Meds_guidlines_5

Question 1

Percentage of patients who will experience relapse if stopped antidepressants within 6 months after recovery

Answer 1

50%

Question 2

In refractory depression what medication is recommended for augmentation by NICE?

Answer 2

Quetiapine
Lithium

Question 3

Why is it so important to manage recurrent depression for long time?

Answer 3

Chances for 3rd and 4th episode increase up to 70%

Question 4

What antidepressants used in post CVA depression?

Answer 4

SSRI (not if there is risk of GI bleeding)
Nortriptyline

Question 5

Post CVA antidepressant of choice in a case who is on warfarin

Answer 5

Citalopram and escitalopram

Question 6

NICE recommendation for 1st line medical treatment of depression in young people?

Answer 6

Fluoxetine

Question 7

Starting dose for Fluoxetine in a 10 year old patient with moderate depression

Answer 7

10 mg

Question 8

1st line of treatment in moderate depression in adolescents

Answer 8

individual CBT

Question 9

1st line treatment for adolescent with mild depression

Answer 9

group CBT

Question 10

What medication can cause impulsive behavoiurs?

Answer 10

Ropinirole (DAs)

Question 11

Effects of magic mushrooms are similar to that of…

Answer 11

LSD

Question 12

Medical treatment for children above 7 with enuresis who did not respond to reward system and alarms

Answer 12

200mcg Desmopressin

Question 13

A drug that should be avoided in breasfeeding moms

Answer 13

Doxepin(induces resp. depression and sedation in the baby)

Question 14

An antipsychotic that has antidepressant effect at low dose

Answer 14

Flupentixol

Question 15

the ssri that suits patients with low mood and liver disease

Answer 15

paroxetine

Question 16

preferred drug in manic patient with liver impairment

Answer 16

lithium

Question 17

preferred drug for anxious patient with insomnia and liver impairment

Answer 17

alprazolam, lorazepam, oxazepam and temazepam

ALOT

Question 18

what is a known side effect of st john’s wort

Answer 18

Potential to cause significant photosensitivity or phototoxicity

Question 19

St john’s wort and cyp450 system

Answer 19

Causes induction cyp3a4

Question 20

Another name for st john’s wort

Answer 20

Hypericum perforatum

Question 21

Herbal remedy with evidence to be helpful in treating depression

Answer 21

St john

Question 22

Herbal remedy with evidence to be helpful in treating anxiety

Answer 22

Piper methysticum (KAVA)

Question 23

risk of KAVA

Answer 23

hepatotoxicity (hence not recommended)

Question 24

Antipsychotic of choice in schizo +HIV

Answer 24

Risperidone

then olan, aripiprazole and quetiapine

Question 25

Medication that is used in HIV but can cause depression and mania and fatal suicide

Answer 25

Efavirenz

Question 26

In a patient with schizophrenia in whom osteoporosis is suspected, what is preferred antipsychotic?

Answer 26

Aripiprazole (no effect on prolactine)

Question 27

A schizophrenia patient on risperidone develope gynecomastia or signs of hyperprolactemia ,what is alternative antipsychotic

Answer 27

Aripirazole

Question 28

In patients with sexual dysfunction as a result of risperidone, what is alternative if aripiprazole is not available

Answer 28

Quetiapine

Question 29

A depressed patient on venlafaxine or sertraline stops lactating, what is alternative?

Answer 29

Mirtazapine (NaSSA) specific serotonergic antidepressant

Question 30

What else is serious consequence of hyperprolactemia induced by psychotropics that you should let patients know about?

Answer 30

Breast cancer

Question 31

Anti psychotic choices in parkinson's

Answer 31

1st clozapine 2nd quetiapine (low affinity for d2 receptors, hence no blockinh of nigrostriatal pathway)

Question 32

a benzodiazepine Drug with high chance of interdose withdrawal symptoms

Answer 32

Oxazepam

Question 33

Artefact for low calcium in elderly

Answer 33

Low albumin

Question 34

What if hypnotics did not solve insomina in patients who failed to respond to sleep hygiene too?

Answer 34

Stop hypnotics (zoplicone 7.5 mg daily) and do not prescribe anything from that class due to dependency

Question 35

Who are at more risk of developing benzo dependency?

Answer 35

Patient with history of anxiety

Question 36

Telorance to hypnotic effects of benzodiazepine?

Answer 36

May happen within days

Question 37

1st line treatment for insomnia less than 4 weeks

Answer 37

Zopiclone (NICE) Promethazine (high next day drowsiness)

Question 38

recommended Rx for insomnia 2 months duration or more

Answer 38

CBT-I

Question 39

when should prolonged melotonin be given in cases of insomnia

Answer 39

1-2 hrs before bed

Question 40

Mention a recognised medication for insomnia with minimun next-day sedation effect...

Answer 40

Darido-rexant Dual Orexin Receptor Agonist (DORA)

Question 41

Optimal therapeutic range for lithium

Answer 41

0.8-1 mmol/L

Question 42

Ideal range for lithoum (plasma level) as prophylaxis of bipolar

Answer 42

0.6-0.75

Question 43

Lithium monitoring in >65 y.o after plamsa level and mood stabilized?

Answer 43

Every 3 months

Question 44

In adults, how often lithium level is checked after stabilising and abscent of drug interaction??

Answer 44

Every 6 month

Question 45

In adults, how often lithium level is checked after stabilising and precence of drug interaction??

Answer 45

Every 3 month

Question 46

Effective mood stabilizer in steroid induced psychosis

Answer 46

Lithium

Question 47

Sign of toxicity on AMDISEN for lithiun

Answer 47

Myoclonus

Question 48

Mania can be induced by which Parkinson medication

Answer 48

Levadopa Selegiline

Question 49

A drug that is very effective but poorly tolerated in acute mania

Answer 49

Haloperidol

Question 50

A drug that is effective and well tolerated in acute mania

Answer 50

Olanzapine

Question 51

Not recommended for acute mania

Answer 51

Topiramate

Question 52

Not recommended for acute mania

Answer 52

Topiramate

Question 53

1st line of treatment for depression in Multiple Sclerosis

Answer 53

Sertraline