Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PRITE-Tx > AntiDepre > Flashcards

AntiDepre Flashcards

1
Q

27 y/o depressed patient treated with SSRI and tranylcypromine (and with 5- hydroxytryptophan) now presents with VH, mild confusion, myoclonic jerks, diaphoretic, flushing, restless: (6x)

A

SEROTONIN SYNDROME

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What drug has a curvilinear therapeutic window? (6x)

A

NORTRIPTYLINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What drug is useful in the Rx of urinary retention secondary to TCA therapy (5x)

A

BETHANECHOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which opioid has a potentially lethal interaction with monoamine oxidase inhibitors (MAOIs)? (4x)

A

MEPERIDINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

After an OD on Amitriptyline, what test is needed? (4x)

A

EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

45 y/o F pt on phenelzine for MDD, takes OTC medication for cold sx and develops hypertensive crisis. Which OTC medication would most likely cause this? (3x)

A

PSEUDOEPHEDRINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Antidepressant less likely to cause sexual dysfunction: (3x)

A

BUPROPION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antidepressant preferred for >65 y/o for which blood levels are clinically useful (3x)

A

DESIPRAMINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pt with hx of bipolar disorder p/w immobility, posturing, and echopraxia. First line tx? (3x)

A

LORAZEPAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which SSRI has mild anticholinergic activity due to some affinity at the muscarinic receptors? (3x)

A

PAROXETINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The most common reason that people discontinue the use of SSRI: (3x)

A

GI SIDE EFFECTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

62 y/o pt with hx chest pain has and depression, one month ago started on paroxetine, presents with new onset of lethargy and headache, low Na and BUN, normal K , and Cr of 0.4. Next test: (2x)

A

URINE OSMOLALITY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

38 y/o taking imipramine 300mg qday for recurrent MDD. After 3 weeks, mood is improved, but has difficulty passing urine and mild erectile dysfunction. Appropriate action? (2x)

A

BETHANECHOL 25MG TID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which is a muscarinic SE of antidepressants? (2x)

A

URINARY RETENTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

30 y/o pt has been treated for unreasonable fear of eating in public places, feeling of embarrassment in public places, and anger over the possibility of being scrutinized. Pt has not responded to high doses of paroxetine, citalopram, buspirone, and alprazolam, each of them administered for 4-6 wks. Which meds would be appropriate for next? (2x)

A

PHENELZINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What meds could be helpful in the treatment of depression in persons over the age of 65 because it does not produce orthostatic hypotension: (2x)

A

BUPROPION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What antidepressant med is considered to be the most effective in the tx of premature ejaculation? (x2)

A

PAROXETINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Minimum recommended washout period for fluoxetine prior to starting MAOI (2x)

A

5 WEEKS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment for patients with MAOI related hypertensive crisis in the ER may involve the administration of which of the following meds? (2x)

A

PHENTOLAMINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most frequent cause of death following TCA overdose: (2x)

A

ARRHYTHMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Optimal strategy in maintenance tx with TCA for patient with recurrent MDD (2x)

A

FULL DOSE ANTIDEPRESSANT THERAPY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Monitor TCA overdose using (2x)

A

EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fluoxetine should NOT be prescribed with what? (2x)

A

PHENELZINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

21 y/o pt experiences a brief manic episode after starting an SSRI. The pt meets Dx criteria for what disorder? (2x)

A

SUBSTANCE-INDUCED MOOD DISORDER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Serotonergic antidepressants are appropriate treatment for depression in 54 y/o pt with recent coronary artery bypass graft surgery because they: (2x)

A

INHIBIT PLATELET FUNCTIONING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which SSRI has the greatest potential for discontinuation syndrome with missed doses (x2)?

A

PAROXETINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which of the following has the longest mean half-life: citalopram, paroxetine, venlafaxine, fluvoxamine, trazodone (x2)?

A

CITALOPRAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which SSRI used to treat discontinuation syndrome caused by SSRI termination (x2)?

