Psychiatry

Question 1

action of methylphenidate

Answer 1

increase catecholamines in the synaptic cleft (esp norepinephrine and dopamine)

Question 2

action of aripiprazole

Answer 2

D2 partial agonist

Question 3

action of typical antipsychotics

Answer 3

block dopamine D2 receptor (increase cAMP)

Question 4

action of atypical antipsychotics

Answer 4

block dopamine D2 receptor + block serotonin 5HT receptor

Question 5

when is clozapine used

Answer 5

treatment resistant schizophrenia and those with persistant suicidality

Question 6

antipsychotics with increased risk of weight gain

Answer 6

olanzapine and clozapine

Question 7

antipsychotics which cause ophthalmology side effects and what are these

Answer 7

chlorpromazine (typical) -> corneal deposits
thioridazine (typical) -> retinal deposits

Question 8

treatment for akathisia

Answer 8

beta blockers, benztropine, benzodiazepines

Question 9

treatment for parkinsonism

Answer 9

benztropine, amantadine

Question 10

treatment for tardive dyskinesia

Answer 10

benzodiazepines, botulinum toxin injections, valbenzine, deutrabenzine

Question 11

are antipsychotics lipid or water soluble

Answer 11

fat soluble, stored in fat - slow to be removed from the body

Question 12

side effects of lithium

Answer 12

LiTHIUM
low thyroid (hypothyroidism)
Heart (ebstein anomaly)
Insipidous (nephrogenic diabetes insipidous)
Unwanted Movements (tremor)

Question 13

action of mirtazepine

Answer 13

alpha2 antagonist, potent 5-HT2 and 5-HT3 receptor antagonist and H1 antagonist

Question 14

side effects of SSRI’s

Answer 14

serotonin syndrome
GI
SiADH
sexual dysfunction (anorgasmia, erectile dysfunction, decreased libido)
mania if underlying bipolar

Question 15

side effects of SNRI’s

Answer 15

hypertension
stimulant effects
sedation
sexual dysfunction
nausea

Question 16

side effects of TCA

Answer 16

sedation
postural hypotension
anti-cholinergic (dry mouth, dry eyes, urinary retension)
confusion
hallucinations
QT prolongation

Question 17

anti-depressant drug of choice post MI

Answer 17

sertraline

Question 18

risks associated with SSRI’s during pregnancy

Answer 18

first trimester - congenital heart defects
third trimester - persistent pulmonary hypertension of newborn

Question 19

action of zopiclone

Answer 19

non-benzo hypnotic that potentiates GABA via Alpha2 subunit

Question 20

which atypical antipsychotic is most likely to cause galactorrhoea

Answer 20

risperidone

Question 21

mode of action of methylphenidate

Answer 21

CNS stimulant - dopamine and noradrenaline re-uptake inhibitor

Question 22

what antidepressant is contradindicated in eating disorders

Answer 22

bupriopion
- lowers seizure threshold

Question 23

mode of action of Atomexatine

Answer 23

used in ADHD
norepinephrine re-uptake inhibitor

Question 24

what medication might be given to alleviate sexual dysfunction in patients taking SSRI’s

Answer 24

bupropion

Question 25

mechanism of action of modafinil?

Answer 25

used in ADHD dopamine reuptake inhibitor

Question 26

mechanism of methylphenidate

Answer 26

indirect sympathomimetic (stimulates release of norepinephrine from presynaptic vesicles)

Question 27

mechanism of TCA's

Answer 27

block norepinephrine and serotonin reuptake within CNS

Question 28

antidepressant which can cause priapism and postural hypotension

Answer 28

trazadone

Question 29

smoking cessation therapy that is useful for cravings

Answer 29

varenicline

Question 30

mode of action of varenicline

Answer 30

nicotinic Ach receptor partial agonist

Question 31

mode of action of nicotine replacement therapy

Answer 31

binds to nicotinic Ach receptors

Question 32

action of naltrexone and indication for use

Answer 32

long acting oral opioid antagonist used after detoxication to prevent relapse also useful in obesity, smoking and smoking cessation

Question 33

action of buprenorphine

Answer 33

partial opioid agonist

Question 34

side effects of varenicline

Answer 34

GI upset sleep disturbance

Question 35

why is sodium bicarbonate used in TCA toxicity

Answer 35

prevents TCA from blocking Na channel thus treating cardiac toxicity

Question 36

if there is risk of serotonin syndrome, what antidepressant would you choose

Answer 36

bupropion (less risk of serotonin syndrome)

Question 37

phenolazine drug class

Answer 37

MAO inhibitor

Question 38

what antidepressant also has pain relief properties and mode of action

Answer 38

MAO inhibitors. They also inhibit GABA transaminases which increases GABA = pain relief

Question 39

drugs which exacerbate lithium toxicity

Answer 39

NSAIDS ACE inhibitors / ARB's loop diuretics metrondiazole