Psych Pharm (not covered in other categories) Flashcards

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1
Q

(PPP 571)

what is the only antidepressant approved for treatment of bulimia?

A

fluoxetine

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2
Q

(RoshReview)

what SSRI has the longest half-life?

A

fluoxetine

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3
Q

(Rosh Review)
if a pt has a hx of chronic kidney disease, which is a contraindication for lithium, then ________________ is the recommended antimanic (mood-stabilizing) medication.

A

valproate

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4
Q

(RoshReview)

what mood stabilizer is contraindicated in pts with CKD?

A

lithium

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5
Q

(RoshReview)

what are rare adverse effects that may occur due to valproate use?

A

hepatotoxicity,
thrombocytopenia,
and pancreatitis

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6
Q

(RoshReview)

pts who take valproate have to have what labs checked? and how often?

A
liver enzymes (AST, ALT)
platelets

every 6-12 months

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7
Q

(RoshReview)

valproate is contraindicated for….who?

A

women who could possibly become pregnant due to the possibility of teratogenicity

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8
Q

(RoshReview)

four uses for valproate

A

mania
TBI-related agitation (off-label)
sz
status epilepticus

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9
Q

(RoshReview)
if a pt presents with s/s of OCD and would prefer pharmacologic therapy rather than CBT, what would be the most appropriate first-line agent?

A

sertraline

initial pharm treatment is a SSRI (fluoxetine, sertraline, paroxetine, citalopram, escitalopram)

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10
Q

(RoshReview)

“How long should patients with OCD and a positive response to pharmacologic therapy remain on medication?”

A

“at least 1 year”

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11
Q

(RoshReview)

define serotonin syndrome

A

rapid onset

combination of 2+ serotonin agonists or dosage changes

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12
Q

(RoshReview)

three common categories of serotonin syndrome symptoms:

A

MENTAL STATUS CHANGES (agitation, pressured speech)

AUTONOMIC INSTABILITY (tachycardia, diarrhea, shivering, diaphoresis, mydriasis (WIDE OPEN PUPILS)

NM ABNORMALITIES (clonus, hyperreflexia (lower > upper), tremor, seizure

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13
Q

(RoshReview)

what is the tx for serotonin syndrome?

A

benzos
hydration/cooling
cyproheptadine
(in that order)

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14
Q

(RoshReview)

“what is the mechanism of action of buspirone?”

A

blocking 5HT1A autoreceptors

“it affects the serotonergic system by blocking 5HT1A autoreceptors”

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15
Q

(RoshReview)

key differences between NMS and serotonin syndrome?

A

NMS: more gradual, usually develops over 24 hrs; associated w/ slow NM activity, rather than NM hyperactivity

SS: NM abnormalities = clonus, hyperreflexia, tremor, sz; rapid onset

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16
Q

(RoshReview)

“which SSRI is best tolerated?”

A

escitalopram