A

FLUOXETINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

46 y/o F pt presents w increasing dysphoria, progressively increased frequency with which she washes her hands to the point of excoriation, dose range for effective Tx: (x2)

A

FLUVOXAMINE 200-300MG DAILY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Two antidepressants are tested alone and as a combo treatment against a waitlist control group in pts with treatment resistant MDD. Both meds are found to have a significant therapeutic effect individually, and the combo treatment is more efficacious than the summed effects of each med given alone. What has been demonstrated? (2x)

A

TWO TREATMENTS MAIN EFFECTS AND AN INTERACTION EFFECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

First pass effect refers to which of the following aspects of a med’s metabolism? (2x)

A

PRESYSTEMIC ELIMINATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which is an NMDA receptor antagonist? (2x)

A

MEMANTINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Psychiatrist is called to eval a pt on a medical floor who has developed acute dysarthria w/ protruding tongue and torticollis. Which med is suspect? (2x)

A

METOCLOPRAMIDE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

70yo w depression plus confusion x 2wk following the start of fluoxetine . An adverse effect is suspected but neuro exam normal. What evaluation would be most useful to confirm suspicion of an adverse effect? (x2)

A

UREA AND ELECTROLYTES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

causes seizure in overdose?

A

CLOMIPRAMINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

effects of SSRI in pregnancy

A

ASSOCIATED WITH NEONATAL ADAPTATION SYNDROME

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Medication reduces analgesic effect when administered w/ hydrocodone

A

FLUOXETINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pt on clozapine and VPA. Psychiatrist increases VPA and adds Fluvoxamine, PCP gives aspirin, atorvastatin, and zolpidem, pt has seizure. Which med increased clozapine levels?

A

FLUVOXAMINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

SE with ketamine?

A

INCREASE BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

SSRI that mostly to cause birth defect?

A

PAROXETINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Tx for neuropathic pain in diabetes

A

DULOXETINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which antidepressant is least likely to cause sexual side effects?

A

ESCITALOPRAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the best reason for preferring the use of SSRI antidepressants over TCAs in tx of pts w/depression who are > 65yo?

A

LESS LIKELY TO CAUSE ORTHOSTATIC HYPOTENSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

A psychiatrist wished to start an inpatient on a TCA but the pt is reluctant due to hearing these drugs may cause dry mouth, constipation, blurred vision and urinary retention. What TCA would have the least side effects?

A

DESIPRAMINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

25 yo CF started on desipramine 50mg Qday. SE of constipation, dry mouth, visual difficulties, tremor and agitated feeling. Not on any other medications. Blood level is 400ng/ml. Most likely cause?

A

POOR METABOLISM OF CYTOCHROME P450 SUBSTRATES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Which side effect occurs less frequently in pts treated with mirtazapine vs SSRIs?

A

DIARRHEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

29 y/o M h/o recurrent depression & 1.5 PPD smoking. Medication?

A

BUPROPION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Mirtazapine is an antagonist at which receptor?

A

ALPHA-2-ADRENERGIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

The risk of increased psychosis for pts with psychotic disorders who take bupropion is attributable to enhancement of:

A

DOPAMINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Which dietary supplement has demonstrated some efficacy in Tx of depression?

A

S-ADENOSYL-L-METHIONINE (SAME)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The side effects of sedation and weight gain are associated with mirtazepine’s antagonism of which of the following receptors?

A

H1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Pt taking venlafaxine for months stops abruptly and calls psychiatrist 3 days later with nausea, insomnia, muscle aches, anxiety, dizziness, and transient “electric shock” sensations. The most likely cause:

A

ANTIDEPRESSANT WITHDRAWAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

58 y/o pt is started on citalopram 20mg for MDD. After 3 wks pt reports some improvement in vegetative sxs but remains dysphoric. What is the next step?

A

CONTINUE CITALOPRAM AT THE PRESENT DOSE WITH NO ADDITIONAL MED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Antidepressant w/ shortest elimination half-life:

A

TRAZODONE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

An effective antidepressant for depression w/ atypical features is:

A

PHENELZINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Why is l-methylfolate preferable to folate in adjunctive tx of depression?

A

INCREASE TRANSFER ACROSS BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Phenylethylamine antidepressant that targets serotonin and norepinephrine reuptake inhibition:

A

VENLAFAXINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Pt presents to ED with 5-day hx of N/V, diarrhea, HR of 90, BP 150/92, and temp 100, sweating, tremor, hyperreflexia and distractibility, normal labs an and CT head, and years of Fluoxetine use. One week ago a new med was started, what med was it?:

A

TRAMADOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

19 y/o pt presents for evaluation of depression. Pt reports a generally very low mood, although it brightens up briefly when something good happens. Pt reports feeling best in the morning. Pt has been sleeping and eating more than usual, and complains of feelings of heaviness in the extremities. Pt reports always being very sensitive to perceived rejection by others. Trials with two selective serotonin reuptake inhibitors (SSRIs) have failed. Which of the following treatments may be particularly effective for this pt?

