Drugs 2

Question 0

When to draw Li levels in relation to last dose?

Answer 0

Trough - 12 hours since last dose

Question 1

Lithium - pretreatment labs?

Answer 1

TSH
Cr
BUN
EKG
Urinalysis

Question 2

Li toxic range?

Answer 2

Really any level, but especially above 1.5

Question 3

Li side effects?

Answer 3

GI - diarrhea, nausea

cardiac - QT prolongation, bradycardia

Neurologic - fine tremor, headaches, confusion, sluggishness (SILENT - cerebellar dysfunction and extrapyramidal symptoms)

Question 4

Cardiac condition that is a contradiction for Li?

Answer 4

Sick sinus syndrome, Brugada

Question 5

Patient on Li - must be careful is patient is also on?

Answer 5

NSAIDS, diuretics, ACE inhibitors,

Question 6

Li OD treatment?

Lasting symptoms?

Answer 6

Dialysis

Scanning speech, cerebellar symptoms

Question 7

Days to steady state, drug that takes 3 days? 4? 5?

Answer 7

Valproic acid, carbamazepine, lithium

Question 8

Carbamazepine - effect on liver enzymes?

Answer 8

“Grand inducer” (increased metabolism of drugs)

Especially problematic with blood thinners or women on OCP

Question 9

Side effects of carbamazepine?

Answer 9

Double vision, blurred vision, memory issues etc

Question 10

Anticonvulsant that can cause depression?

Answer 10

Levetiracetam

Question 11

Lamotrigine used for what psychiatric disease?

Not useful when?

Answer 11

Bipolar

In acute setting

Question 12

Benzodiazepines for people with liver disease?

Answer 12

Lorazepam, oxazepam, temazepam

Question 13

Management of hallucinogen intoxication?

Answer 13

Benzodiazepines or traditional antipsychotics (haloperidol)

Question 14

Treatment for cocaine intoxication?

Answer 14

#Haloperidol or benzodiazepines for agitation
#Anti-emetics and antidiarrheals for G.I. symptoms
#NSAIDs for muscle cramps

Question 15

PCP intoxication – treatment?

Answer 15

Reassurance
#If severe, benzodiazepines

Question 16

Atomoxetine - drug class? Indication? Severe side effects?

Answer 16

SNRI; ADHD

Liver injury

Question 17

Non-stimulant drugs for ADHD?

Answer 17

#Antidepressants (nortriptyline, imipramine, bupropion)
#Alpha agonist (clonidine, guanfacine)
#SNRI (atomoxetine)