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gen pharm Flashcards

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1
Q

FDA requires that generics not be significantly different from the parent compounds in what way? (6x)

A

BIOEQUIVALENCE

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2
Q

After OD, pt has fever, confusion, tachycardia, dry mouth, urinary retention, dilated and unresponsive pupils. Which medication would treat this? (Anticholinergic toxicity) (4x)

A

PHYSOSTIGMINE

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3
Q

Pt presents to ED c/o ringing in ears, abdominal pain, and is found to have mild metabolic acidosis. Overdose of what substance? (4x)

A

ASPIRIN

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4
Q

Hepatitis C treatment with interferon can cause what psychiatric symptom? (3x)

A

DEPRESSION

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5
Q

Which of the following agents used to treat patients with Alzheimers disease has a mechanism of action related to an antiglutaminergic mechanism? (x2)

A

MEMANTINE

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6
Q

In addition to life support, which class of meds to consider for the treatment of neuroleptic malignant syndrome? (2x)

A

DOPAMINE AGONISTS (bromocriptine)

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7
Q

What medication may cause mood d/o in pts being treated for melanoma? Also worsens fatigue and cognitive inefficiency: (2x)

A

INTERFERON

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8
Q

What med is effective in tx of motor/vocal tics associated w Tourette syndrome refractory to tx with antipsychotics and alpha adrenergic agonists? (x2)

A

TETRABENAZINE

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9
Q

Pt confused, disoriented, dry mouth, dilated unresponsive pupils. Likely ingested: (2x)

A

BENZTROPINE

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10
Q

Flumazenil is used to treat: (2x)

A

BENZO INTOXICATION

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11
Q

This is a relative contraindication for interferon treatment in pt’s with Hepatitis C: (2x)

A

DEPRESSION WITH SUICIDAL IDEATION

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12
Q

The effects of caffeine on which of the following results in increased dopaminergic activity? (x2)

A

ADENOSINE RECEPTOR

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13
Q

A pt with cancer, pain, depressed mood, poor appetite, fatigue, impaired concentration, prognosis is less than three weeks. What should you treat with?

A

METHYLPHENIDATE

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14
Q

Contraindication for treatment for psychostimulants

A

UNDERLYING HEART DEFECT

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15
Q

54 yo female takes prozac 60 mg for MDD, having worsening migraines then fever, diarrhea, and “muscles are tightening up”. Which medicine is causing these sx?

A

SUMATRIPTAN

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16
Q

84 yo pt goes to ED with fever, dry mouth, visual hallucinations. Is found tachycardia, restless, toxicity of what medication most likely caused symptoms?

A

BENZTROPINE

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17
Q

Prolonged ingestion of high doses pyridoxine causes:

A

SUBACUTE SENSORY NEUROPATHY

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18
Q

Physostigmine is useful in treating toxic syndrome from overdose with:

A

SCOPOLAMINE

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19
Q

Pt in ED for treatment of OD - was found 4 hrs ago after ingesting 10 cold med packs of 650mg Tylenol, antihistamine, and alpha 1 agonist decongestant. Pt is pale and vomiting. How do you decide whether to use N-acetylcysteine as an antidote?

A

PT’S SERUM N-ACETYL-P-AMINOPHENOL (APAP) LEVEL OVER TIME

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20
Q

Tx of pts w/ substance abuse who have acute pain

A

PATIENT-CONTROLLED ANALGESIA

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21
Q

Which of the following agents has been shown to moderate weight gain in some pts treated w/ valproate and atypical antipsychotic?

A

METFORMIN

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22
Q

Pt took 20 tabs 500mg acetaminophen tabs 6 hours ago. Pt is 52kg, pulse 96, BP 135/65. Pt alert and in NAD. Serum acetaminophen level is 60 Ug/ml. Liver fxn test are minimally elevated. Most appropriate action?