A

TRANYLCYPROMINE

60
Q

Which of the following meds has the lowest likelihood of discontinuation symptoms if the medication is abruptly stopped?

A

FLUOXETINE

61
Q

What med has some evidence of effectiveness in both psychotic/nonpsychotic subtypes of body dysmorphic disorder?

A

FLUOXETINE

62
Q

What med is most potent inhibitor of the norepinephrine transporter?

A

PAROXETINE

63
Q

What pharmacological treatment should be used for long-term insomnia in pts with dementia over 65 years of age?

A

TRAZODONE

64
Q

Mirtazepine (vs other antidepressants) has low incidence of what side effect?

A

SEXUAL SIDE EFFECTS

65
Q

Orthostatic hypotension is least likely to occur as a S/E with what antidepressants?

A

SERTRALINE, NORTRIPTYLINE, IMIPRAMINE, AMITRIPTYLINE, TRAZODONE

66
Q

Which antidepressant has active metabolites that extend its effective half-life?

A

SERTRALINE

67
Q

50 y/o fireman became clinically depressed after sustaining a myocardial infarction. What is an appropriate medication to prescribe?

A

SERTRALINE

68
Q

MDD patient with good response to venlafaxine presents with dysphoria, agitation, nausea, poor balance after running out of medication. Cause of sx?

A

SEROTONIN DISCONTINUATION SYNDROME

69
Q

Receptor blocked by antidepressants -> blurred vision

A

MUSCARINIC

70
Q

Which antidepressant has strongest histamine-R affinity?

A

MIRTAZAPINE

71
Q

45 y/o pt w/ first episode MDD, on Paxil and insight-oriented therapy, but depression worsens over months. Takes Paxil only occasionally, as he is worried about becoming dependent on it (a friend was addicted to Valium). Best intervention?

A

EDUCATE PATIENT ON THE DIFFERENCES BETWEEN ANTIDEPRESSANTS, LIKE PAXIL, AND BENZODIAZEPINES, LIKE VALIUM.

72
Q

What antidepressant increases REM sleep?

A

BUPROPION

73
Q

What antidepressant has an FDA pregnancy use B rating?

A

BUPROPION

74
Q

Antidepressant with low risk of weight gain:

A

BUPROPION

75
Q

40 y/o pt experienced delirium, tremor, diaphoresis, rigidity, hyperpyrexia, and myoclonus in making the transition from the use of clomipramine to phenelzine. Pt is most likely experiencing:

A

SEROTONIN SYNDROME

76
Q

Antidepressant that causes Parkinson’s sx:

A

AMOXAPINE

77
Q

In pts over 65 w MDD, Bupropion has what advantage over SSRIs?

A

FEWER DRUG INTERACTIONS

78
Q

Trazodone requires larger doses to be used as an antidepressant due to lower potency affinity to which receptor?

A

SEROTONIC TRANSPORTER

79
Q

Which med is comparative safety during Tx w/ MAOI?

A

FENTANYL

80
Q

Pts taking MAOIs should use caution when consuming what?

A

FAVA BEANS

81
Q

Which med is irreversible MAO-B inhibitor?

A

SELEGILINE

82
Q

2 wks washout of which med is needed before starting fluoxetine

A

PHENELZINE

83
Q

MAOI least likely to cause drug-food interaction in therapeutic antidepressant doses:

A

MOCLOBEMIDE

84
Q

Pt taking phenelzine is treated in ED for chest pain. While treated, pt develops hyperreflexia, HTN, goes into coma. Which med is most likely cause?

A

MEPERIDINE (DEMEROL)

85
Q

Pt taking tranylcypromine for atypical depression called Psych MD, reports HA, vomiting, chills, palpations over one day. Pt asks if he continue med during illness. In addition to directing pt to stop med, emergent Tx would 1st include what med?

