Psychopharm Final

Question 1

MOA of common antidepressants?

Answer 1

inhibit serotonin and NE reuptake
Stimulate non-adrenergic and dopamine activity
Alpha 2 antagonism of nor-adrenergic and seratonergic neuron

Question 2

ADR of antidepressants DDRI

Answer 2

SSRI: insomnia
appetite change
Nausea
Dry mouth
Headache 
sexual Dysfx

Question 3

ADR of antidepressants TCA

Answer 3

anticholinergic: dry mouth/constipate/urinary retention/blur vision

Histaminic: Sedation/weight gain

Alpha 1 adrenergic blockade: orthostatic hypotension/ falls

there can be arrhythmias and OD so dont combine be careful..

Question 4

Widended QRS?

Answer 4

overdose

Question 5

What is serotonin syndrome?

Answer 5

agitation
diaphoresis
tachycardia
autonomic nstability
clonus
tremor
hyperreflexia****
increase bowel sounds

everything mostly in LE.

Question 6

Management of serotonin syndrome?

Answer 6

Discontinue drug
Supportive care (icu)
Control agitation
5-HT2A antagonist
Control instability and hyperthermia

Question 7

what dont you manage serotonin syndrome with?

Answer 7

Propranolol
Bromocriptine
Dantrolene

Question 8

Indications for Lithium and Sideffects?

Answer 8

mood stabilizer (bipolar)

ADR: Tremor
lethargic
confused
seizure
coma
GI issues.

other mood stabilizers: anti-convulsive
anti-psychotics

Question 9

What are major signs of toxicity with Lithium?

Answer 9

altered mental status
muscle fasciculation
stupor
seizure 
coma
hyperreflexia

monitor every 6 mo

Question 10

Neurobiology of schizophrenia?

Answer 10

Dopamine hyperactivity in mesolimbic pathway

Faulty NMDA synapse on GABA interneurons in PFC. cause overstimulation of b brainstem neurons to mesolimbic.

Question 11

side effects of D2 receptor blockers

Answer 11

more likely to cause movement problems and hyperprolactinemia

Question 12

DWaht are 1st gen anti-psychotics?

Answer 12

D2 blockade drugs
targets mesolimbic (hallucination) and mesocortical (speech/motor)

can cause movement problems and hyperprolactinemia

Question 13

What are 2nd gen anti-psychotics?

Answer 13

work at D2 and serotonergic receptors

Side effects:
cause HTN
Metabolix syndrome
Diabetes 
Wt gain

Question 14

Neuroleptic Malignant syndrome?

Answer 14

reaction to neuroleptic meds

rigidity
Hyperthermia
Autonomic instability
Changes in LOC

Question 15

What is tardive Dyskinesia

Answer 15

unwanted movement of jaw mouth face

caused by first then antipsychotics.