CPE Review

Question 1

Lithium teratogenicity:

Answer 1

heart valve defects

Question 2

carbamazepine teratogenicity

Answer 2

spina bifida, craniofacial problems, decreased birth weight

Question 3

valproic acid teratogenicity

Answer 3

spina bifida

Question 4

paroxetine teratogenicity

Answer 4

heart malformation - small risk

Question 5

therapeutic drug level of valproic acid

Answer 5

50 -100 mcg/ml

Question 6

carbamazapine therapeutic drug level

Answer 6

4-14 mcg/ml

Question 7

nortriptyline therapeutic drug level

Answer 7

50-150 ng/ml

Question 8

what is the composition of methylphenadate LA?

Answer 8

50:50 mix IR:CR

Question 9

how does methylphenadate work?

Answer 9

It blocks DA and NE reuptake

Question 10

guanfacine and CYP:

Answer 10

CYP 3A4 substrate

Question 11

clonidine and CYP

Answer 11

CYP 2D6 substrate

Question 12

is guanfacine or clonidine more potent?

Answer 12

clonidine

Question 13

what would be a good first line therapy for the kid who has the 2D6 issues and ADHD?

Answer 13

Methylphenadate Oros 27 mg (Concerta)

Question 14

which ADHD medication is a prodrug?

Answer 14

Vyvanse (lisdexamphetamine)

Question 15

list three opioids that are safe in renal insufficiency

Answer 15

fentanyl, oxycodone, methadone

Question 16

Ibuprofen dosing in children over 6 months:

Answer 16

5-10 mg/kg q 6-8 hours

Question 17

ibuprofen dosing in 12+ years

Answer 17

200 mg q 4-6 hours

Question 18

dosing of ibuprofen for a 46 pound child

Answer 18

150 mg q6 hours

Question 19

what drug would you use for neuropathic pain if the patient has hypertension?

Answer 19

pregabalin

Question 20

how long to relieve diabetic neuropathic pain?

Answer 20

4 weeks

Question 21

which opioid has the longest half life?

Answer 21

methadone

Question 22

NPO patient with Crohn’s, what would you give?

Answer 22

IV Ketorolac

Question 23

Emilia broke her hip and doesn’t want more narcotics

Answer 23

give APAP

Question 24

what opioid can you give a patient with a true morphine allergy?

Answer 24

fentanyl

Question 25

what type of drug is first line prophylaxis for migraines?

Answer 25

beta blockers

Question 26

if you have migraines with comorbid seizure or bipolar, give

Answer 26

VPA/ TOP

Question 27

If you have migraines with comorbid depression, give

Answer 27

TCA

Question 28

what are contraindications for using triptans?

Answer 28

ischemic heart condition, MI, cerebrovascular issues

Question 29

how would you treat a migraine with light sensitivity?

Answer 29

sumatriptan

Question 30

what is the mechanism of action of methotrexate?

Answer 30

inhibits folic acid metabolism

Question 31

if a patient is taking methotrexate and sulfasalazine, what else should you add on?

Answer 31

folic acid

Question 32

should NSAIDs be used alone in RA?

Answer 32

no, as a bridge to DMARD therapy

Question 33

what is important to consider when a patient is on zolendronic acid?

Answer 33

check serum creatinine levels

Question 34

what is the definition of fever in children?

Answer 34

100.4

Question 35

why is paroxetine class D?

Answer 35

heart malformations

Question 36

what is the max dose for paroxetine?

Answer 36

60 mg

Question 37

which trial was inadequate?

Answer 37

sertraline 50 mg - can go up to 200 mg

Question 38

what is not a common side effect of SSRIs?

Answer 38

orthostatic hypotension

Question 39

what antidepressant doesn't cause weight gain, but can cause weight loss instead?

Answer 39

bupropion

Question 40

what augmentation therapy can you use for MDD?

Answer 40

lithium

Question 41

when is it OK to get off of seizure meds?

Answer 41

control within one year of seizure onset

Question 42

what tests do you order for patient on VPA?

Answer 42

AST/ASL

Question 43

how do you initiate lamotrigine therapy if no other antiseizure meds?

Answer 43

25 mg/ day

Question 44

how do you initiate lamotrigine therapy if patient is on valproate?

Answer 44

25 mg every other day

Question 45

how do you initiate lamotrigine therapy if patient is on carbamazapine?

Answer 45

50 mg/ day

Question 46

interaction between OCPs and lamotrigine?

Answer 46

OCP lower lamotrigine levels by 50%

Question 47

how do you convert from carbamazepine to oxcarbazapine?

Answer 47

1.5 carb: 1 oxcarb

Question 48

carbamazapine black box warning:

Answer 48

SJS, TEN. Agranulocytosis

Question 49

lamotrigine black box warning

Answer 49

SJS

Question 50

subtherapeutic dose of valproate can be bumped up to how much?

Answer 50

1000 mg/day

Question 51

nortriptyline CYP

Answer 51

2D6 substrate

Question 52

paroxetine CYP

Answer 52

2D6 substrate and inhibitor

Question 53

name a drug that is a 1A2 inducer

Answer 53

caffeine

Question 54

if someone is allergic to sulfasalazine, they would have a reaction to

Answer 54

Bactrim

Question 55

what antibodies are responsible for type I hypersensitivity reactions?

Answer 55

IgE

Question 56

how to rechallenge sulfonamides?

Answer 56

don't, they can cause serum sickness

Question 57

how to rechallenge penicillin?

Answer 57

graded challenge or desensitization

Question 58

which vaccine is contraindicated in pregnancy?

Answer 58

Varicella

Question 59

absolute risk of not having problems with drug X 5% and drug Y 20%

Answer 59

75% and statistically significant

Question 60

which parkinson's treatment should not be used alone?

Answer 60

entacapone (COMT), should be used with levodopa

Question 61

what do you give a patient on levodopa/carbidopa for wearing off symptoms?

Answer 61

entacapone

Question 62

name a drug that could exacerbate parkinson's symptoms

Answer 62

chlorpromazine or prochlorperazine

Question 63

which drug is not adjunctive with paroxetine?

Answer 63

venlafaxine - both are 2D6

Question 64

what type of hypersensitivity reaction is hives?

Answer 64

Type I (TH2)

Question 65

what type of hypersensitivity reaction is puritis?

Answer 65

type IV (TH1), delayed type