A

NIFEDIPINE

86
Q

At 10 mg selegiline does not require dietary restriction because

A

MAO-B IS NOT INVOLVED WITH INTESTINAL TYRAMINE REACTION

87
Q

Most frequent side effect of MAOI’s

A

HYPOTENSION

88
Q

42 y/o pt with hx of HTN treated with HCTZ and lisinopril presents for f/u of severe melancholic and vegetative depression. The patient, while adherent to all med regimens, has failed multiple combos of antidepressants and is currently on a regimen that includes fluoxetine. The psychiatrist plans to discontinue fluoxetine and start selegiline. The most important consideration to be made before starting?

A

IT IS AN IRREVERSIBLE MAO-A & MAO-B INHIBITOR AND CAN ONLY BE STARTED 5 WEEKS AFTER DISCONTINUING FLUOXETINE TO DECREASE RISK OF SEROTONIN SYNDROME

89
Q

MAOIs affect catecholamines by directly retarding:

A

DEACTIVATION

90
Q

Pt w/ MDD has been unresponsive to prior trials with a TCA and SSRIs. Pt has 1st degree right bundle branch block and poorly controlled HTN. Pt w/ no SI. Next step?

A

BEGIN TX WITH PHENELZINE

91
Q

What inhibitor of monoamine oxidase is also useful in the treatment of Parkinson’s disease?

A

SELEGILINE

92
Q

Blood levels for therapeutic and potentially toxic effects can routinely be assessed for which med?

A

NORTRIPTYLINE

93
Q

Increased PR, QRS, or QT on EKG:

A

TRICYCLICS

94
Q

Psychiatrist plans to add nortriptyline as adjunct to fluoxetine. He should proceed how?

A

START NORTRIPTYLINE AT LOWER THAN NORMAL DOSE

95
Q

The best time to obtain ECG in the treatment of children with TCA:

A

BEFORE TREATMENT, FOR ALL CHILDREN, TO ESTABLISH BASELINE

96
Q

Which antidepressant is successfully used to treat pain syndromes?

A

AMITRIPTYLINE

97
Q

Nortriptyline is the active metabolite of which of the following TCAs?

A

AMITRIPTYLINE

98
Q

Dry mouth, blurred vision, constipation, urinary retention. S/E of what psychotropic?

A

AMITRIPTYLINE

99
Q

Do NOT use in pt w/ narrow-angle glaucoma

A

AMITRIPTYLINE

100
Q

Which tricyclic antidepressant has the most potent antihistaminic effect?

A

DOXEPIN

101
Q

Which TCA should be avoided in pts w/ Parkinson’s?

A

AMOXAPINE

102
Q

85 y/o pt w/ hx of HTN and COPD reports feeling depressed. The pt has an episode of depression 20 yrs ago, which was successfully treated with nortriptyline. The pt’s HTN is currently well managed with hydrocholorothiazide. The physician prescribes nortriptyline 25mg qday. After 1 wk, the pt calls and reports feeling no better. What would be an appropriate reason to obtain a nortriptyline level?

A

PT’S ADVANCED AGE

103
Q

32 y/o pt w/ hx of treatment resistant depression was brought to ER after overdose on imipramine. Pt reported wanting to die, but then changed her mind and then called for help. Pt’s regular psych MD had recently added imipramine to the pt’s partially effective regimen of fluoxetine 80mg qday. Pt is afebrile, BP is 100/58 and HR is 96 and regular. Pt is vague about the detail of the attempt, but reports no longer feeling suicidal. Medical resident recommends admission to a psych unit. Request for a TCA blood level and EKG are deferred. Medical resident asserts that the pt’s combined imipramine and desipramine level of 750ng/ml is not in the cardiotoxic range. What is the best course of action for the psych MD to take?

A

INSIST ON FURTHER CARDIAC MONITORING IN EITHER THE ED OR ICU

104
Q

What causes the cardiac toxicity of imipramine in overdose?

A

BLOCKADE OF VOLTAGE-GATED SODIUM CHANNELS

105
Q

Orthostatic hypotension associated with TCA’s is caused by blockade of what receptor?

A

ALPHA-1-ADRENERGIC

106
Q

80yr old pt with MDD has tried SSRIs and SNRIs with no improvement, wants to start TCA, no cardiac hx and EKG is normal, which medication is most appropriate due to the side effect profile?

