Substances & Medications Flashcards
An overdose on which opiate specifically can lead to seizures?
Meperidine. Accumulation of normeperidine, a metabolite, with cerebral irritant properties.
How long does intoxication with PCP usually last?
8 to 12 hours (sometimes psychosis can last up to weeks)
How long does marijuana stay in the urine? PCP? alprazolam?
marijuana: 3 days to 4 weeks (depending on use)
PCP: 8 days
alprazolam: 3 days
Antiretroviral agents lead to increases/decreases in SSRIs, bupropion, meperidine, and various benzos.
Increases
Patients on lithium should have TSH drawn every ___ months.
6
When WBC drop below _____, start twice weekly CBCs while continuing clozapine. When WBC drops below ____, daily CBCs and stop clozapine.
3000-3500 = CBC q2wks, continue cloz <3000 = CBC daily, stop cloz
What is the MOA of ramelteon? Most common side effect? Contraindications?
Mimics melatonin’s sleep inducing properties; high affinity for melatonin’s MT1 and MT2 receptors in the brain.
Headache
contraindications: severe hepatic impairment, severe sleep apnea, severe COPD
**no rebound insomnia or withdrawal effects!!
While on carbamazepine, what should be monitored every 3 months?
liver function tests
Ginseng and St. John’s wort are used to treat
depression
Dissociative-like states with sleepwalking and binge-eating, aggressive outbursts, and night-driving–all while patient is unaware of behavior–is caused by
zolpidem, zaleplon
Which anesthetic is used frequently for ECT?
Methohexital (lower cardiac risks than other barbiturates; rapid unconsciousness and quick reawakening)
Describe the following drugs’ relationships to carbamazepine levels: erythromycin, OCPs, theophylline, warfarin, cisplatin
erythroycin: increases carbamazepine
theophylline and cisplatin: decrease carbamazepine
warfarin, OCPs: decreased BY carbamazepine
What do you do when a patient on clozapine has seizures?
Stop the clozapine (this happens when levels over 400), start phenobarbital. Can restart carbamzepine at 50% of its previous dose and gradually raise
Why are haldol and fluphenazine preferred in elderly patients with cardiovascular problems and prostatic hypertrophy?
because they are high potency and low in anticholinergic side effects
What is the cardiac risk posed by thioridazine?
prolongs QT interval
