drugs

Question 1

naltrexone

Answer 1

MOA: opioid antagonist

- reduces craving thru blockage of DA (rewarding) pathways

Question 2

vivitrol

Answer 2

injectable ER naltrexone

Question 3

suboxone

Answer 3

MOA: opioid agonist-antagonist receptor modulator

-buprenorphine + naloxone

Question 4

which labs should you check on a pt using lithium at 6 and 12 mo

Answer 4

6 mo - TSH (for hypothyroid)

12 mo - BUN

Question 5

good depression med for elderly

Answer 5

SSRI’s

Question 6

clomipramine

Answer 6

MOA: TCA (inhibits serotonin reuptake)
USE: OCD

Question 7

biggest side effect of clozapine

Answer 7

agranulocytosis/leukopenia

Question 8

benzos

Answer 8

MOA: GABA
USE: anxiolytic or hypnotic

Question 9

ramelteon

Answer 9

MOA: agonist of melatonin receptors
USE: insomnia
contraindications: severe hepatic impairment, severe sleep apnea, severe COPD

Question 10

best SSRI to avoid weight gain

Answer 10

sertraline

Question 11

pregnancy category C and D neuro drugs

Answer 11

C: lithium (can be used in emergencies)
D: valproic acid (never use)

Question 12

med with side effect of night driving, sleep walking, or sleep eating

Answer 12

zolpidem

Question 13

anesthetic for ECT

Answer 13

methohexital

• fewer cardiac effects
• quick duration of action (5-7 minutes)

Question 14

flumazenil can precipitate sz in which pt population?

Answer 14

those with pre-existing sz disorders

Question 15

ADR of TCA

Answer 15

anticholinergic effects (i.e.: urinary retention, blurred vision)

Question 16

ADR of ritalin

Answer 16

insomnia (don’t take after noon), anorexia

Question 17

best antipsychotic to use in Parkinson pts

Answer 17

clozapine (spares DA pathway and has anti-cholinergic effects)

Question 18

clonidine

Answer 18

MOA: alpha2 agonist (anti-adrenergic) (activates NE release from locus ceruleus)
USE: PTSD, ADHD (hyperarousable states)

Question 19

best antipsychotic for pt with prostatic hypertrophy

Answer 19

haloperidol (low in anticholinergic side effects)

Question 20

most common side effect of sildafinil (impotence)

Answer 20

MI

Question 21

cardiac side effect of TCA

Answer 21

slowing of cardiac conduction (do not affect contractility or cardiac output), can cause fatal heart block

Question 22

3 Cs of TCA toxicity

Answer 22

convulsions, coma, cardiac arrhythmias

Question 23

evolution of EPS side effects

Answer 23

4 hr: acute dystonia
4 day: akathisia (restlessness)
4 week: bradykinesia (parkinsonism)
4 mo: tardive dyskinesia

Question 24

HORNET (lithium)

Answer 24

HypOthydoid
Renal function (can't concentrate urine)
Nephrogenic DI
Ebstein abnormality
Tremor

Question 25

don’t give bupropion to which pts?

Answer 25

bulimic (risk of sz)

Question 26

remeron

Answer 26

mirtazapine
- atypical antidepressant
MOA: alpha2 antagonist (incr. NE and SE via agonism of 5-HT2 receptor)
-sedating
-increased weight

Question 27

black box warning for valproic acid (depakote)

Answer 27

hepatotoxicity (necrosis)

Question 28

side effects of typical antipsychotics

Answer 28

EPS
anticholinergic
hyperprolactinemia

Question 29

devalproex names

Answer 29

valproic acid, Depakote

Question 30

ziprasidone

Answer 30

atypical antipsychotic

Question 31

clomipramine

Answer 31

TCA

Question 32

atomoxetine

Answer 32

USE: ADHD
MOA: NE reuptake inhibitor

Question 33

which SSRI has the shortest t1/2?

Answer 33

paxil (paroxetine)

- thus has discontinuation syndrome

Question 34

which SSRI is associated with QTc prolongation?

Answer 34

citalopram

Question 35

which SSRI is best for OCD refractory to other SSRIs?

Answer 35

fluvoxamine