Medication

Question 1

Why should antipsychotics not be prescribed for patients in alcohol withdrawal?

Answer 1

Reduce seizure threshold

Question 2

Safest SSRI in pregnancy

Answer 2

Fluoxetine

Question 3

Percentage of patients developing metabolic syndrome in CATIE study

Answer 3

30-40%

Question 4

Benzo with half life of 15 hours

Answer 4

Lorazepam

Question 5

Zero Order Kinetics

Answer 5

Rate of drug elimination is independent of the concentration and is constant.

Question 6

Pentalomine

Answer 6

IM injection to treat HTN secondary to MAO-induced hypertension. Alpha-1-adrenoreceptor antagonist. Chlorpromazine is 2nd line.

Question 7

Difference between iatrogenic cushing’s presentation to endogenous?

Answer 7

Mania/euphoria vs depression

Question 8

Why is Clozapine recommended as drug of choice to avoid EPSEs?

Answer 8

High affinity for D4 receptors which are more highly concentrated in the front cortex and amygdala than in the basal ganglia.

Question 9

Drugs not to be used as augmentation with Clozapine?

Answer 9

Pimozide (Cardiotoxicity), Olanzapine (no evidence)

Question 10

Sigma receptors associated with which medication?

Answer 10

Fluvoxamine and Sertraline act on sigma 1 as agonists, anxiolytic and antipsychotic.

Question 11

Reason why Clozapine is effective in refractory schizophrenia

Answer 11

Dissociates quickly

Question 12

How does ecstasy work?

Answer 12

Increases release of seretonin, blocks dopamine reuptake, blocks enzyme tryptophan hydroxylase,

Question 13

Prolonged withdrawal effects if given in pregnancy

Answer 13

SHORT HALF LIFE PAROXETINE.

Question 14

Benzo halflives

Answer 14

Ultra long: Diazepam (200-20) then Clonazepam (50-18). Shortest (Oxazepam 4-15)

Question 15

Long acting Opioid antagonist

Answer 15

Naltrexone - only to be given in detox-ed dependents.

Question 16

Varenicicline mechanism of action

Answer 16

Alpha 4 beta 2 nicotinic partial agonist

Question 17

Medication to treat REM sleep disorder

Answer 17

Clonazepam very effective.

Question 18

Receptors involved in nausea and vomiting in SSRIs

Answer 18

Agonism of 5HT3 and antagonism of 5HT4

Question 19

Prophylactic seizure control on Clozapine with..

Answer 19

Depends on the diagnosis i.e. if Schizoaffective choose sodium valproate, if psychosis poorly controlled choose Lamotrigine. If needs weight loss, choose Topiramate.

Question 20

2mg Lorazepam = how much diazepam?

Answer 20

20mg

Question 21

Which anticholinesterase inhibitor is unique in that it is an positive allosteric modulator of nicotinic receptors

Answer 21

Galantamine

Question 22

Half life of Aripiprazole

Answer 22

75 hours - think once daily dosing.

Question 23

First order kinetics

Answer 23

Dependent on drug concentration.

Question 24

Buproprion

Answer 24

Dopamine and noreadrenaline reuptake inhibitor. PLUS antagonist at nicotinic Ach receptor

Question 25

Pure antagonist at D2 receptors?

Answer 25

Typical antipsychotics. Atypical have antagonism at 5HT2 receptors.

Question 26

Cocaine

Answer 26

Triple reuptake inhibitor (Dopamine, Noradrenaline and Seretonin).

Question 27

Modafinil

Answer 27

Dopamine reuptake inhibitor

Question 28

Clozapine receptor differences

Answer 28

Antagonism at D4 receptor

Question 29

Third generation antipsychotics

Answer 29

Aripiprazole and Cariprazine - partial agonist at D2 receptors (Cariprazine D3). Cariprazine good for persistent negative symptoms.

Question 30

Buspirone

Answer 30

5HT1a partial agonist

Question 31

SSRI with longer half life

Answer 31

Fluoxetine

Question 32

SSRI with shortest half life

Answer 32

Paroxetine, Fluvoxamine - withdrawal symptoms

Question 33

SNRIs?

Answer 33

Venlafaxine and Duloxetine

Question 34

Trazadone

Answer 34

Agonist at 5HT2 Receptors and Seretonin reuptake inhibitors.

Question 35

Use of Clonadine and Lofexadine

Answer 35

Opiate withdrawal where not using opiate substitutes.

Question 36

H1 antagonist

Answer 36

Promethazine crosses BBB (first gen).