Antipsychotics

Question 1

Phenothiazines were originally derived from what compound?

Answer 1

Methylene blue

Question 2

What potency antipsychotic is better for patients with psychosis due to an organic cause?

Answer 2

High potency

Question 3

What potency antipsychotic should be avoided in the elderly and why?

Answer 3

Low potency, anticholinergic and cardiac side effects

Question 4

Typical antipsychotics are contraindicated in what eye problem?

Answer 4

Acute angle closure glaucoma

Question 5

What brain pathways are related to psychosis?

Answer 5

Mesocortical/mesolimbic

Question 6

What brain pathway is related to PRL?

Answer 6

Tuberoinfundibular

Question 7

The basal ganglia and caudate are included in what pathway?

Answer 7

Nigrostriatal

Question 8

What are the main P450 pathways through which typicals are metabolized?

Answer 8

2D6, 3A4

Question 9

What antidepressants increase levels of typicals?

Answer 9

Prozac, Paxil, Luvox

Question 10

Typicals increase levels of what mood stabilizer?

Answer 10

VPA

Question 11

What mood stabilizer decreases levels of typicals if coadministered?

Answer 11

Tegretol

Question 12

Dystonia is more common in what age and gender?

Answer 12

Young males

Question 13

What can you treat akathisia with?

Answer 13

BZD, propranolol, clonidine

Question 14

Thioridazine can cause what ocular problems?

Answer 14

Retinitis pigmentosa and blindness

Question 15

Which typical has the least weight gain?

Answer 15

Loxipine

Question 16

Risperdal is indicated for what things other than schizophrenia in children?

Answer 16

Aggression in ASD, Tic d/o, Impulsive/Disruptive behavior

Question 17

What seizure medicine decreases Seroquel 5x?

Answer 17

Dilantin (Phenytoin)

Question 18

Latuda upregulates what in the prefrontal cortex that can be considered pro-cognitive?

Answer 18

BDNF

Question 19

Basic mechanism of mood stabilizers towards GABA and glutamate?

Answer 19

GABA - enhance

Glutamate - inhibit

Question 20

Lithium was first used to treat what?

Answer 20

Gout

Question 21

What is the mood stabilizer of choice for acute mania in the first trimester?

Answer 21

Lithium

Question 22

What are treatments for lithium toxicity? What doesn’t work?

Answer 22

Dialysis, kayexlate, gastric lavage; charcoal is ineffective

Question 23

VPA ____’s anticoagulants.

Answer 23

Augments

Question 24

Tegretol ____’s Warfarin’s effect.

Answer 24

Decreases

Question 25

Do not give Topamax with what antihypertensive class?

Answer 25

CAH (acetazolamide)

Question 26

Which TCA is best for panic d/o w/ agoraphobia?

Answer 26

Imipramine

Question 27

Which TCA is best for OCD?

Answer 27

Clomipramine

Question 28

What is the ideal plasma level of nortriptyline? What type of window does it have?

Answer 28

50-150; curvilinear

Question 29

What’s the most serotonergic of the TCAs?

Answer 29

Clomipramine

Question 30

What’s the most anticholinergic/alpha TCA?

Answer 30

Amitriptyiline

Question 31

What’s the most noradrenergic TCA?

Answer 31

Desipramine

Question 32

What’s the least anticholinergic TCA?

Answer 32

Nortriptyline

Question 33

What’s the most antihistaminergic TCA?

Answer 33

Doxepin

Question 34

What’s the only TCA w/ antidepressant and antipsychotic properties?

Answer 34

Amoxapine

Question 35

What does MAO-A break down?

Answer 35

NE, 5HT, Epi

Question 36

What do both MAO-A and MAO-B break down?

Answer 36

Tyramine, DA

Question 37

Selegiline, phenelzine, and tranycypromine are structurally related to what drug?

Answer 37

Amphetamines

Question 38

What can you use to treat hypertensive crisis w/ MAOIs?

Answer 38

Nifedipine (Ca channel blocker)

Question 39

What MAOI can be used for Parkinson’s and has less food restriction?

Answer 39

Selegiline

Question 40

What percent of patients w/ MDD relapse upon decreasing or discontinuing their SSRI?

Answer 40

70%

Question 41

Which SSRIs are most selective inhibitors of 5HT reuptake?

Answer 41

Citalopram and escitalopram