A

DESIPRAMINE

107
Q

SSRI with shortest half life

A

FLUVOXAMINE

108
Q

Pt w/ hx of MDD has been taking Fluoxetine 40 mg PO QDay for one year since achieving remission of third depressive episode. Pt wants to stop medication because of sexual side effects responsive to Sildenafil 100 mg PRN. What should psychiatrist recommend to pt?

A

CONTINUE THE FLUOXETINE AS LONG AS IT IS EFFECTIVE

109
Q

Patient with long history of treatment resistant depression on phenelzine complaining of sweating, palpitations, and headache. BP = 210/118. Recently took OTC medicine to treat URI. What is the most appropriate intervention?

A

NIFEDIPINE

110
Q

In studies that compare SSRI antidepressants with TCAs, which of the following is the best documented advantage of SSRIs over TCAs?

A

LOWER DROP OUT RATES DUE TO SIDE EFFECT

111
Q

Most typical SE of fluoxetine:

A

NERVOUSNESS, RESTLESSNESS, AND ANXIETY

112
Q

Discontinuation syndrome associated with SSRI consists of:

A

MALAISE, NAUSEA, PARESTHESIAS, DIZZINESS, MOOD SYMPTOMS, AND HEADACHE

113
Q

Which is a common side effect leading to discontinuation of SSRI’s early in treatment?

A

GI DISTRESS

114
Q

Which SSRIs has longest half-life?

A

FLUOXETINE

115
Q

Black box warning on SSRIs with regard to children and adolescents:

A

SUICIDAL IDEATION

116
Q

Which of the following would represent a concern if administered concomitantly with a SSRI?

A

HYPERICUM PERFORATUM

117
Q

SSRI w/ no or mild inhibition of major P450 isoenzymes of 1A2, 2C9, 2C19, 2D6, 3A4

A

CITALOPRAM

118
Q

Dermatologist asks for psych consult on 38 y/o pt. 5 years ago pt began having concerns of perceived skin irregularity she calls “bumps.” Over time increasingly more difficult for her to ignore “bumps” and picks at them. Several dermatologists have been unable to convince pt it is not a dermatological issue. Aside from this no evidence of other mood or thought d/o. First- line treatment for pt?

A

FLUVOXAMINE

119
Q

Urine toxicology in a pt on bupropion may produce a false-positive screening test for which substances?

A

AMPHETAMINE

120
Q

Increases paxil concentration:

A

CIMETIDINE

121
Q

What is a sleep disturbance likely to occur after initiating a trial of an SSRI?

A

BRUXISM

122
Q

45 y/o pt who is in good physical health reports increased fatigue, decreased appetite, and an inability to take pleasure in usual activities. Pt is begun on fluoxetine 20mg/day, and pt’s mood improves over the course of 2 weeks. However, pt now notes a new onset of anxiety symptoms, including restlessness in the arms and legs. Pt is observed to fidget and seems unable to sit still for the exam. Neurological exam: unremarkable. Which courses of Tx would be most appropriate?

A

BEGIN PROPRANOLOL 10MG TID

123
Q

22 y/o brought to ED by roommate who found him unconscious with a suicide note. Temp 100.9, BP 100/60, P 124, RR 8, warm and dry skin, dilated pupils and reactive to light, bowel sounds decreased, EKG with sinus tachy and QTC of 589, no obvious trauma. On which did pt OD?

A

TCA

124
Q

Pt who responded in the past to SSRIs requests a drug from this class when subsequently seen for another episode of depression. However, pt reports concerns that when the previous medication was tapered, pt experienced fatigue, insomnia, abdominal distress, flu-like symptoms, and dizziness. What meds would be appropriate for this pt?

A

FLUOXETINE

125
Q

36 y/o pt c/o dysphoria, insomnia, fatigue, poor concentration. Pt is started on sertraline 50mg, increased to 100mg in 2 weeks. 2 months after dose increase, pt reports mood greatly improved. However, pt notes new onset of sx of delayed ejaculation, frequently to point of anorgasmia. He believes this began almost immediately after dose increase. First step in management of problem would be?

A

DECREASE THE SERTRALINE DOSAGE TO 50MG/DAY

126
Q

Cytochrome P450 (CYP450) subenzyme, inhibited by (blank) , increases TCA levels (blank)

A

FLUOXETINE, 2D6

127
Q

SSRIs with the greatest potential for slowing or blocking metabolism of other medications?

