Psychopharm

Question 1

Side effects of Li

Answer 1

acne, follicular and maculopapular eruptions, alopecia, GI complaints, tremor, DI, hypothyroidism, weight gain, cardiac arrhythmia, edema, psoriasis flare-ups

Question 2

side effects of Lamotrigine

Answer 2

SJS, anemia, thrombocytopenia, liver failure, pancreatitis

Question 3

SEs of benzos

Answer 3

sedation, respiratory suppression, addictive potential

Question 4

SEs of risperidone

Answer 4

NMS, metabolic syndrome, GI upset, sialorrhea, lactation

Question 5

Oxcarbazepine SEs

Answer 5

leukopenia, thrombocytopenia, SJS

Question 6

MAOIs mechanism of action

Answer 6

increase levels of biogenic amine NTs, (serotonin, norepinephrine, dopamine) through prevention of degradation

Question 7

types of MAO enzymes

Answer 7

MAO-A: breaks down serotonin, norepi, and dopamine

MAO-B: Breaks down dopamine

Question 8

Merperidine drug class

Answer 8

Opioid

Question 9

Meperidine MoA

Answer 9

Binds to opioid receptors

Question 10

Triad of serotonin syndrome

Answer 10

neuromuscular hyperactivity, autonomic hyperactivity, altered mental status

Question 11

serotonin $ neuromuscular hyperactivity symptoms

Answer 11

tremor clonus, myoclonus, hyper-reflexia (in advanced stage), pyramidal rigidity

Question 12

serotonin $ autonomic hyperactivity symptoms

Answer 12

diaphoresis, fever, tachycardia, tachypnia

Question 13

serotonin $ AMS sx

Answer 13

agitation, excitement, confusion in advanced stage

Question 14

Therapeutic drugs implicated in severe serotonin $ reactions

Answer 14

MAOI + SRI (selective and non-selective)

• SSRIs
• SNRI
• opioids

Question 15

Side effects of MAOIs

Answer 15

orthostatic hypotension, weight gain, edema, sexual dysfunction, insomnia

Question 16

Which anticonvulsant induces its own metabolism?

Answer 16

Carbamazepine: its 24-hour half-life by at least 50% during the first 3 to 4 weeks of therapy

Question 17

Alzheimer cholinesterase inhibitors

Answer 17

tacrine, donepezil, rivastigmine, galantamine

Question 18

Memantine MoA

Answer 18

binds to N-methyl-d-aspartate (NMDA) receptors, as a receptor antagonist. Slows Ca influx into the cells. Slowing calcium influx halts destruction

Question 19

Through what MoA do meds increase concentration of TCAs?

Answer 19

CYP450 system

Question 20

What drugs increase TCA conc’ns?

Answer 20

Methylphenadate, clozapine, haldol, risperidone, fluoxetine, acetazolamide, thiazides, aspirine, cimetidine, sodium bicarb

Question 21

What drugs decrease TCA conc’ns?

Answer 21

Cigarette smoking, cyp450 (1A2 enz); vitamin C, Li, barbiturates, primidone

Question 22

hyperprolactinomas are caused by what psych meds

Answer 22

conventional neuroleptics, and risperidone. increase pituitary microadenomas through dopamine blockade.

Question 23

Tx pf hyperprolactinomas iso neuroleptics?

Answer 23

Stop neuroleptic, and possibly administer bromocriptine. Perhaps surgery if refractory to the above

Question 24

13 Tricyclic meds

Answer 24

amitriptyline, amoxapine, clomipramine, desipramine, doxepin, dothiepin, imipramine, lofepramine, maprotiline, nortriptyline, protriptyline, tianeptine, trimipramine