Lange - Drugs 2

Question 0

Which TCA should be used in the elderly?

Answer 0

Nortriptyline (less alpha-1 blocking means less orthostatic hypotension)

Question 1

Unlike typical neuroleptics, clozapine is much more potent and which receptor? Also, unlike typical neuroleptics, clozapine also acts at this receptor?

Answer 1

D4 antagonism > D2 antagonism

Serotonin 2

Question 2

TCA’s affect which receptors?

Answer 2

#Muscarinic antagonist
#alpha-1 and 2 antagonist
#Dopaminergic antagonist
#Histaminergic antagonist

Question 3

Only mood stabilizing medication that does not carry to teratogenic risk?

Answer 3

Clonazepam (Klonopin)

Question 4

Drug to reduce agitation in delirious patients?

Answer 4

Risperidone or haloperidol

Question 5

Cardiovascular side effects of TCAs? Patients with these cardiovascular conditions should not get these drugs?

TCA toxicity can have what cardiac effects?

Answer 5

Slows conduction

#Prolonged QT
#Widening of QRS
#AV conduction abnormalities

#Heart block
#Bundle branch block
#Tachyarrhythmias

Question 6

Low potency Antipsychotics?

Adverse effects?

Answer 6

#chlorpromazine
#thiordazine

Orthostatic hypotension and anticholinergic effects

Question 7

Role of Naltrexone in alcohol dependence?

Answer 7

#Decreases the number of days an alcoholic drinks
#Increases the time before relapse of heavy drinking

Question 8

Cholinesterase inhibitors approved for use in the Alzheimer’s dementia?

Answer 8

Donepezil and Tacrine

Question 9

Neuroleptics that must be used carefully in the elderly?

Answer 9

Chlorpromazine (extrapyramidal symptoms and anticholinergic properties)

Question 10

Detoxification from heroine can usually be managed with? How?

Answer 10

Clonidine

#Suppresses the sympathetic response to heroin withdrawal
#Controls agitation and autonomic instability

Question 11

Antidepressants that may play a role in chronic pain management?

Answer 11

SSRIs

Question 12

Yohimbine is used to treat? Mechanism? Should not be used by patients with history of?

Answer 12

Impotence

Alpha 2 antagonist

#heart or renal disease
#glaucoma
#Ulcers

Question 13

First-line agents for the treatment of primary insomnia?

Answer 13

Benzodiazepines

Question 14

Which is more contraindicated for patients with cardiac disease – TCAs or amphetamines?

Answer 14

TCAs – increased mortality

Question 15

Class of drugs that are known to cause hyperglycemia and diabetes?

Answer 15

Atypical antipsychotics

Question 16

Specific drug has been shown to increase cholesterol levels?

Answer 16

Olanzapine

Question 17

Sialorrhea is a common side effect of which specific drug? Treatment?

Answer 17

Clozapine; propylthiouracil

Question 18

Persistent cardiac effect of clozapine? Management?

Answer 18

Persistent sinus tachycardia

Propranolol

Question 19

Which depressive symptoms respond first after antidepressant treatment?

Answer 19

Neurovegetative symptoms (SIGECAPS)

Question 20

Drug that is approved to treat both depression and diabetic neuropathy?

Answer 20

Duloxetine (SNRI)

Question 21

Antidepressants that do not cause sexual dysfunction?

Answer 21

#Mirtazapine
#Bupropion
#Nefazadone

Question 22

Dopaminergic based side effects of antipsychotics?

Answer 22

#Prolactin (Galactorrhea, Gynecomastia)
#Extrapyramidal (blepharospasm, opisthotonos, torticollis)
#Pseudoparkinsonism
#Akathesia
#Rabbit syndrome