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psych clerkship & jeopardy > Jeopardy Hard ?s Schizo/Anti-depressants/antipsychotics > Flashcards

Jeopardy Hard ?s Schizo/Anti-depressants/antipsychotics Flashcards

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1
Q

This SGA may cause side effects of sialorrhea, weight gain, sedation, anticholinergic effects, myocarditis, and a lower seizure threshold

A

What is clozapine (clozaril)?

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2
Q

This SGA is unique since it

is a partial agonist

A

What is aripiprazole (abilify)?

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3
Q 
This SGA has almost zero risk of 
EPS or agranulocytosis, is 
often sedating & has a 
moderate risk of 
metabolic syndrome
A

What are quetiapine (seroquel)?

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4
Q

This SGA does not require hepatic metabolism because it is an active metabolite of risperidone (risperdal)

A

What is paliperidone (invega)?

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5
Q

This SGA has the highest risk
of metabolic syndrome, is very sedating, and the CATIE study showed patients are highly
likely to be compliant

A

What are olanzapine (zyprexa)?

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6
Q

This SGA has a low risk of metabolic syndrome, needs to be taken with food, and is the most likely SGA to cause qTc prolongation

A

What is ziprasidone (geodone)?

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7
Q 
These 2 SGA’s are available in
 long acting injectable form 
but can cause dose
dependent EPS &
prolactin elevation
A

What are risperidone (risperdal) & palliperidone (invega)?

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8
Q

This SGA has a particularly long half life and a low risk of metabolic syndrome, but is the SGA most
likely to cause akathisia

A

What is aripiprazole (abilify)?

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9
Q

These two SGA’s are least likely to have EPS side effects

A

What is clozapine (clozaril) and quetiapine (seroquel)?

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10
Q

This is the most likely SSRI
to cause the side effect
of weight gain

A

What is paroxetine (paxil)

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11
Q

The washout period when
switching from an MAOI
to any SSRI is this

A

2 weeks

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12
Q

These two SSRI’s have very
short half lives & should
be tapered to be
discontinued

A

What is paroxetine (paxil) & fluvoxamine (luvox)

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13
Q

This SNRI is the psychoactive metabolite of another SNRI

A

What is desvenlafaxine (pristiq)

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14
Q

Whether the dose is very high,

moderate, or low, this neurotransmitter’s reuptake is blocked by venlafaxine (effexor)

A

What is serotonin?

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15
Q 
At very high doses (>375mg/d) 
of venlafaxine (effexor) this neurotransmitter’s reuptake 
may begin to be blocked
A

What is dopamine?

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16
Q

This SNRI is preferred for painful symptoms of depression or
diabetic neuropathy pain

A

What is duloxetine (cymbalta)

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17
Q

As with the SSRI’s, some patients take SNRI’s for depression,
have an initial response,
continue taking the medication
but then experience this

A

What is poop-out syndrome (relapse)?

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18
Q

As with all antidepressants, a depressed patient started on an SNRI who experiences activation & agitation may be having this

A

What is an induced bipolar state?

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19
Q

While venlafaxine (effexor) may cause the side effect of sweating, ironically it may be helpful to perimenopausal women with this

A

What are hot flashes/flushes?

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20
Q

Venlafaxine (effexor) has
this relatively common, dose
dependent, cardiac system
related side effect

A

What is increased blood pressure?

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21
Q

This medication is the most

well known NDRI

A

What is Bupropion (Wellbutrin)

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22
Q

NDRI’s are useful in treating cravings from dependence

on this substance

A

What is nicotine (smoking cessation)?

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23
Q

Not only do NDRI’s not have this common SSRI side effect, NDRI’s may be used to treat patients who have this SSRI side effect

A

What is sexual dysfunction?

24
Q 
Like most anti-depressants, at typical doses NDRI’s carry a small risk 
of this serious side effect but 
the risk increases from 
0.4% to 4% at very 
high doses
A

What is a seizure?

25
Q

Compared to SSRI’s or SNRI’s,
NDRI’s are less effective
in treating this class of
psychiatric illnesses

A

What are Anxiety Disorders

26
Q

NDRI’s may be especially helpful in treating this sleep disturbance that is seen in atypical depression

A

What is hypersomnia? (> 10 hours/nite)

27
Q

NDRI’s commonly do this

to a patient’s weight

A

What is decrease? (or no change)

28
Q

While not a first line treatment,

NDRI’s “stimulating” effects may be helpful in treating children and adults with this disorder

A

What is Attention Deficit Hyperactivity Disorder (ADHD)?

