Antipsychotics

Question 1

Anti-depressants: After therapeutic dose is achieved, how long does it take for symptoms to improve?

Answer 1

3-6 wks

Question 2

When do u switch for another med/increase dose in antidepressant?

Answer 2

2 months

Question 3

Which drug causes QT lengthening?

Answer 3

TCA

Question 4

Tertiary TCA examples?

Answer 4

amitriptyline, Imipramine, doxepin, clomipramine

Question 5

Secondary TCA examples?

Answer 5

Desipramine, notrtriptyline

Question 6

Effective med for depression?

Answer 6

MAOI

Question 7

MAOI S/E?

Answer 7

Sedation, weight gain
dry mouth, Postural HT
Sexual dys, sleep disturbance

Question 8

what med if taken with tyramine rich food cause HTN crisis?

Answer 8

MAOI

Question 9

How long do u wait before switching from SSRI to MAOI?

Answer 9

2 EXCEPT fluoxetine 5 wks

Question 10

Serotonin syndrome symptoms include

Answer 10

• Abdominalpain • Diarrhea
• Sweats • Tachycardia
• HTN
• Myoclonus
• Irritability • Delirium

Question 11

Severe S/E in serotonin syndrome?

Answer 11

Hyperpyrexia, cardiovascular shock and death.

Question 12

SSRI is treatment for

Answer 12

depression and anxiety

Question 13

SSRI S/E

Answer 13

GI upset, sexual dys

insomnia+sedation=fatigue

Question 14

discontinuation syndrome caused by?

Answer 14

SSRI, SNRI

Question 15

discontinuation syndrome cause

Answer 15

agitation, nausea, disequilibrium and dysphoria

Question 16

Fluoxetine + and - ?

Answer 16

\+
low incidence of discontinuation syndrome
-
active metabolite may build up
Significant P450 interactions

Question 17

Antidepressant: Bad choice in pts already on a number of meds

Answer 17

Fluoxetine

Question 18

QT interval prolongation in Citalopram dose above

Answer 18

40 mg/day

Question 19

Antidepressant (SSRI) with fast response?

Answer 19

Escitalopram

Question 20

Venlafaxine not given to pts w/

Answer 20

HTN

Question 21

Venlafaxine s/e

Answer 21

Sexual s/e
QT prolongation
nausea
Discontinuation syndrome

Question 22

effective for physical symptoms of depression?

Answer 22

Duloxetine

Question 23

What antidepressant inc cholesterol and triglyceride?

Answer 23

Mirtazapine

Question 24

what drug is sedating at low doses and activating at high doses?

Answer 24

Mirtazapine, 30mg is cutpoint

Question 25

hyperlipidemia pt, what antidepressant is avoided?

Answer 25

Mirtazapine

Question 26

Bupropion is good for?

Answer 26

depression and smoking cessation

Question 27

Which med decreases suicide rate?

Answer 27

Lithium

Question 28

prophylaxis for mania/depressive ep?

Answer 28

lithium

Question 29

Factors predicting positive response to lithium

Answer 29

- classic mania - mania followed by depression - Prior long-term response or family member with good response

Question 30

Affective in mania only (depression no)

Answer 30

valporic acid

Question 31

Factors predicting a positive response to valporic acid?

Answer 31

-rapid cycling patients - comorbid substance issues – mixed patients – Patients with comorbid anxiety disorders

Question 32

___ is better tolerated than lithium

Answer 32

valporic acid

Question 33

First line agent for acute mania and mania prophylaxis

Answer 33

Carbamazepine

Question 34

used for neuropathic/chronic pain

Answer 34

Lamotrigine

Question 35

before Lamotrigine is started check?

Answer 35

Liver function test

Question 36

when to use antipsychotics?

Answer 36

``` Schizophrenia Psychotic depression Bipolar delirium dementia ```

Question 37

Typical antipsychotics (high pot)?

Answer 37

Haloperidol, Pimozide

Question 38

which drug have higher extrapyramidal S/E?

Answer 38

Typical antipsychotics: HIGH potency

Question 39

Typical antipsychotics: low potency s/e?

Answer 39

Higher risk for Cardiotoxic and Anticholinergic adverse effects

Question 40

Typical antipsychotics (low pot)?

Answer 40

Chlorpromazine and Thioridazine.

Question 41

which atypical antipsychotic drug act like typical in high doses?

Answer 41

Risperidone at 6 mg

Question 42

which antipsychotic drug is used with patients who have hyperactivity?

Answer 42

Risperidone

Question 43

Olanzapine s/e?

Answer 43

Weight gain hypertriglyceridemia hypercholesterolemia hyperglycemia

Question 44

Extrapyramidal side effects include

Answer 44

Acute dystonia, Parkinson syndrome, Akathisia

Question 45

Anxiolytics indications

Answer 45

– Panic disorder – Generalized Anxiety disorder – Substance-related disorders and their withdrawal – Insomnias

Question 46

Buspirone +/-

Answer 46

+ no sedation - 2 wks for results

Question 47

Buspirone will not work on the anxiety if

Answer 47

patient used to take BZD

Question 48

How long is BZD given for

Answer 48

3-5 days

Question 49

Benzodiazapine s/e?

Answer 49

Dependence Tolerance Cognitive deficits Disinhibition

Question 50

drug to treat insomnia? (BZD)

Answer 50

triazolam

Question 51

drug to treat anxiety? (BZD)

Answer 51

Lorazepam Oxazepam Diazepam