Final Exam Part 3

Question 1

MOA of 1st generation antipsychotics

Answer 1

Dopamine receptor antagonists (DRAs)

D2 receptor blockers

Question 2

dopamine pathway responsible for positive symptoms of schizophrenia

Answer 2

Mesolimbic

Question 3

dopamine pathway responsible for negative symptoms of schizophrenia

Answer 3

mesocortical

Question 4

mesocortical pathway:

dorsolateral prefrontal cortex regulate ______

Answer 4

cognition and executive function

Question 5

mesocortical pathway:

Ventromedial prefrontal cortex regulate _______

Answer 5

emotions and affect

Question 6

neurotransmitters involved in psychosis

Answer 6

dopamine, serotonin, GABA

Question 7

MOA of atypical antipsychotics

Answer 7

Block D2 receptors at lower affinity
5HT2A antagonist
serotonin and dopamine

Question 8

typical antipsychotics

Answer 8

Haldol - Mellaril. stelazine

Prolixin - thorazine Loxitane - compazine

Question 9

Treatment for Acute dystonia

Answer 9

Benztropine (cogenitn) - anticholinergic

Question 10

Treatment for pseudoparkinsonism

Answer 10

Benztropine (cogentin) - anticholinergic

Question 11

Treatment for akathesia (restless)

Answer 11

Benzodiazepine or betablocker

Question 12

Treatment for tardive dyskinesia

Answer 12

Switch to atypical or clozapine

VMAT2 inhibitor

Question 13

side effects of typical antipsychotics

Answer 13

S - sedation/sunlight sensitivity/sexual SE
T - Tardive dyskinesia
A - Anticholinergic effects & Agranulocytosis
N - neuroleptic syndrome
C - Cardiac arrythmias
E - Extrapyramidal symptoms

Question 14

Treatment of neuroleptic malignant syndrome

Answer 14

early detection - increased muscle tone, autonomic dysfunction - reduced consciousness
d/c med
manage symptoms

Question 15

atypical antipsychotic with less sedating side effects

Answer 15

aripiprazole, iloperidone, lurasidone, paliperidone, risperidone, ziprasidone
*pines more sedating than dones

Question 16

atypical antipsychotic with less metabolic side effects

Answer 16

ziprasidone, aripiprazole, lurasidone

Question 17

high risk of weight gain and sedation

Answer 17

clozapine, then olanzapine (Zyprexa)

Question 18

2nd gen antipsychotics with potent antihistamine actions

Answer 18

clozapine, quetiapine, olanzapine

Question 19

labs to monitor with atypical antipsychotics

Answer 19

CBC, LFTs, EKG

Question 20

labs to monitor with clozaril

Answer 20

ANC, BMI, LFTs

EKG

Question 21

interventions if patient becomes ill with clozaril

Answer 21

slowly taper. Watch for cholinergic rebound. Treat with anticholinergic if warranted.

Question 22

buprenorphine/naloxone (Suboxone) patient education

Answer 22

Must be in mild state of withdrawal

Naloxone poorly absorbed and present only to prevent misuse.

Question 23

partial mu opioid agonist

Answer 23

buprenorphine

Question 24

used to treat alcohol withdrawal

Answer 24

disulfiram (Antabuse)
acamprosate (Campral)
naltrexone

Question 25

Benzos used to treat alcohol withdrawal

Answer 25

Ativan

Question 26

Signs of Wernicke’s encephalopathy

Answer 26

decreased mental functioning
Muscle weakness
ataxia (unsteady gait)
nystagmus

Question 27

Treatment for Wericke’s encephalopathy

Answer 27

thiamine and food

Question 28

Education on disulfiram

Answer 28

Do not drink alcohol or consume any products with alcohol including cough medicine

Wait at least 12 hours after last drink

Question 29

MOA of amphetamine

Answer 29

Dopamine and norepinephrine reuptake inhibitor

VMAT inhibitor

Question 30

MOA of methylphenidate

Answer 30

Dopamine and Norepinephrine reuptake inhibitor

Question 31

Non-stimulant drugs for ADHD

Answer 31

Strattera and Wellbutrin

Question 32

Treatment of anxiety in children

Answer 32

Luvox
Prozac
Zoloft
Paxil

Question 33

Treatment of depression in children

Answer 33

Prozac
Celexa
Zoloft
lexapro - if older than 12