Side Effects

Question 1

HAM side effects

Answer 1

antiHistamine- sedation, weight gain
Adrenergic- hypotension
antiMuscarinic- dry mouth, blurred vision, urinary retention, constipation

Question 2

Which class of antidepressants do you see HAM side effects?

Answer 2

TCAs and low potency antipsychotics

Question 3

Signs of Serotonin Syndrome

Answer 3

confusion, flushing, diaphoresis, tremor, myoclonic jerks, hyperthermia, hypertonicity, rhabdomyolysis, renal failure and death

Question 4

Which combination of meds usually cause serotonin syndrome?

Answer 4

SSRIs and MAOIs

Question 5

What is the treatment for serotonin syndrome?

Answer 5

stop the drugs

Question 6

What causes hypertensive crisis?

Answer 6

buildup of catecholamines, MAOI plus tyramine-rich foods (red wine, cheese, cured meats, chicken, liver)

Question 7

EPS- extrapyramidal syndrome

Answer 7

Parkinsonism - masklike faces, cogwheel rigidity, pill-rolling tremor, akathisia–restlessness and agitation, dystonia- sustained contraction of muscles of neck, tongue, eyes, diaphragm.

Akithisia- anxiety and distress; fidgity

Dystonia- sustained painful muscle contractions of neck, tongue, eyes (oculogyric crisis)

–>reversible with Benztropine

Question 8

Which atypical antipsychotic usually causes hyperprolactinemia? - galactorrhea, gynecomastia, irregular menses

Answer 8

Risperdone (and all typical antipsychotics)

Question 9

Tardive dyskinesia

Answer 9

choreathetoid muscle movements of tongue and mouth

Question 10

Neuroleptic Malignant Syndrome

Answer 10

fever, tachycardia, hypertension, tremor, elevated CPK, lead pipe rigidity

Question 11

Drug interactions - name all of the inducers of cytochrome P450

Answer 11

smoking
carbamazepine
Barbituates
St. John’s Wort

Question 12

Drug interactions - important inhibitors of cytochrome P450

Answer 12

Fluvoxamine
Fluoxetine
Paroxetine
Duloxetine* - SNRI
Sertaline