A

LUVOX

128
Q

45 y/o pt w/ hx of MDD recently had Citalopram twofold, with addition of Trazodone 100 mg/night for sleep. Ten days later, pt presents to ED with severe restlessness, nausea, vomiting, and diarrhea. Serum tox negative. On exam, pt confused, mildly agitated, febrile to 100.8, and tachy to 108. Neuro exam = nystagmus, B/L hyperreflexia, and ankle clonus. Tone without rigidity. In addition to stopping all meds & starting supportive care, what med should be given?

A

LORAZEPAM

129
Q

Pt with flashbacks, nightmares, and insomnia r/t sexual trauma is improving slightly with Zoloft but still having nightmares, next step in mgmt.?

A

PRAZOSIN

130
Q

Patient comes to ED confused, lethargic, flushing, diaphoretic, and restless. Recently started fluoxetine but doesn’t recall names of other psychotropics he’s taking. Temp is 101.5, BP 110/62, has tremor and myoclonus. What’s causing his symptoms?

A

SEROTONIN SYNDROME

131
Q

In pts w/ recurrent depression, successful Tx with antidepressants should be followed by which Tx strategies?

A

CONT ANTIDEPRESSANT AT SAME DOSE

132
Q

Pt with multiple past med trials reporting extensive SEs with those meds has been started on fluoxetine and now reports severe sweating. Pt’s depression and anxiety have significantly improved on 10mg daily but pt reports “my bedding is drenched every day when I wake up”. Most appropriate next course of action?

A

ADD TERAZOSIN TO PT’S MED REGIMEN

133
Q

Mirtazapine’s side effects of sedation and weight gain are caused by binding to which receptors?

A

HISTAMINE

134
Q

Concurrent use of phenelzine and meperidine can cause hypermetabolic reaction secondary to what?

A

INDIRECT PHARMACODYNAMIC EFFECTS AT A COMMON BIOACTIVE SITE

135
Q

15 y/o pt w/ physical complaints, decreased appetite, irritability, thoughts of death, anhedonia. Which med is FDA-approved for first line tx? (2x)

A

ESCITALOPRAM

136
Q

Which of the following agents is most likely to be helpful in the treatment of visual hallucinations and psychosis associated with advanced Parkinson’s disease?

A

QUETIAPINE

137
Q

6 year old with autism spectrum is referred to psychiatrist for irritability, aggression, and hitting self. Child has not responded to Risperdal. Which has the most evidence for managing irritability and aggression?

A

ARIPIPRAZOLE

138
Q

22 y/o pt suffers a traumatic brain injury following a skiing accident, and is admitted to an inpatient rehabilitation facility. There, pt has frequent episodes of sudden anger and aggression directed toward staff. On psychiatric evaluation, pt is aware of these episodes, saying, “I can’t help it, I just see red.” Pt denies symptoms of depression or anxiety, and there is no evidence of acute confusion on examination. The rehabilitation staff report that all behavioral strategies have failed, and that pt’s outbursts are intimidating the staff. Which of the following medications has the best evidence for efficacy?

A

PROPRANOLOL

139
Q

Which vitamin is effective as an adjunct to antidepressants for treating depression?

A

D3

140
Q

Which antidepressant is safest in seizure disorders and depression?

A

FLUOXETINE

141
Q

Patient depressed, low energy, poor concentration, weight gain. Best med?

A

BUPROPION

142
Q

Of the following, first medication approved to treat depression: lithium, iproniazid, desipramine, methylphenidate, chlorpromazine:

A

IPRONIAZID

143
Q

A patient with depression and epilepsy responded well to Bupropion SR. No seizures have occured while on bupropion SR.. Insurance wants to switch antidepressant because of buproprion’s side effect of reducing seizure threshold. What should the psychiatrist do?

A

CONTINUE BUPROPION SR

144
Q

25 yo m with no psych history has new preoccupation and excessive concern with imagined defects in appearance, no other symptoms. Which is best med (Quetiapine, Mirtazapinne, Olanzapine, Bupropion, Fluoxetine)?

A

FLUOXETINE

145
Q

Memantine’s cognitive preservation effect has which mechanism?

A

GLUTAMATE NMDA RECEPTOR ANTAGONIST

PRITE-Tx (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions