March 16

Question 1

at what age do you give ADHD medication to a child?

Answer 1

6 or older

Question 2

if a child below age 6 has ADHD symptoms, what should you recommend?

Answer 2

parent-child behavioural therapy

Question 3

how do you treat an acute dystonic reaction?

Answer 3

anticholinergic medication

Question 4

what anticholinergics are used to treat an acute dystonic reaction?

Answer 4

benztropine, diphenhydramine

Question 5

what is dantrolene used to treat (in the setting of antipsychotic medication use)?

Answer 5

neuroleptic malignant syndrome

Question 6

features of neuroleptic malignant syndrome?

Answer 6

high fever, rhabdomyolosis, muscle rigidity

Question 7

what type of drug is fluoxetine?

Answer 7

SSRI

Question 8

what changes in sleep patterns occur in major depressive disorder?

Answer 8

decreased REM latency and decreased slow wave sleep

Question 9

which anticonvulsant is most associated with liver injury?

Answer 9

valproate

Question 10

how long is an adequate antidepressant trial?

Answer 10

4-6 weeks

Question 11

what is bipolar disorder I?

Answer 11

manic episodes with or without depressive episodes

Question 12

what is bipolar 2?

Answer 12

at least 1 hypomanic episode and depressive episode

Question 13

MOA of dextromethorphan?

Answer 13

activates sigma opioid recetpros but also has activity on serotonin receptors

Question 14

what is dextromethorphan?

Answer 14

a cough suppressent

Question 15

characteristics of serotonin syndrome?

Answer 15

• mental status changes
• autonomic dysregulation
• neuromuscular excitability

Question 16

what causes the hyperthermia in serotonin syndrome?

Answer 16

sustained muscle contraction

Question 17

which drug may cause paradoxical agitation?

Answer 17

benzo’s

Question 18

presentation of paradoxical agitation caused by benzo?

Answer 18

increased agitation, confusion, aggression and disinhibition (usually within an hour of taking the benzo)

Question 19

what should you do in a patient taking regular benzo’s that begins experiencing paradoxical agitation?

Answer 19

taper and discontinue benzo

Question 20

MOA of bupropion

Answer 20

NE and dopamine reuptake inhibitor

Question 21

does bupropion cause weight gain?

Answer 21

no

Question 22

does bupropion cause sexual dysfunction?

Answer 22

no

Question 23

does mirtazapine cause weight gain?

Answer 23

yes

Question 24

does mirtazapine cause sedation?

Answer 24

yes

Question 25

does bupropion cause sedation?

Answer 25

no

Question 26

what is phenelzine?

Answer 26

a MAOi

Question 27

what is venlafaxine

Answer 27

SNRI

Question 28

venlafaxine is associated with dose dependent….

Answer 28

hypertension

Question 29

which antipsychotic may cause agranulocytosis

Answer 29

clozapine

Question 30

how often should you monitor bloods in a patient who has started clozapine?

Answer 30

every week for the first 6 months

Question 31

what do you need to measure at baseline in a patient who starting a 2nd gen antipsychotic?

Answer 31

BMI, fasting plasma glucose and lipids, BP and waist circumferance

Question 32

how often should BMI be measured in a patient on a 2nd gen antipsychotic?

Answer 32

monthly

Question 33

how often should fasting plasma glucose and lipids, BP and waist circumferance be measured in a patient who is on a 2nd gen antipsychotic?

Answer 33

baseline, then 3 months, then at a year