CNS Flashcards

1
Q

What drug is least preferred? And give its SEs

A) Mirtazapine B) Sertraline C) Bupropion D) Venlafaxine E) Duloxetine

A

A. Increase appetite (weight gain), sedation

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2
Q

Which antidepressants increase risk of bleeding when combined with NSAIDS? And give its SEs

A

SSRIs. Nausea (most common), dry mouth, somnolence, sweating and inc. risk of GI bleeding, constipation

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3
Q
A patient is on haloperidol for the past 3 weeks presents with tremor, muscle stiffness, and shuffling gait. What type of SE is this and give other examples.
A) Neuroleptic malignant syndrome
B) Extra pyramidal symptoms
C) Serotonin syndrome
D) Schizophrenia flare ups
A

B. EPS: “PADT”

Parkinsonism, Akathisia, Tardive dyskinesia, Dystonia

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4
Q

All of the following common issues with psychosis patient? Except A) cognitive functions decrease
B) non-compliance increase
C) High occurrence of discontinuation of treatment
D) Addiction potential

A

???

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5
Q
Which one of the following CNS receptors is directly coupled to an ion channels, and this do not involve secondary messenger system?
A-Alpha (NE)
B-dopamine D2 (DA)
C-Acetyl choline (N)
D- serotonin (5HT)
E- None of the above
A

C

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6
Q

Which AED causes elevation of blood glucose levels and how?

A

Phenytoin

Decreasing insulin release

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7
Q

What are antimuscarinic drugs that are used in treatment of antipsychotic induced Parkinson’s disease?

A

Benztropine and Trihexphenidyl

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8
Q

Metabolism of local anesthetic takes place in?

A

Liver

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9
Q

All of the following are GABA analogs except? Give derivative.
A-Gabapentin B-Pregabalin C-Vigabatrin D-Beclofen E-Phenytoin

A

E — Hydantoin derivative

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10
Q

Drugs that cause Stevens Johnson Syndrome SE? What is the tx?

A

SASPAN: Sulfonamides, antiepileptics (pheny, carb, VA), Sulfonylureas, penicillin, allopurinol and NSAIDs
TX: Cortisone

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11
Q

What drugs can OCPs can have drug interactions with?

A

Antibiotics, Anticonvulsants, Antifungals

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12
Q
Drug that increase effectiveness of Donepezil: And Explain
A. Carbamazepine
B. Erythromycin
C. Phenytoin
D. All of the above
A

B. Erythromycin is a CYP2D6 or CYP3A4 inhibitor that increases Donepezil’s effect/toxicity
-Carb and Pheny are CYP inducers that decreases Donepezil’s effectiveness

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13
Q
  • slow movement
  • involuntary movement of mouth, face, limbs and trunk
  • difficulty in movement
A
  • dyskinesia
  • tardive dyskinesia
  • Akinesia
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14
Q
60-year-old adult who has been treated with haloperidol for 3 weeks. He presents with muscle stiffness, tremors. This is the most likely what kind of side effect:
Explain other SEs
A-Acute dystonia
B-Akathisia
C-Tardive dyskinesia
D-Parkinsonism disease
E-Pseudo parkinsonism
A

E. Pseudo Parkinsonism
Extrapyramidal SEs: PADT
Parkinsonism, Akathisia, Dystonia, Tardive dyskinesia

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15
Q

Which of the following is NOT side effect of levodopa? Give SEs:
A) hypotension B) Arrhythmias C) peptic ulcer D) sudden onset of sleep E) pulmonary disease

A

D.

N and v, ortho. hypo., dyskinesia, hallucinations, confusion

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16
Q

Long term tx of Carbidopa/L-dopa SEs:

A

Mydriasis, precipitation of glaucoma and melanoma

17
Q

Neuropathic pain during pregnancy

A

Baclofen

18
Q

Fentanyl patch should be applied every?

A

72 hours

19
Q

Most patient suffering from anxiety must continue pharmacotherapy for at least?
For depression?

A

anxiety: 1-2 years
depression: 1 year

20
Q
  • Recommended washout period for any a.dep switching to Irrev. MAOi
  • Irrev. MAOi to any other a.dep?
  • Moclobemide to any other a.dep?
A
  • 5 half-lives of first antidepressant
  • 2 weeks
  • 5 days
21
Q

Antidepressant to have noticeable effect?

  • Optimal effect?
  • TCA onset of action?
A
  • 2-4 weeks
  • 4-8 weeks
  • TCA 2-4 weeks
22
Q

What is monitored while administering Sertraline?

A

Improved quality of sleep. One of the earliest responses of effective therapy