MEDCHEM EXAM 2

Question 1

EPS

Answer 1

High:
some “done medications”
High potency FGAs
D2 partial agonists- akathisia

Low:
-most “pine” medications

Question 2

Anticholinergic

Answer 2

pines (except asenapine)
-clozapine highest

low potency FGAs

Question 3

Hypotension

Answer 3

Clozapine> risperidone
low potency FGAs
older pines

Question 4

Sedation

Answer 4

high: asenapine, quietiapine, cloazpine, olanzapine
low potency FGAs

low: D2 partial agonists, lumateperone, high potency FGAs

Question 5

Risperidone

Answer 5

EPS, hypotension, prolactin elevation, moderate weight gain

CYP2D6 substrate

Starting dose: 1-2mg
Target dose: 2-8 mg

Question 6

Olanzapine

Answer 6

moderate-high risk of orthosasis, weight gain, sedation

CYP1A2 Substrate

Starting Dose: 5-10mg
Target: 10-20mg

Question 7

Weight gain

Answer 7

high: clozapine, olanzapine
low: lurasidone, ziprasidone

Question 8

Clozapine

Answer 8

5 black box warnings:

-agranulocytosis
-myocarditis
-hypotension
-seizures
-mortality in dementia patients

Starting dose: 12.5mg bid, increasing 25mg /day until desired efficacy
Target: 300-430 mg in divided doses
Max: 900mg/day

Question 9

MAOIs

Answer 9

phenelzine- neuropathy
tranylcypromine- amphetamine metabolites
isocarboxazid

Question 10

TCAs

Answer 10

Tertiary amines:
-imipramine
-amitriptyline
-doxepine

Secondary amines:
-desipramine
-nortriptyline
-proptriptyline

Question 11

Parkinsons

Answer 11

decrease dopamine
increased acetylcholine

Question 12

Alzheimers

Answer 12

decreased acetylcholine
increased glutamate
increased neuroinflammation

Question 13

Parkinsons meds

Answer 13

L-DOPA

COMT Inhibitors:
entacapone
tolcapone

DDC inhibitor
carbidopa

MAOIs- rasagiline, selegiline

Dopamine receptor agonist:
-apomorphine
-rotigotine
-pramiprexole
-ropinirole

Question 14

Alzheimers Meds

Answer 14

AchE Inhibitors:
-donepezil
-rivastigmine
-galantamine

NMDA receptor antagonist
-memantine