A

N-ACETYL-CYSTEINE

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23
Q

A post-op pt’s was receiving 75mg IM meperidine. After switching to meperidine 100mg po pt reports inadequate pain relief. She has no past psych and abuse issues. This is due to:

A

THE LOWER POTENCY OF PO MEPERIDINE COMPARED TO IM

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24
Q

Acetylcysteine is Tx of choice for OD of:

A

ACETAMINOPHEN

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25
OD on sleeping pill. Hot skin, blurry vision, urinary retention, dry mucous membranes, tachycardia, decreased bowel sounds. What is the pill?
DIPHENHYDRAMINE
26
Risk of hepatotoxicity will peak in how many hours after acetaminophen overdose?
72 TO 96 HOURS
27
MC complication of corticosteroid therapy?
MOOD DISORDER
28
Molecular targets for improving cognition in schizophrenia have shown promise via which of the following mechanisms?
D1 RECEPTOR AGONISM
29
Which med is helpful in Tourette Syndrome who can't tolerate clonidine?
GUANFACINE
30
Guanfacine's primary effect is through what mechanism of action?
PRESYNAPTIC ALPHA2 ADRENERGIC RECEPTOR ACTIVATION
31
Key element in emergency treatment of pt w serotonin syndrome, beyond stopping offending agent is:
SUPPORTING VITAL FUNCTIONS
32
Restlessness, myoclonus, hyperreflexia, diaphoresis, shivering, tremor, and confusion are compatible with which diagnosis?
SEROTONIN SYNDROME
33
Research on the use of psychostimulants to treat pts w/ secondary depressive symptoms in medical setting suggest:
WHEN TREATED WITH THESE AGENTS, PT MAY ENGAGE IN REHABILITATION SOONER.
34
A psychiatry consult is placed regarding a patient with SI. History of Bipolar disorder and admitted for VRE bacteremia. BP of 171/95, temp of 100.9. Has tremors, hyperreflexia, myoclonic jerks, not oriented at all, has visual hallucinations. Meds include linezolid, lithium, sertraline, Risperdal. What is diagnosis?
SEROTONIN SYNDROME
35
What drug has been known to cause hypertensive crisis?
PHENELZINE
36
African Americans tend to have higher activity of which of the following cytochrome p450 enzymes?
3A4
37
Sudden death in children taking which medication?
TRICYCLICS
38
47 yo pt presents with fever, confusion, and tremor and found to be tachy and diaphoretic. Clonus easily elicited on exam. Pt suspected to have serotonin syndrome, is taking Celexa and Lithium. What additional medication may have contributed to syndrome?
ST. JOHN'S WORT
39
Autonomic instability, nonfocal neurological signs, and elevated temp associated with which elevated lab value?
CREATININE PHOSPHOKINASE (CPK)
40
Drug-drug interactions in pts taking HIV meds are particularly problematic with which medication:
METHADONE
41
In addition to benzos, which class of meds is assoc with falls in pts older than 60?
ANTIDEPRESSANTS
42
The potency of medication refers to which of the following properties of a medication?
RELATIVE DOSE REQUIRED TO ACHIEVE A CERTAIN EFFECT
43
60 yo pt with chronic schizophrenia takes cogentin for neuroleptic induced parkinson now has increased urine retention and confusion. What medication would be the best alternative for treating this patient's condition?
AMANTADINE
44
Most of the body's serotonin is located where?
GI TRACT
45
Common side effect of acetylcholinesterase inhibitors
DIARRHEA
46
Diphenhydramine's ability to treat acute dystonia is due to action on which receptor?
MUSCARINIC-1
47
28 y/o with BMDII wants to use phototherapy for depressive Sx treatment in winter. What should you advise?
CAN BE USED BUT REQUIRES VIGILANCE AND CAREFUL TITRATION OF DOSE
48
Which med is used to treat hep C viral infection and is associated with depression, anxiety, and cognitive impairment?
INTERFERON-ALPHA
49
In pts who surreptitiously use excess sulfonylurea, which of the following substances can be administered to r/o possible insulinoma?
TOLBUTAMIDE
50
Which of the following medications inhibits the enzyme ETOH acetaldehyde dehydrogenase?
