Pharm 3

Question 1

A patient on TCA is getting elective surgery…do you need to do anything and what is the risk?

Answer 1

TCA should be stopped prior to elective procedures BC combination with anesthesia can cause significant HTN.

Question 2

Of all the TCAs, which is most serotonin selective?

Answer 2

Clomipramine

Question 3

What are potential positive heart effects TCAs can have?

Answer 3

TCAs act as Class 1A antiarrhythmics:

1. Terminate V-fib
2. Increase collateral supply to ischemic parts of heart

Question 4

1. The antipsychotic effect of neuroleptics is due to it’s effect on what area of the brain?
2. Neuroleptics cause increased prolactin due to it’s effect on what area of the brain?
3. What area for Parkinsonism SE?

Answer 4

1. Meso-limbic and Meso-cortical tract.
2. Tuberoinfundibular tract
3. Nigrostriatal

Question 5

Other than supportive treatment, what two drugs can be helpful in treatment of NMS?

Answer 5

Bromocriptine

Dantrolene

Question 6

etoh, bzd, sedative hypnotic agents, and barbiturates all exert their effect by which receptor?

Answer 6

GABA-A

Question 7

Entacopone and Tolcapone exert their anti-parkinsons like effect by what mechanism?

Answer 7

COMT (Catechol-O-methyltransferase) inhibition.

These medications block COMT from degrading Dopamine and L-DOPA/levodopa in the CNS (and levodopa in the periphery)

Question 8

3- hydroxy benzodiazepines are directly metabolized by glucuronidation thus have no active metabolite. What 3 BZDS are 3-hydroxy BZDS?

Answer 8

1. Oxazepam
2. Lorazepam
3. Temazepam

Question 9

Lithium can be used to treat aggression in what patient population?

Answer 9

1. Mental Retardation
2. Conduct disorder
3. Schizophrenia
4. Prisoners

Question 10

What are 10 notable SE of Valproic Acid

Answer 10

Most common SE :

1. Weight gain
2. Ankle swelling
3. Hair thinning
4. Tremow

OTHER notable SE:

5. GI effects
6. Pancytopenia
7. Liver toxicity
8. Sedation
9. Pancreatitis
10. Bone marrow suppression (pancytopenia)