Quiz 1 Psychotic and Mood Disorders

Question 1

First Generation APS typically end in what suffix

Answer 1

Zine

most common - chlophromazine, fluphenazine

include Haloperidol

Question 2

Atypical APS with relative potency dose

Answer 2

Risperidone 1mg (2-6)
Olanzapine 4mg (15-30)
Ziprasidone 20mg (80-160)
Clozapine 50mg (200-500)
Quetiapine 80mg (300-800)

Question 3

Typical APS with relative potency dose

Answer 3

Fluphenazine 1-2mg (2-20)
Haloperidol 2mg (5-20)
Mesoridazine 50mg (50-150)
Chlorpromazine 100mg (100-600)

Question 4

High potency dose - higher risk for?

Answer 4

EPS

Question 5

Low potency dose - higher risk for

Answer 5

Metobolic disturbance

Question 6

Second Generation APS typically end in what suffix?

Answer 6

PINE or IDONE or AZOLE

Question 7

FGA preliminary diagnostics would consist of:

Answer 7

AIMS (abnormal involuntary scale)
VS
ECG

Question 8

SGA - Metabolic syndrome diagnostics are:

Answer 8

Weight, BMI, blood glucose, lipid panel

Prolactin levels related to gynecomastia (dose-depemdent)

Question 9

Side effects of APS D2 occupancy should be between what percentage?

Answer 9

60-80%

> 80% = EPS

Question 10

Patient experiencing EPS should add what drugs?

Answer 10

Benztropine
Benadryl
Amantadine

Question 11

Pseudoparkinsonism - presentation and drug

Answer 11

Muscle rigidity, masked facies, shuffling gait, tremor

Drugs: benztropine or amantadine

Question 12

Benztropine used for what side effects

Answer 12

Pseudoparkinsonism
Dystonia or dyskinetic movements
Akathisia (beta blocker, lower dose)

Question 13

Tardive Dyskinesia (TD) - drugs to use

Answer 13

Austedo

Vilbenazine

Question 14

Drug to treat QTc prolongation

Answer 14

Beta Blocker

Question 15

Hyperprolactinemia causes

Answer 15

Dopaminne inhibits prolactin

FGAs more risk due to potency and affinity

Question 16

Neuroleptic Malignant Syndrome definition and treatment

Answer 16

Impaired body temp regulatio

Needs to be treated emergently - ER
Remove offending agent
Dantrolene

Question 17

Clozapine indications

Answer 17

Diminish S/S of EPS, specifially TD

Common S/E - excessive salivation, metabolic syndrome, ileus, rediced seizure threshold, tachy

Question 18

Mood Stablizer drugs

Answer 18

Divalproex, Valproate (Depakote)
Lithium
Caramazepine (Tegretol)
Latroigine

Question 19

Lithium indication and SE

Answer 19

Considered gold standard for bipolar/suicide
Ebstein anomaly (heart defect)

Drug/drug interactions - NSAIDS, ACE inhibitors, diurectics

Plasma trough level at 12hrs after last dose. >2 is considered toxic levels

Toxicity SE ataxia, N/V/D, vision changes, unsteadiness

Question 20

Divalproex, Valproate (Depakote)

Answer 20

mood stabilizer depression (manic) and seizure disorder

drug/drug interactions - carbamazine & lamictal

assoc with PCOS

Question 21

Carbamazepine indications and SE

Answer 21

Mood stabilizer/ bipolar (manic)
CYP induction -
Rash - Steven Johnsons Syndrome
Neural tube defects in pregnant woman

Question 22

Lamotrigine indication and SE

Answer 22

Mood stabilizer/ bipolar depression

Steven Johnsons Syndrome (titrate slowly)

When given with Divalproex, start with half the Lamotrigine dose and titrate slowly

Weight neutral

Question 23

what drugs treat both manic and depressive bipolar

Answer 23

olanzapine, quetiapine, cariprazine, lurasidone

Question 24

SSRI

Answer 24

citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline

fluvoxamine- not indicated for depression, ok for OCD and social anxiety disorder

sertaline- indicated for social anxiety, MDD, OCD, panic, PTSD, PMDD. Most lethal

paroxetine- short half life, discontinuation syndrome, PTSD, SAD, MDD, OCD, GAD

These drugs above are CYP450 inhibitors (increases drug concentration)

Question 25

SNRI

Answer 25

Venlafaxine, devenlafaxine, duloxetine, milnacipran, levomilnacepran

May help to alleviate chronic pain
Venlafaxine short half life - produces discontinuation syndrome, hypertension

Question 26

SARI

Answer 26

nefazodone, trazodone, vortioxetine

trazodone- more useful for sleep than depression, priaprism, orthostatic hypotens
vortioxetine- GI distress
nefazodone- Black box warning LIVER FAILURE (rarely used)

Question 27

SPARI

Answer 27

vilazodone- must take with food

works as SSRI and a partial agonist. Meaning it doesn’t reach its full potential

Question 28

NDRI

Answer 28

Bupropion- norepinephrine-dopamine reuptake inhibitor

Do not use with hx of seizures or eating disorder
Aids in smoking cessation
Lowest risk for sexual SE
Used as an augmenting agent to SSRI
Lowest risk for “switch” to mania in bipolar

Question 29

TCA

Answer 29

Amitriptyline, amoxapine, dlomipramine, desipramine, doxepin, imipramine, maprotiline, nortriptyline, protriptyline, trimipramine

Usually have suffix -triptyline or -ipramine

Desipramine - lethal in overdose (death by cardiac conduction, wide QRS)

SE- dry mouth, constipation, blurred vision, urinary retention, tachy

Amitriptyline- help alleviate chronic pain/migranes

Question 30

MAOI

Answer 30

iscocarboxazid, moclobemide, phenelzine, trancylopromine, selegeline

MAO-A (advanced) inactivates serotonin, norepi, dopamine)
MAO-B (basic) can only inactivate dopamine

phenelzine, transcyclopromine, isocarboxazid = MAO-A & B
selegiline = MAO-B

Must have 4-5 week wash out period, dietary restrictions, foods high in tyramine can cause hypertension Risk of serotonin syndrome

Most effective antidepressants.

Phenelzine for depression with atypical features
Trancyclopromine for anxiety

Question 31

Mirtazapine

Answer 31

Mirt-a-2-apine - is an a2 receptor antagonist, works as an antidepressant

Stimulates appetite, sedation at lower doses, can be useful in elderly population