit

94
Q

Which hypnotic has a unique side effect of metallic taste in the mouth

A

Zopiclone

95
Q

disturbance in cerebral torque is proposed as the underlying pathological change in

A

Psychosis

96
Q

Wad protein is involved in Motor neuron disease

A

Superoxide dismutase

97
Q

Mifepristone is wad

A

glucocorticoid receptor antagonis

Can help in depression

98
Q

Wad is the male to female ratio for FTD and how many % it is associated with MND

A

1:1

15%

99
Q

ECG in Huntington can be

% will have abnormal ECG

A

Conduction abnormalities and bradycardia, QTC elevation

25%

100
Q

Elfin facial feature is wad syndrome

Other symptoms include

A

Williams syndrome hoarse voice, premature wrinkling and sagging of the skin, LD, hypercalcemia, supravalvular aortic stenosis

101
Q

Wad disease is due to lack of sphingomyelinase?

A

Niemann Pick disease
sphingomyeline accumulate in liver, spleen, lungs, bone marrow and brain leading to neurological damage
Two types type 1 in infants, type b before teenager

102
Q

Melatonin is secreted in

A

Pineal gland

103
Q

Normal ration of CSF and serum glucose is

It is decreased due to

A

0.6 (CSF has 60%) seen in blood

Bacterial meningitis

104
Q

Contraindication of disease in MAOI include

A

Phaeochromocytoma

Adrenal medulla tumors

105
Q

Sigma receptors are associated with

Wad drugs might affect it (4)

A

Depression

Haloperidol, setraline, fluvoxamine, cocain, phenytoin

106
Q

Methadone can cause wad cardiac problems

A

QTC prolongation, torsades de -pointes

107
Q

Cleft palate is indicated in wad three drugs

A

Diazepam, lamotrigine, sodium valproate , and ?SSRI

108
Q

Having clozapine will hav a cumulative risk of developing seizure by how much

A

10%

109
Q

Atypical depression can usually use wad to treat

A

MAOI

110
Q

Which 3 are potent inhibitors of CYP2D6

A

Parole Tien, fluoxetine and duloxetine

111
Q

Wad antibiotic will cause an reaction with alcohol

A

Metronidazole

112
Q

Acetylation
how many percent will b from Caucasian tat is slow
Wad drugs will be affected in slow acetylations

A

50%

IsonAzid, procainamide, nitrazepam

113
Q

D2 are excitatory/inhibitory

Pre+post or just post

A

Inhibitory, pro+postsynaptic

114
Q

Which serotonin receptor has auto-regulatory function in synaptosomes (5-HT terminals)

A

5-HT1B

115
Q

What you can see in EEG in R.E.M.

A

Saw tooth

116
Q

Wad u can see in EEG for delirium tremens

A

Low voltage fast wave

117
Q

What drugs should be avoided in Organic disinhibition

Should use wad

A

Benzodiazepine

Can use SSRI and trazodone

118
Q

What is the highest risk if developing NMS

A

Sudden withdrawal of antiparkinsonian medication

119
Q

What should be monitor when starting agomelatonin.

A

Liver function test

120
Q

Wad drugs should be given to SSRI induced hyponatremia

A

following treatment with antidepressants such as Fluoxetine. For those who develop hyponatraemia with an SSRI, consider Noradrenergic drugs such as Nortriptyline and Lofepramine, riboxetine or an MAOI such as Moclobemide

121
Q

NMS is usually due to

A

Young male, use high potensive drugs, use high potency drugs, dopaminergic drugs on withdrawal

122
Q

How do change TCA to most SSRI

A

Half TCA, add new drug then slow withdrawal

123
Q

What will happen with pregnancy in terms of pharmacokinetic changes

A 
Reduce gastric emptying 
Reduce motility 
Reduce plasma protein binding 
Some drugs have higher metabolism due to oestrogen and progesterone 
Increase renal elimination 
Increase volume of distribution
124
Q

Which antidepressant has a Low predicate for a manic switch

A

Bupropion

125
Q

What to give if someone js hypertensive crisis due to MAOI

name two

A

Phentolamine

Phenoxybenzamine

126
Q

Common side effect of rivastigmine

Name 5

A

Nausea, vomiting, diarrhoea, high blood pressure, hallucination

127
Q

Tricyclics that has the highest antihistamine is

Which tricyclics is the most toxic in overdose

A

Doxepine

Dosulepin and amitriptyline

128
Q

Botox can be use to treat

A

Tardive dystonia

129
Q

What can cause floppy baby syndrome

A

Benzodiazepine

Also can cause cleft palate

130
Q

Difference between NMS and SEROTONIN syndrome

A

SS has myoclonus and hyperreflexia

131
Q

Which ssri is good for cardiac ppl

Which ssri can be found in milk

Which ssri can cause virginismasmus

A

Setraline

Fluoxetine

Paroxetine

132
Q

Toxic confusional stage in antipsychotic is likely due to

A

Muscarinic receptor blockage

133
Q

Cholesterol check for antipsychotics every how many months on the first year

A

3 months

134
Q

Wad drugs can cause ovarian cyst

A

Sodium valproate

135
Q

What are the risk of tetratrogic for sodium valproate

And birth defect in general

A

Neural tube defect (1-2%)

Spina Bifida(10 fold increase), anencephaly , heart defect

Birth defect in general for valproate is 7 %

136
Q

Normal range for phenytoin

A

10-20

137
Q

What does ramelton do

How does atomoxetine works

A

Ramelton: MT1/MT2 receptor agonist promoted as hypnotic

Atomoxetine is a presynaptic norepinephrine inhibitor

Misc Facts For Mrcpsych (5 decks)

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