Pharmacology

Question 1

27 y/o depressed patient treated with SSRI and tranylcypromine (and with 5- hydroxytryptophan) now presents with VH, mild confusion, myoclonic jerks, diaphoretic, flushing, restless:

Answer 1

SEROTONIN SYNDROME

Question 2

What drug has a curvilinear therapeutic window?

Answer 2

NORTRIPTYLINE

Question 3

What drug is useful in the Rx of urinary retention secondary to TCA therapy

Answer 3

BETHANECHOL

Question 4

Which opioid has a potentially lethal interaction with monoamine oxidase inhibitors (MAOIs)?

Answer 4

MEPERIDINE

Question 5

After an OD on Amitriptyline, what test is needed?

Answer 5

ECG

Question 6

45 y/o F pt on phenelzine for MDD, takes OTC medication for cold sx and develops hypertensive crisis. Which OTC medication would most likely cause this?

Answer 6

PSEUDOEPHEDRINE

Question 7

Antidepressant less likely to cause sexual dysfunction:

Answer 7

BUPROPION

Question 8

Antidepressant preferred for >65 y/o for which blood levels are clinically useful

Answer 8

DESIPRAMINE

Question 9

Pt with hx of bipolar disorder p/w immobility, posturing, and echopraxia. First line tx?

Answer 9

LORAZEPAM

Question 10

Which SSRI has mild anticholinergic activity due to some affinity at the muscarinic receptors?

Answer 10

PAROXETINE

Question 11

The most common reason that people discontinue the use of SSRI:

Answer 11

GI SIDE EFFECTS

Question 12

62 y/o pt with hx chest pain has and depression, one month ago started on paroxetine, presents with new onset of lethargy and headache, low Na and BUN, normal K , and Cr of 0.4. Next test:

Answer 12

URINE OSMOLALITY

Question 13

8 y/o taking imipramine 300mg qday for recurrent MDD. After 3 weeks, mood is improved, but has difficulty passing urine and mild erectile dysfunction. Appropriate action?

Answer 13

BETHANECHOL 25MG TID

Question 14

Which is a muscarinic SE of antidepressants?

Answer 14

URINARY RETENTION

Question 15

30 y/o pt has been treated for unreasonable fear of eating in public places, feeling of embarrassment in public places, and anger over the possibility of being scrutinized. Pt has not responded to high doses of paroxetine, citalopram, buspirone, and alprazolam, each of them administered for 4-6 wks. Which meds would be appropriate for next?

Answer 15

PHENELZINE

Question 16

them administered for 4-6 wks. Which meds would be appropriate for next? (2x) PHENELZINE What meds could be helpful in the treatment of depression in persons over the age of 65 because it does not produce orthostatic hypotension?

Answer 16

BUPROPION

Question 17

What antidepressant med is considered to be the most effective in the tx of premature ejaculation?

Answer 17

PAROXETINE

Question 18

Minimum recommended washout period for fluoxetine prior to starting MAOI?

Answer 18

5 WEEKS

Question 19

Treatment for patients with MAOI related hypertensive crisis in the ER may involve the administration of which of the following meds?

Answer 19

PHENTOLAMINE

Question 20

Most frequent cause of death following TCA overdose:

Answer 20

ARRHYTHMIA