Psychopharmacology Flashcards
What pharmacokinetic factor of psychotropic medication is different in children from adults?
Faster metabolism in children
Pharmacokinetic feature of lamotrigine causing interactions with valproate and carbamazepine? hepatic
glucuronidation/metabolism
What consideration should be taken for an ultra-rapid metabolizer of CYP2D6 being prescribed atomoxetine?
Higher dose may be needed
Children often require a larger dose compared to adults due to what weight-adjusted characteristic?
Higher GFR
Term for proportion of medication taken that reaches systemic circulation?
Bioavailability
Which medication may lead to toxicity in children due to its zero order kinetics?
Paroxetine
Some medications for psychiatric conditions may seem to lack efficacy in youth due to which factor in youth?
Relatively immature neural networks
Best way to monitor emerging diabetes for patients on atypical antipsychotic?
Fasting Glucose
Obtain baseline and follow up serum prolactin for which medication?
Olanzapine
What is shown to reduce weight gain in antipsychotic use?
Metformin
Adolescent male with developmental disability gets IM shot for aggression, then develops twisting of neck with pain. What receptor is blocked?
D2
Most likely neuronal tract involved in milky discharge from breast of patient on risperidone?
Tubero-infundibular
Which receptor site provides some therapeutic effects of second-gen antipsychotics?
5-HT 2A
Lab test for adolescent on aripiprazole for 3 months and no reported side effects?
Fasting total cholesterol
First-line treatment for patient just started antipsychotic who can’t stay seated and has new onset restlessness?
Propranolol
What medication is appropriate for an adolescent who has akathisia without dystonia?
Propanolol
Which drug increases serum levels of dextromethorphan/Risperdal due to interactions with CYP2D6 system? (2x)
Prozac
Why do SSRIs take time?
Desensitization of presynaptic 5HT1A receptors
Antidepressant with most potent inhibition of CYP450 2D6?
Fluoxetine
Most likely reason for relapse of symptoms in adolescent with OCD who was previously stable on 200mg of Fluvoxamine?
Starting nicotine use
Patient on paroxetine wants to taper off. Previous taper attempts failed (dizziness, fatigue, irritability, paresthesias). Cross taper to, then discontinue off which antidepressant?
Fluoxetine
Contraindicated antidepressant in patient with epilepsy due to lower seizure threshold?
Bupropion
Medication that is less effective in children due to immature brain noradrenergic pathways?
TCAs
Most important interaction between ibuprofen and lithium?
Nausea and vomiting
What should be monitored in first 6 months of starting Lithium?
Thyroid-stimulating hormone (TSH) at initiation and at every 3 months
New serum test to monitor GFR in patients on lithium maintenance?
Cystatin-C
At what time should you get a lithium level?
Morning, 12 hours after last dose
Why does lithium have a lower plasma concentration in children vs adults?
Higher volume of distribution
Important Oxcarbazepine side effects in adolescent?
Hyponatremia
Adolescent with hepatic insufficiency. Best mood stabilizer?
Topiramate
Adolescent on oral contraceptive has an unexpected pregnancy after starting what new medication?
Topiramate
What is the mechanism of action of Lamotrigine?
Inhibition of 5HT3 and release of aspartate and glutamate
Psychostimulants stimulate the release of which neurotransmitter?
Norepinephrine
