Jeopardy Flashcards
This class of drugs increase synaptic serotonin levels by blocking the reuptake of serotonin.
Selective Serotonin Reuptake Inhibitors
This class of drugs potentiate the activity of GABA and inhibits neuronal activity.
Benzodiazepines
This drug blocks Dopamine and Norepinephrine reuptake
Wellbutrin (bupropion)
This drug selectively targets the α1 subunit of the GABAA Receptor.
Zolpidem (Ambien)
This drug blocks presynaptic alpha2 receptors and antagonizes 5-HT2 and 5-HT3 receptors.
Mirtazapine (Remeron)
Your client taking Elavil reports dizziness when he gets up from lying down.
What is this patient experiencing?
Orthostatic or postural hypotension
Your patient on antidepressant drug therapy reports high energy, insomnia, sweating and diarrhea. She also describes seeing shadows moving like ghosts. She reports that these symptoms began after taking some cold medicine.
What do you suspect?
Seratonin Syndrome
- A patient on Carbamazepine reports a severe rash.
* What do you suspect?
Steven Johnson Syndrome or Toxic Epideral Necrosis
A client taking Parnate reports dry mouth, constipation and visual discomfort on sunny days.
What is the patient experiencing?
Anticholinergic Effects
Your bipolar client taking Lamictal complains of sore throat, fever and weakness.
What do you suspect?
Agranulocytosis
A patient on Pamelor experiences sedation with the medication.
What do you recommend to minimize harm?
Take at bedtime, avoid activities that require alertness after taking the drug, avoid other sedating drugs or substances.
A patient on Phenelzine complains of nasal congestion. She asks if it is ok to get a decongestant at the pharmacy. What is your response?
Do not use while on Phenylzine. It can cause a hypertensive crisis.
A patient taking Lithium is planning a summer beach resort vacation to Cancun, Mexico.
What is your advice for this patient?
Stay hydrated because dehydration can lead to lithium toxicity.
Your 25-year old patient with bipolar disorder reports being sexually promiscuous during her hypomanic phases. She is started on Depakote.
What else might you recommend for her?
Recommend birth control because valproic acid is teratogenic and she is of child bearing age.
Your patient on Topiramate comes to you office breathing heavily.
Should you be concerned?
YES! Hyperventilation is a sign of metabolic acidosis which required immediate medical attention.
Is the difference between Lorazepam and Clonazepam PK or PD?
PK
Carbamazepine is an inducer for the cytochrome P450 isoform required for its own metabolism. Therefore overtime, the dose of carbamazepine may…
Increase
How does St. John’s Wort pharmacokinetically decrease the effectiveness of oral birth control pills?
Induce Cytochrome P450 enzymes which metabolize and eliminate the components of birth control pills.
How does St. John’s Wort pharmacodynamically interact with Zoloft?
Both drugs increase synaptic levels of serotonin thereby increase the risk of serotonin syndrome
A patient has taken an overdose of Clonazapam which has a 18-24 hour half-life. Flumazenil, the antidote for overdose has a half-life of 1 hour.
What will be required for Flumazenil administration to treat overdose with clonazapam?
Multiple doses or continuous infusion.
“I am really struggling with the sexual dysfunctions caused by Lexapro.”
What can you recommend?
Discuss adding or switching to Wellbutrin or adding Viagra as needed with your physician
A client on Parnate says, “ I’m going to a family reunion barbeque this weekend in Napa!”
What should you recommend?
•Stay away from tyramine-rich foods (hot dogs, wine, aged cheeses, cured meats)
“The Buspirone is not working. When I was on Valium I could feel it right away. I started Busprione and I don’t feel anything. I want to stop taking the Buspirone”
Busprione has a delayed onset of action. Will take 3-4 weeks to feel therapeutic effects.
“My Ativan is not working like it used to. I just want to stop taking it!”
You may be experiencing tolerance to the medication. Discuss changing the dose with your prescriber.
Do not discontinue abruptly because you may experience serious withdrawal symptoms.
