Recap

Question 1

Person has generalized anxiety with an acute onset of recent attacks. What drugs do you give them for short and long term?

What if they have a hx of heroin and alcohol abuse? Downside to this drug?

Answer 1

Short term - benzo
Long term - SSRI

Addictive personality - give buspirone, but it takes 1-2 weeks for effects.

Question 2

Do not give fluoxetine with what S-H?

Answer 2

Do not give fluoxetine (SSRI) with Ramelteon (melatonin S-H) bc of CYP inhibiton by fluoxetine

Question 3

Treatment of EPS

Answer 3

trihexylphenydyl, benztropene, diphenhydramine

Question 4

EPS worst with?

Answer 4

Haloperidol and all typical anti-psychotics

Question 5

Anti-depressants:

sedation, muscarinic, hypotension

Answer 5

typicals - chlorpromazine, fluphenazine, haloperidol

Question 6

indications for what drug: tx resistant schizophrenia and suicide.

Answer 6

clozapine (anti-psychotic)

Question 7

adverse effects of clozapine -

agranulocytosis and….

Answer 7

metabolic syndrome

Question 8

monitor thyroid function in pts taking

Answer 8

Lithium
Movement (tremors)
Nephrogenic DI
hypOthyroid
Pregnancy Contraindicated

Question 9

prolonged QT interval

Answer 9

ziprasidone (atypical antidepressant)

and haloperidol

Question 10

elevated PRL levels

Answer 10

risperidone and Haloperidol (and all typical antipsychotics)

Question 11

Main (only-ish) side effect is seizures when administered at high doses treatment for anorexia and bulemia, as well as 1st line tx of depression with hypersomnia.

Answer 11

Buproprion (NDRI - anti depressant)

Question 12

High potency v. low potency typical antidepressants

Answer 12

High potency (neuro EPS) - fluphenazine, haloperidol
Low potency (alpha, Histamine, anti-cholinergic) - chlorpromazine

Question 13

suicide prevention (two drugs)

Answer 13

lithium (antipsychotic mood stabilizer) clozapine (atypical antidepressant)

Question 14

sexual dysfunction in 1/2 of all patients on ___ class

What does not cause sexual dysfunction?

Answer 14

SSRI

buproprion

Question 15

Low potency anti-depressants have these side effects (along with TCAs)

Answer 15

alpha (orthostatic hypot), Histamine, anti-cholinergic -const/dry mouth/dizzy

Question 16

Highly sedating antidepressant

Priapism

Answer 16

Trazodone

Question 17

Drug that inhibits reuptake of monoamines (NE, dop, 5HT). Increases sympathetics. Coronary artery vasospasm (Myocardial ischemia).

Answer 17

cocaine

Question 18

Best treatment for alcohol withdrawal.

Answer 18

Benzodiazepines.
Diazepam (long acting bezo- best). BAD for liver.
Lorazepam, oxazepam (short acting benzo). BETTER for liver.

Question 19

What drug in treatment of alcohol dependence decreases cravings?

MOA?

Answer 19

Naltrexone

Mu-opioid receptor antagonist

Question 20

What drug in treatment of alcohol dependence does not decrease cravings, but causes aversion?

MOA

Answer 20

Disulfram

ALDEHYDE dehydrogenase inhibitor

Question 21

MOA of acamprosate.

Answer 21

NMDA receptor antagonist and GABA agonist.

Question 22

Non-benzo used to treat insomnia.

Answer 22

Zolpidem and zaleplon (fall asleep), eszopiclone (stay asleep)

Question 23

Suspect what?
Fever
Encephalopathy (confusion)
Vitals (temp/BP)
Enzyme elevation
Rigidity

Answer 23

Neuroleptic Malignant Syndrome (antipsychotic side effect)

Question 24

Serotonin Syndrome

Answer 24

Activity (tremor)
Agitation
Autonomics (hypertension, hyperthermia, tachycardia)

Question 25

TCA toxicity

Answer 25

Cardiotoxicity
Convulsions
Coma

Question 26

acute dystonia (mm contractions), akathisia (leg restlessness), dyskinesia, parkinson-like movements (tremor, rigidity, bradykinesia, masked facies)

Answer 26

EPS (typical > atypical side effect)

Question 27

Involuntary movement after chronic use (lip smacking).

Answer 27

Tardic dyskinesia

Question 28

Muscle contractions in EPS

Answer 28

acute dystonia

Question 29

Leg restlessness in EPS

Answer 29

akathisia

Question 30

Tremor, rigidity, bradykinesia, masked facies in EPS

Answer 30

Parkinson-like

Question 31

MOA of ____ inositol monophosphate inhibition

Answer 31

lithium

Question 32

MOAI’s have what MAO

Answer 32

irreversible inhibitor of monoamine oxidase (except selegine)

Question 33

anticholinergic/antimuscarinic toxicity

Answer 33

• typical anti-depressant (chlorpromazine)

- TCAs (amytriptyline, impiramine)

Question 34

ACEI toxicity

Answer 34

DUMBBELSS

Question 35

Anti-muscarinic drug

Toxicity

Answer 35

atropine

Question 36

Amenorrhea for 3 months. Schizophrenic/bipolar treatment. Etiology.

Answer 36

Risperidone and Haloperidol

-due to hyper-PRL. Block D2, increase PRL, causing amenorrhea.

Question 37

Pure opioid receptor antagonist - antidote for overdose.

Answer 37

Naloxone, for opioid overdose.

Question 38

What two physical signs indicate opioid/narcotic use?

Answer 38

miosis and constipation.

Question 39

NMDA receptor antagonist

Answer 39

ketamine

Question 40

flumazenil use

Answer 40

intoxication/andicdote for:

benzo, Z-Z-EsZ

Question 41

Buproprion v. Buspirone

Answer 41

Buspirone - S-H, anti-anxiety, no side effects

Buproprion - NDRI for smoking, stimulant. Toxicity - Seizure in anorexic/bulemics.

Question 42

Seizure side effects

Answer 42

• buproprion

- typical anti-depressants and clonapine/olanzapine

Question 43

Taking what types of meds interfere with Lithium excretion?

Answer 43

thiazide diuretics, ACEIs, NSAIDs

Question 44

Anti-seizure and bipolar

Answer 44

lamotrigine, carbamazapine, valproate (mood stabilizers)