Psychopharmacology

Question 1

What can sertraline cause that can lead to delirium?

Answer 1

Hyponatremia

Question 2

Olanzapine and quetiapine are known for

Answer 2

Cardio metabolic SE, sedation, weight gain

Question 3

What is a major risk with clozapine, and how is it monitored + other SE

Answer 3

Agranulocytosis.

Needs weekly FBE for first 18 weeks, Then every 4 weeks after

Seizures, myocarditis, paralytic ileus (causing intestinal onstruction), hypersalivation

Question 4

Neuroleptic malignant syndrome

Answer 4

Fever, muscle rigidity, mental status change, autonomic instability, rhabdomyolysis, CK elevation

Question 5

Risperidone SE

Answer 5

Enuresis, reflex tachy, prolactinemia

Question 6

Ziprasidone SE

Answer 6

Prolonged QT - palpitations, chest discomfort, syncope

Question 7

Prolonged QT caused by which antidepressants

Answer 7

Escitalopram, citalopram, fluoxetine

Question 8

SSRI with sedating effects

Answer 8

Fluvoxamine, paroxetine

Question 9

What drugs can cause serotonin syndrome in combination with SSRI

Answer 9

NSAID
Tramadol
St. john wart
other antidepressant

Question 10

Which SSRI for back pain

Answer 10

Duloxetine

Question 11

TCA SE

Answer 11

Cardiotoxicity

Acute urinary retention, blurred vision, constipatin, postural hypotension

Question 12

Bupropion indications and CI

Answer 12

Patients unable to tolerate SSRI SE
CI: History of seizures, eating disorders, bipolar disorders
Helps in smoking cessation - can reduce craving and withdrawal symptoms

Question 13

Which SSRI is best for anxiety

Answer 13

Escitalopram

Question 14

Which AP is most likely to cause EPSE

Answer 14

Haloperidol

Question 15

Which AP causes the most akathisia but can reduce prolactinemia

Answer 15

Aripiprazole

Question 16

SSRI for elderly/pregnant with depression

Answer 16

Sertraline (safe for CVS dx)

Question 17

Amphrtamine induced psychosis drug

Answer 17

Haloperidol

Question 18

What to give for serotonin syndrome

Answer 18

Cyproheptadine

Question 19

Managing NMS

Answer 19

Discontinue AP
Admit to ICU for monitoring
Fever: antipyretic, evaporative cooling, ice pack, cooled IV fluids
Prevent acute renal failure and reduce excretion of breakdown products: aggressive fluid resus and alkalisation of urine
Antidote: amantadine/bromocriptine
Rigidity; benzo
ECT

Question 20

Akathisia management

Answer 20

Propanolol > benztropine > lorazepam

Question 21

Parkinsonism and dystonia due to AP

Answer 21

Benztropine, diphenhydramine

Question 22

Tar dive dyskinesia due to AP caused by

Answer 22

Clozapine

Question 23

Antipsychotic causing sedation, weight gain, orthostatic hypotension and corneal deposits

Answer 23

Chlorpromazine

Question 24

Which antidepressant requires regular LFT

Answer 24

Agomelatine

Question 25

Which antidepressant causes severe headache with cheese

Answer 25

Irreversible MOA-i like tranylcypromine, phenctine

Question 26

Which mood stabilizer causes bone marrow suppression

Answer 26

Carbamazepine

Question 27

Which mood stabilizers cause a diffuse blustery purple skin rash

Answer 27

Carbamazepine, Lamotrigine

Question 28

Which benzo causes respiratory depression after getting medicated for aggression

Answer 28

Midazolam

Question 29

Naltrexone contraindication and benefits

Answer 29

Liver failure

Effective in maintenance phase, person should be opioid free for 7 days at least

Question 30

Disulfiram effects when take alcohol and CI

Answer 30

Flushing, headache, n&v, SOB

CI in cardiac disease, liver failure

Question 31

Acamprosate indication and CI

Answer 31

Relapse prevention

Severe renal disease, pregnancy, breastfeedingn

Question 32

Methadone SE and CI

Answer 32

QTC prolongation

CI in decompensated liver patient

Question 33

Benefit of bruphenorphine

Answer 33

Lower risk of overdose than methadone

But can ppt withdrawal if patient still has opioids acting on receptors

Question 34

Serotonin syndrome antidote

Answer 34

Cryptoheptadine