CNS Qs

Question 1

Pregabalin dose for neuropathic pain/ GAD

Answer 1

initially 150mg OD, MAX 600mg in 2-3 divided doses

Question 2

Which antipsychotic is most likely to cause weight gain

Answer 2

Think 2nd gen cause metabolic syndromes
Clozapine and olanzapine

Question 3

What metabolic side effects do 2nd gen antipsychotics have?

Answer 3

• weight gain
• raised BP
• rasied BG
• raised cholesterol

Question 4

Gabapentin and opioids

Answer 4

Increased resp dep

Question 5

deteriorated renal function, opioid in syringe driver

Answer 5

alfentanyl

Question 6

What are the monitoring requirements for the use of methadone?

Answer 6

ECG monitoring recommended in those with INCREASED QT-PROLONGATION RISK FACTORS or >100mg DAILY

Question 7

What schedule is methadone

Answer 7

2

Question 8

Methadone SE

Answer 8

• Mood changes
• Exacerbation of asthma
• Tiredness
• Hyperprolactinaemia
• QT interval prolongation

Question 9

Which SSRIs are most associated with QT interval prolongation?

Answer 9

• Citalopram, Escitalopram
• Fluoxetine and sertraline = some evidence
• Paroxetine and venlafaxine – not typically associated

Question 10

Which antidepressants is the most likely cause of the patient’s abnormal menstrual cycle?

Answer 10

Fluoxetine

Question 11

Symptoms of subarachnoid haemorrhage

Answer 11

• thunderclap headache
• stiff neck
• blurred vision
• nausea

Treated with nimodipine

Question 12

what ingredient excipient in tegretol oral solution may be responsible for a patient experiencing bloating and gastro-intestinal side effects?

Answer 12

sorbitol

Question 13

ACEi/ ARBs and surgery

Answer 13

• severe hypotension after induction of anaesthesia
• these drugs may need to be discontinued 24 hours before surgery

Question 14

Which blood test must be normal before starting pt on clozapine?

Answer 14

Leucocyte and differential blood counts

Question 15

Which drug can be detected using roadside screening device

Answer 15

Cannabis
Ketamine
Methadone
Morphine
Opiates

Question 16

Levetiracetam + NSAIDs =

Answer 16

OK no significant interaction and do not affect seizure control

1.

Question 17

SSRI toxicity

Answer 17

N+V, agitation, tremor, nystagmus, sinus tachy

Question 18

TCA toxicity

Answer 18

dry mouth, seizures, coma, arrythmias

Question 19

Fentanyl toxicity

Answer 19

resp dep, euphoria, reduced consciousness

Question 20

Aspirin toxicity

Answer 20

tinnitus, hyperventilagion, deafness

Question 21

SS symptoms

Answer 21

Confusion
Dizziness
Tachycardia
Tremor

Question 22

MIDRID

Answer 22

Paracetamol + isometheptene = acute attacks in migraines MIDRID

Question 23

Aripiprazole MHRA update

Answer 23

Increased risk of impulse control disorders

Question 24

TCA washout period

Answer 24

at least 1-2 weeks
3 weeks if its clomi/ imi

Question 25

SSRI washout period

Answer 25

Fluoxetine = 5 weeks Sertraline = 2 weeks

Question 26

How long does Madopar capsules/tablets last once dispensed into another container before it expires? →

Answer 26

2 weeks

Question 27

Which drug is preferred in renal impairment? Codeine, Oxycodone or morphine

Answer 27

Oxycodone - similar properties to morphine, but preferred in renal impairment

Question 28

Clozapine and smoking

Answer 28

induces metabolism = significant increase in levels when smoking.

Question 29

Clozapine and stopping smoking

Answer 29

increased levels of clozapine

Question 30

Autonomic neuropathy symptoms

Answer 30

- Excessive facial sweating - Postural hypotension

Question 31

Donepezil common SE

Answer 31

Aggression No renal restrictions

Question 32

Which drug is effective for a pregnant woman with bipolar and epilepsy?

Answer 32

Lamotrigine

Question 33

Antipsychotic with the lowest risk of sexual dysfunction

Answer 33

Aripiprazole

Question 34

Treatment for overdose of diazepam

Answer 34

Flumanezil

Question 35

Which Parkison'd medication causes hepatotoxicity

Answer 35

Tolcapone

Question 36

Which antiemetic can cause oculogyric crisis? | involuntary upward deviation of both eyes

Answer 36

Metoclopramide - Acute dystonic reaction

Question 37

What is the best method to switch from fluoxetine to paroxetine?

Answer 37

Stop fluoxetine; wait 4-7 days before starting paroxetine.

Question 38

Duloxetine + aspirin

Answer 38

Increased risk of bleeding

Question 39

Pt on lithium with dry skin and brittle nails - what should we monitor?

Answer 39

* Hypothyroidism symptoms * Long term use = thyroid disorder * Monitor thyroid function