other pharmacology

Question 1

beta blockers with 5 HT1A blocking acivity

Answer 1

Pindolol, propranolol, nadolol

Question 2

what does Rivastigmine block?
Galantamine?
Donepezil?

Answer 2

1. Ach and buterylcholine
2. Ach and nicotinic
3. Only Ach

Question 3

acute dosing of :
benztropine (cogentin)
Kemadrin (procyclidine)
Benadryl (diphenhydraine)

Answer 3

benztropine (cogentin): 1-2 IV/IM
Kemadrin (procyclidine): 5 TID, max 30 per day (only PO)
Benadryl (diphenhydraine): 25-50 IV/IM Max 200

Question 4

3 lipophilic benzos

Answer 4

Diazepam
Flurazepam
Midazolam

Question 5

Percent of DA receptors blocked for
Efficacy
Prolactin
Parkinsonism

Answer 5

68%
72%
78%

Question 6

Drugs that can cause hyponatremia SIADH

Answer 6

Clozapine
Ssri 
Tca 
Carbamazepine 
Oxcarbazepine
Not Li, it csuse nephrogenic DI

Question 7

Tx of sexual SE of SSRIs

Answer 7

sildinafil
cyproheptadine
buspirone
buproprione
amantadine
yohimbine

Question 8

what decreases Li

Answer 8

high salt
caffiene
carboni cnhydrase inhibitors
osmotic diuretics

Question 9

Aims

Answer 9

i. instructions for the AIMS
1. observe the patient unobtrusively at rest
2. ask patient to remove shoes/socks, anything in mouth
3. ask about current condition of teeth or if they wear dentures
4. ask if they notice any movements in mouth
5. observe entire body for movements while patient sits in chair with hands on knees, legs slightly apart
6. ask patient to sit with hands hanging between legs; observe
7. ask to open mouth; observe tongue at rest (do this twice)
8. ask to protrude tongue (do this twice)
9. ask patient to tap thumb with each finger for 10 seconds, each hand separately; observe for facial/leg movements
10. flex/extend arms, observing for rigidity
11. ask patient to stand up
12. ask patient to extend arms with palms down (observe trunk, legs, mouth)
13. have patient walk a few paces and return (do this twice, observing hands and gait)

Question 10

hyponatremia/SIADH

normovolemic hyponatremia

Answer 10

carbamaz
oxcarbaz (2.5-50%)
SSRI (o.5-30%) in first few weeks
TCA
MAOI

Question 11

benzo equivalents

Answer 11

Alprazolam (Xanax) 1

Chlordiazepoxide (Librium ) 25

Clonazepam Klonopin .5–1.0

Diazepam (Valium ) 10

Estazolam (ProSom) 1

Flurazepam (Dalmane) 30

Lorazepam (Ativan) 2

Oxazepam (Serax) 30

Temazepam (Restoril ) 20

Triazolam (Halcion) .25

(Zolpidem (Ambien ) 10

Zaleplon (Sonata) 10

Question 12

benzo detox

Answer 12

if high doses hospitalize
switch
reduce by 30%
thenby 5-10%

if low dose
switch as an option
reduce by 10-25%

Question 13

1 mg of Ativan =?

Answer 13

0.25 clonaz
0.5 alpraz
2.5 midazolam
5 diazepam
10 chlordiazepoxide

Question 14

Evidence based txt for sud

Answer 14

Cbt
Met
12 step
Contingency
Relapse prevention 
Community reinforcement
Pharma