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Pharmacology > L16: Anti-psychotics II > Flashcards

L16: Anti-psychotics II Flashcards

1
Q

Which receptor is primarily associated with orthostatic hypotension?
A. M1
B. Adrenergic alpha-1
C. Beta receptors

A

B. Adrenergic alpha-1

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2
Q

FLudrocortisone is occasionally used as a volume expander in those without other options to ___

A

Clozapine

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3
Q

Drugs that act on which receptor can be hard for elderly patients with which condition to handle?

A

Alpha-1 adrenergic; Poor vasomotor tone

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4
Q

True or false: AE’s associated with drugs that act on histamine receptor include weight gain and sedation

A

True

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5
Q

Rapid discontinuation of H1-R is followed by rebound ___ and ____

A

insomnia; sleep disturbance

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6
Q

Which drug may moderate anti-psychotic-induced weight gain?

A

Metformin

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7
Q

What side effect is commonly associated with Clozapine or Risperidone use?

A

Orthostatic hypotension

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8
Q

True or False: Use of anti-psychotics can lead to dyslipidemia and impaired glycemic control

A

True

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9
Q

What are two major adverse cardiac effects seen with use of anti-psychotics?

A
  1. QRS Widening
    - Increase in PR interval
  2. Greater risk of developing arrhythmia
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10
Q

Which generation of anti-psychotics is most likely to give rise to neuroleptic malignant syndrome?

A

First generation

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11
Q

Neuroleptic malignant syndrome is associated with decreased activity in the D2 receptors. What are the effect on nigrostriatum?

A

Muscle rigidity and tremor

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12
Q

How can neuroleptic malignant syndrome affect hypothalamus?

A

Impair temp regulation ; autonomic hyper-reactivity

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13
Q

How to manage neuroleptic malignant syndrome?

A
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14
Q

Dantrolene can be used to treat ____, consequence of decreased activity at D2 receptors in the skeletal muscle and nigrostriatum

A

rhabdomyolysis

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15
Q

Compare and contrast Serotonin Syndrome and Neuroleptic Malignant Syndrome:

A
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16
Q

The first line agents for treating schizophrenia are ___ anti-psychotics, except ____

A

second-generation (Aripiprazole or Risperidone) ; clozapine (associated w/weight gain, sudden cardiac death)

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17
Q

How do you treat catatonic forms of schizophrenia?

A

IV Benzodiazepines; Anti-psychotic drugs once catatonia has ended

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18
Q

Treatment of schizoaffective disorder?

A

For psychosis…
- anti-psychotic drugs

For mood disorder…
- anti-depressants + lithium + valproic acid

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19
Q

Major depressive disorder (unipolar depression) with psychotic features require lower doses of ___ and ____

A

anti-psychotics and anti-depressants

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20
Q

Which drug is commonly used as an adjunct in unipolar depression?

A

Aripiprazole
- Lithium too

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21
Q

Lithium, Carbamazapine, Lamotrigine, and Valproic Acid are associated with treatment of:
A. Mania
B. Bipolar Depression
C. Unipolar Depression

A

B. Bipolar Depression

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22
Q

Which 4 drugs can be used as a monotherapy for treatment of Mania?
(LOVA)

A
  1. Aripiprazole
  2. Olanzapine
  3. Lithium
  4. Valproic Acid
23
Q

Which two drugs can be used to treat bipolar and act as VG Na blockers?

A

Carbamazepine and Lamotrigine

24
Q

True or False: Lamotrigine both blocks VG Na channels and stimulates GABA synthesis/inhibits GABA degradation

A

True

25
Q

Which of the following is used in acute mania and for prophylaxis in depressive phase?
A. Carbamazepine
B. Lamotrigine
C. Valproic Acid

A

A. Carbamazepine

26
Q

True or False: Both Carbamazepine and Lamotrigine are effective at treating acute mania

A

False - only Carbamazepine is effective!

27
Q

True or False: Valproic Acid is increasingly used as a first choice in acute mania

A

True

28
Q

Which of the following bipolar disorder drugs is prone to cause SJS?
A. Lamotrigine
B. Carbamazepine
C. Valproic Acid

A

A. Lamotrigine
B. Carbamazepine

29
Q

Liver dysfunction, weight gain, and inhibition of drug metabolism are AE associated with which of the following?
A. Lamotrigine
B. Carbamazepine
C. Valproic Acid

A

C. Valproic Acid

30
Q

True or False: Carbamazepine is associated with hematoxicity and induction of P450 drug metabolism

A

True

31
Q

Which drug for bipolar affective disorder suppresses inositol signaling and inhibits GSK-3?
A. Lamotrigine
B. Carbamazepine
C. Valproic Acid
D. Lithium

A

D. Lithium

32
Q

True or False: Lithium has antagonists actions on the ANS-R and specific receptors, as well as sedative effects

A

False - lithium does not have antagonists actions on ANS-R or specific receptors; it also does NOT have sedative effects

33
Q

True or False: Both Valproic Acid and Lithium are pregnancy cat D

A

True

34
Q

What are features of Lithium toxicity?

A

Tremor, edema, hypothyroid, renal dysfunction, arrythmia

35
Q

True or False: Lithium has DDI with thiazides and NSAID’s

A

True

36
Q

True or False: Chronic Lithium treatment may prolong actions of local anesthetics

A

True

37
Q

The early stages of Li+ toxicity mimics ____ intoxications

A

ETOH

38
Q

What should be on the DD for nausea, confusion, hypotension, seizures, dizziness?

A

Serotonin Syndrome
Malignant Neuroleptic Syndrome
Li Toxicity

39
Q

Irreversible Li-effectuated neurotoxicity is known as ___ ___

A

silent syndrome

40
Q

What causes silent syndrome?

A

Demyelination of various CNS sites

41
Q

Elevated levels of Lithium (as in Silent Syndrome) can affect which parts of the brain?

A

Brainstem and Cerebellum

42
Q

Why are some anti-psychotics effective at suppressing tics in patients with Tourette disorder?

A

Reduced D2 NT in basal ganglia sites

43
Q

Which anti-psychotic is the only one to be FDA approved for treatment of Tourette disorder?

A

Aripiprazole

  • note: in the past, haloperidol was used off label
44
Q

Which two anti-psychotics are approved to treat irritability in ASD?

A

Risperidone and Aripiprazole

45
Q

What is the cause of Psychosis Associated with Parkinson’s Disease?

A

Lewy body associated with
1) loss of raphe neurons
2) upregulation of cortical 5HT2a-R

46
Q

What is currently the primary medication used to treat hallucinations and delusions of PDP?

A

Pimavanserin (SS 5-HT2A inverse agonist)

  • note: this drug IS associated with sudden cardiac death
47
Q

What causes chorea, as seen in HD?

A

Over activity in dopaminergic nigrostrial pathways

-increased responsiveness to PS dopamine receptors
- deficiency of NT that normally antagonizes DA

48
Q

Which drug has replaced DA receptor blockade in management of chorea?

A

Tetrabenazine

49
Q

True or False: Haloperidol can suppress chorea and be used for treating psychosis in HD

A

True

50
Q

In rigid Huntington’s Disease, ___ can be more effective for treating psychosis and paranoia

A

clozapine

51
Q

The most striking neurochemical disturbance in Alzheimer’s Disease is a deficiency of ___, a neurotransmitter

A

Ach

52
Q

Which three drugs can be used to treat AD?

A

Low dose clozapine
Risperidone
Haloperidol

53
Q

True or False: Medications w/significant anti-cholinergic properties should be avoided in elderly patients, esp. those with dementia

A

True

Pharmacology (53 decks)

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