DISULFIRAM
51
Buprenorphine's advantages over clonidine, in the management of patients with opioid withdrawal, include better control of which of the following symptoms?
CRAVINGS
52
Therapeutic index is a relative measure of which of the following characteristics of a medication?
RELATIVE MEASURE OF DOSING TOXICITY TO SAFETY
53
Pharmacokinetic factor that declines w/ aging?
GLOMERULAR FILTRATION RATE
54
Patients >65 y/o are more sensitive to psych meds. What physiologic change occurs with aging?
DECREASED PHASE 1 OXIDATION
55
Agitated pt gets rapid tranquilization in ED. Using oral concentrate instead of IM or IV has what advantage?
DECREASED FEELINGS OF HELPLESSNESS
56
What herbal (phytomedicinal) is used as a hypnotic?
VALERIAN
57
The FDA requires that pharmaceutical companies demonstrate that a generic drug is not significantly different from the parent compound in which way?
BIOEQUIVALENCE
58
What is the underlying mechanism of action of sildenafil in erectile dysfunction?
ENHANCEMENT OF NITRIC OXIDE
59
What substance is associated with a risk of bleeding when taken with anti-platelet drugs or warfarin?
GINGKO BILOBA
60
Clonidine mechanism of action:
ALPHA-2 AGONIST
61
42 y/o pt has primary insomnia. Pt complains of difficulty falling asleep, but then sleeps through the night. Which of the following would be the best medication to prescribe for this pt after addressing sleep issues:
ZALEPLON
62
Combined use of Lithium and SSRI is known to increase the risk of which of the following conditions?
SEIZURES
63
28 y/o pt wants to stop smoking with the help of a nicotine replacement product. Pt plans to have orthodontia within the next 2 months; has psoriasis; and has multiple environmental allergies that often cause nasal stuffiness, sore throats, and itchy, watery eyes. Nicotine replacement best?
NICOTINE LOZENGES
64
Prepubertal children differ from adolescents and adults with regards to dosing of liver metabolized medication requiring?
HIGHER WEIGHT ADJUSTED DOSES OF MEDICATION
65
Effective for OCD
PAROXETINE, PHENELZINE, FLUVOXAMINE, CLOMIPRAMINE (NOT BUPROPION)
66
This is an effective pharmacologic treatment for symptoms of OCD?
CLOMIPRAMINE
67
What pharmacokinetic property remains most stable with age
ABSORPTION
68
Irreversible effect of chronic anabolic steroid use
HIRSUTISM
69
What does current evidence show regarding psychiatrists using pharmacogenomics testing in clinical practice?
RESEARCH SHOWS PROMISE FOR CLINICAL UTILITY, BUT REPLICATED EVIDENCE ABOUT OUTCOMES IS LACKING
70
Bipolar II patient w/ CDK, HTN, DMII, obesity has uncontrolled depressive episodes. Currently euthymic on mood stabilizer with significant SE. What med should be trialed: Lithium, Quetiapine, Olanzapine, Lamotrigine, Divalproex?
LAMOTRIGINE
71
Medication caused syncopal episode with hyperthermia, headache, flushing, and tachycardia with hypotension requiring IV fluids in a patient who has a history of schizophrenia, GAD, and EtOH Use Disorder
DISULFIRAM
72
9 year old with ADHD not responding to methylphenidate, next medication?
DEXTROAMPHETAMINE
73
Methadone patient gets pregnant. Best recommendation?
CONTINUE METHADONE MAINTENANCE
74
Marker of autonomic activity and biofeedback:
HEART RATE VARIABILITY
75
What medication can lead to serotonin syndrome if combined with fluoxetine
LINEZOLID
76
First line treatment for restless leg syndrome: Carbamazepine, Clonazepam, Pramipexole, Gabapentin, Imipramine.
PRAMIPREXOLE
77
Which of the following ADHD meds has a black box warning for suicidal ideation in children and adolescents (Modafinil, Atomoxetine, Methylphenidate, Lisdexamfetamine, Dextroamphetamine)
ATOMOXETINE
78
Which is an alpha-2 adrenergic agonist: atomoxetine, buspirone, modafinil, guanfacine, memantine
GUANFACINE
79
Reason for IV atropine administration to patient prior to triggering the electrical stimulus during ECT
PREVENT BRADYCARDIA AND ASYSTOLE

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