Neuropsychiatric Medications

Question 1

Carbamazepine uses

Answer 1

• used for seizures, mood, neuro pain, trigeminal neuralgia
• slows down everything (CNS slowing)

Question 2

carbamazepine metabolism

Answer 2

• induces its own metabolism
• lots of drug interactions and speeds up the metabolism of other meds

Question 3

carbamazepine side effects

Answer 3

• thrombocytopenia
• hyponatremia
• dizziness
• ataxia
• anemia, agranulocytosis

Question 4

oxcarbazepine

Answer 4

• lighter version of carbamazepine
• no auto induction of metabolism, less side effects

Question 5

phenytoin/ fosphenytoin levels

Answer 5

• fosphenytoin = prodrug for parenteral administration
• adjust dose in small increments because level rise rapidly (non-linear)
• concentrations increase with kidney dysfunction and cause cardiac complications

Question 6

phenytoin/ Fosphenytoin ADR

Answer 6

• arrhythmias
• hypotension
• CV depression
• vitamin K deficiencies
• bone marrow hypoplasia
• congenital defects

Question 7

lamotrigine ADR

Answer 7

• less CNS and congenital malformations
• for mood disorders

Question 8

lacosamide side effects

Answer 8

• safe medication
• pregnancy category C

Question 9

gabapentin metabolism

Answer 9

• not protein bound
• unchanged by the kidneys

Question 10

gabapentin meta analysis results

Answer 10

• decreases post-op pain and opiate requirements

Question 11

gabapentin in combo with opiates

Answer 11

• cause severe resp distress

Question 12

pregabalin ADRs

Answer 12

• edema
• difficulty concentrating
• pts complain of walking on this med
• higher side effects but better pain control compared to gabapentin (similar med)

Question 13

valproic acid ADRs

Answer 13

• thrombocytopenia
• hyperammonemia
• hepatotoxicity
• sedation, confusion, irritability

Question 14

felbamate side effects

Answer 14

• high risk of aplastic anemia and fatal hepatic failure

Question 15

topiramate ADRs

Answer 15

• slowed speech
• confusion
• appetite suppression

Question 16

perampanel black box warning

Answer 16

• serious of life threatening psychiatric and behavioral adverse effects (anger, homicidal)

Question 17

withdraw symptoms of baclofen

Answer 17

• hallucinations
• fever
• agitation
• tremor
• tachycardia
• seizures

Question 18

tizanidine

Answer 18

• centrally acting alpha 2 agonist

Question 19

black box warning for dantrolene

Answer 19

• dose dependent diarrhea and hepatotoxicity

Question 20

tricyclic antidepressants ADR

Answer 20

• anticholinergic side effects
• prolong QT
• arrythmias

Question 21

SSRI ADR

Answer 21

• hyponatremia
• thrombocytopenia
• suicidality
• arrhythmias
• serotonin syndrome

Question 22

black box warning for antidepressants

Answer 22

• suicidality

Question 23

SNRIs ADRs

Answer 23

• serotonin syndrome
• hepatotoxicity
• HTN
• insomnia
• tremor, agitation

Question 24

5HT2A antagonists ADRs

Answer 24

• highly sedating
• increased appetite
• hepatotoxicity
• orthostatic hypotension

Question 25

nuedexta ADRs

Answer 25

• QT prolongation
• lupus
• edema
• anemia
• thrombocytopenia

Question 26

lithium MOA

Answer 26

• alters Na transport
• tricks your body into thinking its Na but cant cause an action potential like Na

Question 27

lithium ADRs

Answer 27

• DI, polyuria, polydipsia
• coma, seizures, tremors
• arrythmias, syncope
• hypothyroidism
• skin damage

Question 28

lab to check with clozapine

Answer 28

• WBC

Question 29

black box warning with antipsychotics

Answer 29

• dementia related death
• agranulocytosis (usually due to stroke)

Question 30

side effects of antipsychotics

Answer 30

• tardive dyskinesia
• extrapyramidal movements
• parkinson’s symptoms