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Psychopharm > GoConqr tid bits > Flashcards

GoConqr tid bits Flashcards

1
Q

Mechanism by which serotonin syndrome can be lethal

A

Rhabdomyolysis => renal failure => death

-this is why giving something such as a calcium channel blocker (ex: dantraline) to decrease muscle rigidity- can help in serotonin syndrome support (prevent rhabdomyolysis)

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2
Q

Which antipsychotics have the highest risk of NMS?

A

High potency typicals (Haldol)

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3
Q

Non-psychiatric drugs to avoid w/ MAOIs

A
  • opiates (Demerol)

- some OTC cough meds can increase 5HT

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4
Q

Which antidepressant can (rarely) cause agranulocytosis

A

Mirtazapine

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5
Q

Grimacing and tongue protrusion

A

Characteristic of Tardive dyskinesia

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6
Q

Twisting and abnormal postures

A

Characteristic of acute dystonia

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7
Q

SSRI w/ the fewest drug-drug interactions

A

Citalopram (celexa)

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8
Q

Differentiate SSRI use for depression vs OCD

A

OCD- Fluvoxamine

-use much higher dose in OCD

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9
Q

Which antidepressant should not be used (or used sparingly) in pt w/ liver disease

A

Duloxetine (SNRI, cymbalta)

-may have more liver side effects

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10
Q

Antidepressant w/ high risk of dry mouth and constipation

A

Duloxetine (SNRI) b/c of NE properties

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11
Q

Which antidepressant should be avoided in pts w/ untreated HTN or labile BP?

A

Venlafaxine (SNRI) b/c may increase BP

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12
Q

Which neurotransmitters are deactivated by

(a) MAO-A
(b) MAO-B
(c) both

A

Nt deactivated by
(a) MAO-A = 5HT (hence why MAO-A is needed for the antidepressant effect)

(b) MAO-B = NE
(c) Both breakdown DA and tyramine

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13
Q

SSRI w/ the

(a) fewest drug-drug interactions
(b) most drug-drug interactions

A

SSRI w/ the
(a) fewest = sertraline

(b) most = paroxetine

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14
Q

Treating serotonin syndrome

A

(1) discontinue the meds
(2) can try CCBs (ex: Nifedipine) to prevent rhabdomyolysis => renal failure

If very carefully monitored can give

  • phentolamine (alpha antagonist)
  • chloiprazine
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15
Q

Non-TCA antidepressant indicated for depression + neuropathic pain

A

Depression + neuropathic pain/fibromyalgia:

Duloxetine (SNRI)

TCAs: amitriptyline, nortriptyline

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16
Q

Least sedating TCA

A

Desipramine

17
Q

SSRI w/ the least sexual side effects

A

Citalopram

18
Q

TCA that comes in IM form

A

Imipramine (enuresis and panic d/o)

19
Q

Pt populations that should be careful about taking TCAs

A
  • suicidal pts: b/c TCAs are so lethal in overdose (just one weeks supply can be lethal)
  • history of MI or arrhythmia b/c of the cardiovascular toxicity (slows conduction)
20
Q

What should be monitored in a pt on Li

A
  • creatinine (kidney fxn)
  • white count
  • thyroid levels
  • serum levels of Li
21
Q

Describe the mechanism of lethality from low potency typicals

A

Low potency typicals => QTc prolongation => AV block, arrhythmia, DV

22
Q

Dermatologic side effects of chlorpromazine

A
  • blueish skin discoloration

- photosensitivity

23
Q

Most common side effect of chlorpromazine

A

Chlorpromazine most common side effect = orthostatic hypotension

24
Q

Name the typical antipsychotic associated w/ heart block and VT

A

Pimozide = associated w/ heart block and VT

25
Q

Name 4 structures in the mesolimbic pathway

A

Mesolimbic pathway:

  • amyglada
  • fornix
  • hippocampus
  • nucleus accumbens
26
Q

Mechanism by which antipsychotics cause narrow-angle glaucoma

A

Antimuscarinic effect

27
Q

Most common population that gets

(a) TD
(b) NMS

A

Most common population that gets

(a) TD- elderly women
(b) NMS- young men

28
Q

NMS

(a) most common presenting feature
(b) most universal feature
(c) 2 lab findings

A

NMS

(a) most common presenting feature = fever
(b) most universal feature = lead-pipe rigidity
(c) elevated CPK and leukocytosis (elevated white count)

Psychopharm (10 decks)

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