29
Q

Bupropion:Onset of therapeutic action is usually not immediate, but is delayed
until this time period

A

What is 2-4 weeks

30
Q

NaSSA stands for this

A

What is Noradrenergic and Specific Serotonergic Agent?

31
Q

NaSSA’s novel mechanism of action by which norepinephrine and serotonin system activity is increased is this

A

What is pre-synaptic alpha 2 adrenergic antagonist

32
Q 
The medication that is in the 
NaSSA class is this
A

What is mirtazepine (remeron)?

33
Q

SSRIs or venlafaxine (effexor) may cause these common side effects which NaSSA’s 5HT3 antagonism may help reduce or remove

A

What are GI side effects? (nausea, diarrhea, stomach cramps)

34
Q 
This mirtazapine (remeron) side effect is more likely in women than men, before menopause than after, and 
is unlikely to be a problem if it has not occurred within the first 6 weeks of treatment
A

What is weight gain?

35
Q 
Mirtazapine (remeron) 
is an antagonist of:
 a presynaptic receptor, 
serotonin post synaptic receptors, 
and this post synaptic receptor
A

What is histamine? (H1)

36
Q

Mirtazapine: Onset of therapeutic effect on insomnia and anxiety is typically in this
time period

A

What is almost immediately?

37
Q

Cytochrome P450 enzyme system that is significantly effected by mirtazepine (remeron) is

A

What is none?

38
Q

A tertiary amine, amitriptyline (elavil), is metabolized to a secondary amine which is
this TCA

A

What is nortriptyline (pamelor)?

39
Q

A tertiary amine, imipramine (tofranil), is metabolized to a secondary amine which is
this TCA

A

What is desipramine (norpramin)?

40
Q

TCA’s may be more effective than SSRI’s in treating depression for
this sex of the clinical
population

A

What are men?

41
Q

Fluoxetine (prozac), paroxetine (paxil), bupropion (wellbutrin), duloxetine (cymbalta) and other medications may increase all TCA’s concentration by
inhibiting this p450 enzyme

A

What is cytochrome p450 2D6?

42
Q

Side effects of dizziness, sedation,
and hypotension likely result
from TCA’s antagonist activity
of this receptor

A

What is alpha adrenergic-1 receptor?

43
Q

The dangerous side effects from
a TCA overdose are cardiac arrhythmias caused by
blockade of this

A

What are sodium channels?

44
Q

This typical antipsychotic
has the greatest risk of
any antipsychotic for dose dependent QTc prolongation, torsades de pointes, and cardiotoxicity

A

What is thioridazine (Mellaril)?

45
Q

This SGA is a partial dopamine agonist & commonly has the
side effect akathisia

A

What is aripiprazole (Abilify)?

46
Q

This atypical is FDA approved for adjunct treatment of major depression

A

What is aripiprazole (Abilify)?

47
Q

Lurasidone (latuda), asenapine (saphris) & these two SGA’s are the most metabolically “neutral”

A

What are ziprasidone (geodone) & aripiprazole (abilify)?

48
Q

There is a blackbox warning for the use of antipsychotics in elderly dementia patients due to
increased risk of this

A

What is sudden death (cardiovascular cause?)?

49
Q

While NMS is uncommon to rare (incident rate 0.02-3%), its

cause is this

A

What is dopamine antagonism?

50
Q

Hypoactivity of this dopamine tract is believed to be associated with the development of negative symptoms

A

What is the mesocortical pathway?

51
Q

Prochlorperazine (Compazine) Metoclopramide (Reglan)
Droperidol (Inapsine) Promethazine (Phenergan)

This antiemetic medication(s) is/are a D2 blocker(s) and may cause EPS or TD

A

What is all 4 of them?

52
Q

About 75% of pts with schizophrenia do this unhealthy activity which also induces an  metabolic rate
of antipsychotic medications

A

What is cigarette smoking?

53
Q

Antipsychotics approved for the treatment of bipolar depression are olanzapine/fluoxetine (symbyax), lurasidone (latuda), and this

A

What is quetiapine (Seroquel)?

54
Q

This atypical has a significant risk of causing hyperprolactinemia, is the active metabolite of risperidone (Risperdal), and needs to be
taken with food

A

What is paliperidone (Invega)?

55
Q

While muscular rigidity, hyperthermia, & autonomic instability are all common symptoms of NMS, most often this symptom presents first

A

What is mental status changes?

psych clerkship & jeopardy (5 decks)

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