high yield

Question 1

antipsychotic BBW

Answer 1

increased risk of death in elderly w/dementia

Question 2

acute onset SE

Answer 2

EPS due to decreased DAergic transmission bcuz of blocked DA receptors:

1) Parkinsonism - resting, pillrolling tremors goes away once you move
2) Akathisa - restless
3) Acute dystonic reactions - grimacing, torticollis

Tx: antimuscarinics (benztrophine, trihexyphenidyl, diphenhydramine [h1]) to decrease the excess ACh`

Question 3

late onset SE

Answer 3

neuroleptic malignant syndrome due to increased DA

akinesia
severe rigidity
hyperthermia

Tx: bromocryptine, amantadine, dantroline

Question 4

atypical antidepressants MOA

Answer 4

not just d2 antagonism
also 5ht2a antagonism
mesolimbic pathway

Question 5

atypical vs typical

Answer 5

atypical: less EPS, hyperprolactinemia, more diabetes, dyslipidemia, weight gain; not proven to be more effective

Question 6

TCA

Answer 6

first pass effect

BBW: increased suicide

Question 7

2nd gen antidepressants

Answer 7

know these

Question 8

triazadone

Answer 8

SE: priapism

Question 9

buproprion

Answer 9

MOA: weak inhibitor of NE, 5HT, DA uptake
use: smoking cessation
fewer sexual SE

Question 10

SSRIs

Answer 10

SE:

sexual dysfunction

Question 11

SNRIs

Answer 11

SE: associated hypertension due to NE reuptake

Question 12

5ht syndrome

Answer 12

mix w/MAO inhibitors

Question 13

bipolar DO

Answer 13

lithium
not metabolized
hella effective (go-to Rx)

SE:
decreased thyroid function leading to enlargement&raquo_space; hypothyroidism

carbamazepine
valproic acid (valproate)
lamotragine

Question 14

methohexital

Answer 14

ultra-short acting

anesthesia induction

Question 15

phenobarbital

Answer 15

long acting BARB

status epileptus

Question 16

dose-response curve

Answer 16

know this

Question 17

induction of P450 enzymes

Answer 17

additive effects

Question 18

ethanol

Answer 18

diffuse effect
no specific activity

metabolism:
alcohol dehydrogenase
aldehyde dehydrogenase

0th order kinetics (always fully surated)

Question 19

delirium tremons

Answer 19

acute alcohol withdrawal

Question 20

disulfuram

Answer 20

blocks aldehyde dehydrogenase

Question 21

methylxanthines

Answer 21

caffeine:
MOA - adenosine receptors&raquo_space; increased NT release
physical dependence
withdrawal Sx

Question 22

amphetamines MOA

Answer 22

increase DA and NE release and decrease reuptake

Question 23

amphetamines tolerance

Answer 23

rapid
"tachyphylaxis"
binge intake pattern
psychological/physical dependence
chronic use >> paranoid psychosis

Question 24

methylphenidate

Answer 24

BBW: psychotic episode risk if Hx of drug abuse or alcoholism, withdrawal&raquo_space; depression

blocks DA reuptake

Question 25

ADHD Tx

Answer 25

methylphenidate just as good as amphetamines

Question 26

cocaine

Answer 26

MOA: blocks DA, NE, 5HT reuptake
metabolism: plasma proteases quickly
SE: fatality

Question 27

benzodiazepines

Answer 27

active metabolites:
diazepam > nordiazepam > oxazepam
clonazepam
chlordiazoxide
long acting - accumulates

inactive metabolites:
oxazepam
lorazepam
triazolam

OD: Tx: flumazenil