UWORLD NEURO/PSYCH PHARM

Question 1

Pt with 6-12 Hz tremor of upper extremity over the last 10 years. Tx?

Answer 1

Essential Tremor. Beta Blocker

Question 2

Migraine drug that can cause hypertensive crisis?

Answer 2

sumatriptan

Question 3

Sumatriptan MoA

Answer 3

5HT1b/1d AGONIST

Question 4

MoA MG drugs?

Answer 4

Pyridostigmine. Carbamylates AChE to inactivate it.

Question 5

Drugs that phosphorylate AChE?

Answer 5

nerve gases. Sarin.

Question 6

Depressants that can cause glaucoma?

Answer 6

TCAs - anticholinergic effects

Question 7

Use and MoA of Cyclobenzaprine?

Answer 7

Muscle relaxant. blocks ACh.

Question 8

AChE inhibitor OD. Tx?

Answer 8

parlidoxime. Reactivates AChE (decreases ACh)

Question 9

OD on anticholinergic. TX?

Answer 9

physostigmine.

Question 10

No wine/cheese with what drugs?

Answer 10

MAO-I

Question 11

Antimuscarinic used in PD?

Answer 11

Benztropine, Trihexyphenidyl

Question 12

Ocular pain with halos?

Answer 12

Glaucoma

Question 13

2 distinct ways to Treat Parkinsons?

Answer 13

increase DA, decrease ACh

Question 14

AMPH MoA?

Answer 14

reverses reuptake transporter

Question 15

Don’t give these drugs to a bipolar patient in a mania phase

Answer 15

TCA

Question 16

Mood stablizing drugs: 
Principal agents (2)?
anti-seizure?
atypicals?
other class?

Answer 16

Li, valproate
Carbamazapam
Olanzapine, clozapine
Benzos

Question 17

Pt with controlled MG, comes in with MG symptoms. Give edrophonium. If symptoms improve? If they don’t?

Answer 17

1) Give more drug

2) cholinergic crisis. Stop drugs

Question 18

Penicillans MoA?

Answer 18

bind to transpeptidases (PBPs) that crosslink cell wall. Do not bind to wall itself.

Question 19

Organophosphates/pesticides MoA?

Answer 19

irreversible inhibit AChE -> increases ACh

Question 20

Organophosphate poisoning. Problem with atropine? DoC?

Answer 20

Will only reverse effects at Muscarinc receptors (no effect on muscle). Pralidoxime is DoC - reactivates AChE.

Question 21

Advantages/Disadvatages of buspirone?

Answer 21

no hypnotic, sedative, or euphoric effects but takes 2 weeks to work

Question 22

GABA A vs B vs C? (location, type of channel)

Answer 22

Brain, ion channel
Brain G-protein
Retina, Ion channel

Question 23

Tx: Malignant Hypertension vs Neroleptic Malignant syndrome vs Serotonin Syndrome

Answer 23

Dantrolene vs Dantrolene/D2 ags vs Cyproheptadine (5HT2 antag)

Question 24

Dantrolene blocks what Receptor?

Answer 24

Ryanodine

Question 25

All inhaled anesthetics have this undesirable effect?

Answer 25

increase blood flow to Brain increasing ICP

Question 26

Anti-depressant without any sexual side effects?

Answer 26

Bupropion

Question 27

Drugs that can result in serotonin syndrome: | Analgesic?

Answer 27

tramadol

Question 28

How secondary MoA that causes antibiotic to cause serotonin syndrome?

Answer 28

Linezoid. Weak MAO-I activity

Question 29

Supplement that increases peripheral metabolism of L-dopa?

Answer 29

Multivitamin, specifically Vit B6

Question 30

Chemoprophylaxis for menigococcus?

Answer 30

Rifampin

Question 31

Entacopone and Tolcapone. MoA?

Answer 31

COMT inhibitors. Decrease peripheral degradation of L-Dopa.

Question 32

Opioids that are weak Mu-agonists (can trigger withdrawl in pts high on opioids).

Answer 32

butrorphanol, pentazocine

Question 33

Antiseizure drug that is metabolized to phenobarbitol?

Answer 33

primidone

Question 34

Psychosimulant drug for narcolepsy?

Answer 34

modafinil

Question 35

Drugs that can result in serotonin syndrome: | Anti-emetic?

Answer 35

5HT3 receptor antagonist (ondansetron)

Question 36

Drugs that can result in serotonin syndrome:Antibiotic?

Answer 36

Linezoid

Question 37

Drugs that can result in serotonin syndrome: Neuropsychiatric?

Answer 37

Triptans

Question 38

Benzos that will increase fall risk?

Answer 38

Long acting benzos: | Cblordiazepoxide, Clorazepate, Diazepam, flurazepam

Question 39

To treat TCA-related cardic problems?

Answer 39

NaHCO3

Question 40

Effect of ACh on endothelial cells?

Answer 40

release of NO

Question 41

Li toxicity in increased what what type of drugs?

Answer 41

NSAIDs, Thiazides, ACE inhibitors

Question 42

MoA of TCA cardiotoxicity?

Answer 42

blocks cardiac Na channels