AntiPyschotics

Question 1

SSRI common SE

Answer 1

sexual dysfunction 
dry mouth
prolonged bleeding time, 
weight gain
insomnia
jitteriness

Question 2

ssri with highest wt gain

Answer 2

paxil

Question 3

Drug Interactions- more with Paroxetine (Paxil), Fluoxetine (Prozac)
_____ enzyme inhibition in liver cytochromes)

Answer 3

(P450 2D6

Question 4

Patients on paroxetine (Paxil) or fluoxetine (Prozac) will have less acute pain relief with

Answer 4

Codeine

Question 5

______ given along with SSRIs (all) can have an increased risk of GI bleeding depending on dose, duration, age of patient, hx of GI bleed, ETOH,

Answer 5

NSAIDS

Question 6

SNRI meds include:

Answer 6

Effexor ; cymbalta

Question 7

MOA of SNRI

Answer 7

Inhibits both serotonin and norepinephrine reuptake

Question 8

SNRI’s (unlike SSRI’s) are effective for :

Answer 8

Neuropathic Pain Syndromes
Menopausal symptoms
Migraine prophylaxis
Chronic orofacial pain

Question 9

Caution with use of epinephrine containing local anesthetics & SNRI becaue it -may increase _____

Answer 9

BP

Question 10

SSRI/SNRI with tramadol?

Answer 10

Probably only significant for paroxetine (Paxil) and Fluoxetine (Prozac) due to CYP 450 2D6 inhibition. But you will get a probable phone call from the pharmacy!

Question 11

________ is a group of symptoms that may occur following use of certain serotonergic medications or drugs. Symptoms include high body temperature, agitation, increased reflexes, tremor, sweating, dilated pupils, and diarrhea.

Answer 11

Serotonin syndrome (SS)

Question 12

SSRI/SNRIs with _____(3)_____ cause DDI / Serotonin Syndrome

Answer 12

• migraine medications (triptans) w
• MAOIs
• St. John’s Wort

Question 13

TCA overdose is

Answer 13

lethal

Question 14

TCA’s can be used for

Answer 14

migraine prophylaxis

& Neuropathic pain symdomes

Question 15

Some TCA’s are:

Answer 15

Amitriptyline (Elavil)*
Nortriptyline (Pamelor)*
Doxepin (Sinequan)
Imipramine (Tofranil)
Desipramine (Norpramin)

“ELAVIL & PAMELOR are TCA cllub members- they don’t take NO for and ans and love to wear SINQUNCE”

Question 16

TCA SE are:

Answer 16

• dry mouth, tachycardia, (anticholenergic)
• sedation, carb craving / wt gain (antihistamine)
• Orthostatic HPN

Question 17

TCA snad macrolide antibiotics such as erythromycin, clarithromycin) cause….?

Answer 17

QT interval prolongation with antiarrythmia

Question 18

Use of sympathomimetics (epinephrine) contraindicated with

Answer 18

MOAIs

Question 19

Used in smoking cessation as well as depression. give you dry mouth

Answer 19

Buproprion (Wellbutrin)

Question 20

This drug increases release of both serotonin and norepinephrine at the synaptic level. Common side effects include sedation, weight gain, dizziness, dry mouth, constipation and carbohydrate craving

Answer 20

Remeron

Question 21

______ is most commonly used as an adjunctive medication for insomnia due to its sedating properties with SE of sedation, orthostatic hypotension

Answer 21

Trazadone

Question 22

synergistic with opioids

Answer 22

BENZOs

Question 23

Has these Withdrawal symptoms: increased anxiety, sleep disorder, restlessness, agitation and nausea

Answer 23

BENZOs

Question 24

Used to abrupt cessation of seizures

Answer 24

BENZOs

Question 25

Macrolide antibiotics (erythromycin, clarithromycin) inhibit CYP 450 3A4 which metabolizes all po benzodiazepines EXCEPT lorazepam (Ativan) and oxazepam (Serax). Increased levels could lead to ______?

Answer 25

oversedation

Question 26

Extrapyramidal Effects of Antipsychotics (EPS) are :

Answer 26

Parkinsonian SEs- drooling ects Akathisia Dystonic reactions-

Question 27

Oral/facial/lingual abnormal involuntary movements-Resulting from Potentially irreversible movement disorder due to long term exposure

Answer 27

TARDIVE DYSKINESIA (TD)

Question 28

Bipolar Affective Disorder (BAD): Treatment

Answer 28

- Mood Stabilizers (Lithium, Anticonvulsants, Atypical Antipsychotics) - Benzodiazepines - Antidepressants

Question 29

______ SEs include : Cognitive difficulties (poor concentration and memory), dry mouth, hand tremor,

Answer 29

Lithium

Question 30

Lithium levels can be INCREASED ( reduced renal clearance) by:

Answer 30

NSAIDS

Question 31

BURNING, TINGLING, PINS AND NEEDLES

Answer 31

Neuropathic

Question 32

Rarely used – implies a psychological cause

Answer 32

Psychogenic

Question 33

Unclear etiology.

Answer 33

Idiopathic:

Question 34

Tissue damage/injury, inflammatory, often localized

Answer 34

Nociceptive

Question 35

Anorexia: ______ levels of serotonin

Answer 35

high

Question 36

bulemia: ______levels of serotonin

Answer 36

low

Question 37

the test for depressioN

Answer 37

PHQ – 9 ;

Question 38

the test for ptsd

Answer 38

PC-PTSD

Question 39

What is the most common thing DMD will see?

Answer 39

Anxiety

Question 40

the test for ANX

Answer 40

GAD-7

Question 41

the test for hazardous or harmful alcohol consumption.”

Answer 41

AUDIT