IDT Exam 3 Flashcards

1
Q

D2 agonists end with

A

zine
xene
zide
peridol

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2
Q

D2/5HT2 antagonists end with

A

pine
done

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3
Q

D2 partial agonists end with

A

azole

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4
Q

The 2 D2 partial agonists/5HT2 antagonists

A

Cariprazine
Lumateperone

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5
Q

Pimvanserin is a

A

Pure 5HT2 antagonist

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6
Q

Which generation of antipsychotic has greater affinity for 5HT2

A

SGA

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7
Q

D2 antagonism where causes what

A

Basal ganglia
EPS

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8
Q

Stages/progression of EPS

A

Dystonia
Akathesia
Pseudoparkinsonism
Tardive dyskinesia

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9
Q

How to treat EPS

A

Lower dose
Change to dirty drug
SGA cause less EPS than FGA

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10
Q

Types of dementia

A

MCI
Alzheimer’s
Vascular
Lewy body
Frontotemporal

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11
Q

MMSE weakness

A

Relies on language and is less accurate if poorly educated

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12
Q

MMSE parameters

A

Orientation
Memory
Attention
Language
Visuospatial fxn

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13
Q

How is MoCA different from MMSE

A

MoCA more sensitive to mild symptoms

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14
Q

MoCA parameters

A

Orientation
Delayed word recall
Attention
Language
Visuospatial

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15
Q

AD clinical manifestation progression

A

Memory
Language
Reasoning
Behavior

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16
Q

AD proteins

A

Amyloid alphabeta peptides
Tau proteins

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17
Q

Frontotemoral dementia is characterized by

A

Mood and aphasia

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18
Q

Frontotemporal dementia responds well to
But not

A

SSRIs
CEI may worsen

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19
Q

Lewy body dementia is characterized by

A

Hallucinations
Parkinson’s symptoms

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20
Q

Lewy body dementia should not be treated with

A

Typical APD
May worsen motor symptoms

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21
Q

Nonpharm treatment for dementia

A

Educate pt and care giver
Exercise
Eliminate comorbidities
Ethanol avoid and meds that worsen

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22
Q

Drugs to avoid in dementia

A

CNS depressants
Benzos
Opioids
Anticholinergics
Antipsychotics

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23
Q

Drugs for dementia

A

CEIs
Donepezil
Galantamine
Rivastigmine
Glutamatergic inhibitor
Memantine

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24
Q

AD patients have less
Which decreases

A

Choline acetyl transferase
ACh synthesis

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25
Q

Donepezil
Dosing
Formulation

A

5-10mg QD
Tabs or ODT

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26
Q

Rivastigmine
Dosing
Formulations

A

1.5-6 mg BID
Caps Sln and TD patch
Patch is 4.6-13.3 mg QD

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27
Q

Galantamine
Dosing
Formulations

A

IR 4-12 mg
ER 4-24 mg
Tabs Sln ER caps

28
Q

When is donepezil given and why

A

AM to avoid vivid dreams

29
Q

Rivastigmine is specifically for

A

Dementia in PD

30
Q

Galantamine requires

A

Renal adjustments

31
Q

CEIs take how long to be efficacious

A

3-6 months

32
Q

CEIs cause

A

SLUDS BB

33
Q

What supplements do people try to give with dementia

A

Vitamin E
Ginkgo biloba
Curcumin
None has evidence

34
Q

Tx for anxiety in dementia

A

Buspar
SSRI
Gabapentin
Rather than benzodiazepines

35
Q

Tx dementia apathy

A

Stimulants

36
Q

Tx dementia depression

A

SSRIs
Mirtazapine
Not TCA due to antiACh

37
Q

Tx dementia insomnia

A

Melatonin
Not benzodiazepines or Z drugs

38
Q

Tx dementia hallucinations

A

Atypical APD low dose

39
Q

How to treat MCI

A

No drugs needed

40
Q

Tx Alzheimer’s

A

CEI and memantine

41
Q

Tx vascular dementia

A

Control CV risk factors
BP
Statin
ASA

42
Q

LB dementia Tx

A

CEI and memantine

43
Q

Frontotemporal dementia tx

A

Antidepressants are good here
Speech therapy

44
Q

Phenothiazine SAR

A

Position 2 EWG
-not 1 and 4
3 carbon chain btwn Ns
Tert amine

45
Q

Why does fluphenazine have less antimuscarinic fx

A

It has an ethanol group on the sidechain

46
Q

Which antipsychotic phenothiazide is prodrug

A

Fluphenazine decanoate

47
Q

Which APD has an active sulfoxide metabolite

A

Thioridazine

48
Q

Which APD causes QT prolongation

A

Thioridazine

49
Q

You should not give thioridazine to

A

Poor 2D6 metabolizers

50
Q

Clozapine is a

A

D4/D2 5HT2 antagonist

51
Q

Clozapine may cause
Because it has a

A

Agranulocytosis
Reactive nitrenium ion

52
Q

What APD dibenzazepine has no agranulocytosis
And why

A

Olanzapine
It doesn’t have an EWG
Has sulfur group
This alters metabolism

53
Q

What is added to olanzapine to make IM sln
How does it help?

A

Pamoate ion
Much less water soluble

54
Q

Why is loxapine not considered atypical

A

Still has EPS

55
Q

Loxapines active metabolite
And mechanism of action

A

Amoxapine
Blocks NE reuptake
NRI

56
Q

Which two APD have less antimuscarinic SEs
and why

A

Fluphenazine and quetiapine
They have an ethanol on their sidechain

57
Q

Which APD flourobutyrophenone is a prodrug

A

Haloperidol decanoate

58
Q

What toxicity does haloperidol have

A

Neurotoxic HPP+
Causes EPS
N is oxidized then the sidechain is dehydrated and becomes aromatic

59
Q

This APD like haloperidol has DA antagonism
But it Lao has

A

Lumateperone
5HT2A antagonism

60
Q

Lumateperone should not be taken with

A

3A4 inhibitors/inducers

61
Q

Risperidone is metabolized into

A

Paliperidone

62
Q

Which atypical APD is mostly excreted unchanged

A

Paliperidone

63
Q

What atypical APD is a prodrug

A

Paliperidone palmitate

64
Q

Which D2 partial agonist is a prodrug

A

Aripiprazole lauroxil

65
Q

Cariprazine is a

A

D3/D2 partial agonist like the -iprazoles

66
Q

Three drugs for tardive dyskinisia

A

Tetrabenazine
Deuterbenazine
Valbenazine

67
Q

Samidorphan is an

A

Opioid receptor antagonist/partial agonist