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Pharmacology > L16: Anti-psychotics II > Flashcards

L16: Anti-psychotics II Flashcards

(53 cards)

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1
Q

Which receptor is primarily associated with orthostatic hypotension?
A. M1
B. Adrenergic alpha-1
C. Beta receptors

A

B. Adrenergic alpha-1

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2
Q

FLudrocortisone is occasionally used as a volume expander in those without other options to ___

A

Clozapine

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3
Q

Drugs that act on which receptor can be hard for elderly patients with which condition to handle?

A

Alpha-1 adrenergic; Poor vasomotor tone

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4
Q

True or false: AE’s associated with drugs that act on histamine receptor include weight gain and sedation

A

True

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5
Q

Rapid discontinuation of H1-R is followed by rebound ___ and ____

A

insomnia; sleep disturbance

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6
Q

Which drug may moderate anti-psychotic-induced weight gain?

A

Metformin

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7
Q

What side effect is commonly associated with Clozapine or Risperidone use?

A

Orthostatic hypotension

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8
Q

True or False: Use of anti-psychotics can lead to dyslipidemia and impaired glycemic control

A

True

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9
Q

What are two major adverse cardiac effects seen with use of anti-psychotics?

A
  1. QRS Widening
    - Increase in PR interval
  2. Greater risk of developing arrhythmia
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10
Q

Which generation of anti-psychotics is most likely to give rise to neuroleptic malignant syndrome?

A

First generation

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11
Q

Neuroleptic malignant syndrome is associated with decreased activity in the D2 receptors. What are the effect on nigrostriatum?

A

Muscle rigidity and tremor

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12
Q

How can neuroleptic malignant syndrome affect hypothalamus?

A

Impair temp regulation ; autonomic hyper-reactivity

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13
Q

How to manage neuroleptic malignant syndrome?

A
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14
Q

Dantrolene can be used to treat ____, consequence of decreased activity at D2 receptors in the skeletal muscle and nigrostriatum

A

rhabdomyolysis

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15
Q

Compare and contrast Serotonin Syndrome and Neuroleptic Malignant Syndrome:

A
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16
Q

The first line agents for treating schizophrenia are ___ anti-psychotics, except ____

A

second-generation (Aripiprazole or Risperidone) ; clozapine (associated w/weight gain, sudden cardiac death)

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17
Q

How do you treat catatonic forms of schizophrenia?

A

IV Benzodiazepines; Anti-psychotic drugs once catatonia has ended

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18
Q

Treatment of schizoaffective disorder?

A

For psychosis…
- anti-psychotic drugs

For mood disorder…
- anti-depressants + lithium + valproic acid

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19
Q

Major depressive disorder (unipolar depression) with psychotic features require lower doses of ___ and ____

A

anti-psychotics and anti-depressants

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20
Q

Which drug is commonly used as an adjunct in unipolar depression?

A

Aripiprazole
- Lithium too

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21
Q

Lithium, Carbamazapine, Lamotrigine, and Valproic Acid are associated with treatment of:
A. Mania
B. Bipolar Depression
C. Unipolar Depression

A

B. Bipolar Depression

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22
Q

Which 4 drugs can be used as a monotherapy for treatment of Mania?
(LOVA)

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A
  1. Aripiprazole
  2. Olanzapine
  3. Lithium
  4. Valproic Acid
23
Q

Which two drugs can be used to treat bipolar and act as VG Na blockers?

Study These Flashcards
A

Carbamazepine and Lamotrigine

24
Q

True or False: Lamotrigine both blocks VG Na channels and stimulates GABA synthesis/inhibits GABA degradation

25
Which of the following is used in acute mania and for prophylaxis in depressive phase? A. Carbamazepine B. Lamotrigine C. Valproic Acid
A. Carbamazepine
26
True or False: Both Carbamazepine and Lamotrigine are effective at treating acute mania
False - only Carbamazepine is effective!
27
True or False: Valproic Acid is increasingly used as a first choice in acute mania
True
28
Which of the following bipolar disorder drugs is prone to cause SJS? A. Lamotrigine B. Carbamazepine C. Valproic Acid
A. Lamotrigine B. Carbamazepine
29
Liver dysfunction, weight gain, and inhibition of drug metabolism are AE associated with which of the following? A. Lamotrigine B. Carbamazepine C. Valproic Acid
C. Valproic Acid
30
True or False: Carbamazepine is associated with hematoxicity and induction of P450 drug metabolism
True
31
Which drug for bipolar affective disorder suppresses inositol signaling and inhibits GSK-3? A. Lamotrigine B. Carbamazepine C. Valproic Acid D. Lithium
D. Lithium
32
True or False: Lithium has antagonists actions on the ANS-R and specific receptors, as well as sedative effects
False - lithium does not have antagonists actions on ANS-R or specific receptors; it also does NOT have sedative effects
33
True or False: Both Valproic Acid and Lithium are pregnancy cat D
True
34
What are features of Lithium toxicity?
Tremor, edema, hypothyroid, renal dysfunction, arrythmia
35
True or False: Lithium has DDI with thiazides and NSAID's
True
36
True or False: Chronic Lithium treatment may prolong actions of local anesthetics
True
37
The early stages of Li+ toxicity mimics ____ intoxications
ETOH
38
What should be on the DD for nausea, confusion, hypotension, seizures, dizziness?
Serotonin Syndrome Malignant Neuroleptic Syndrome Li Toxicity
39
Irreversible Li-effectuated neurotoxicity is known as ___ ___
silent syndrome
40
What causes silent syndrome?
Demyelination of various CNS sites
41
Elevated levels of Lithium (as in Silent Syndrome) can affect which parts of the brain?
Brainstem and Cerebellum
42
Why are some anti-psychotics effective at suppressing tics in patients with Tourette disorder?
Reduced D2 NT in basal ganglia sites
43
Which anti-psychotic is the only one to be FDA approved for treatment of Tourette disorder?
Aripiprazole - note: in the past, haloperidol was used off label
44
Which two anti-psychotics are approved to treat irritability in ASD?
Risperidone and Aripiprazole
45
What is the cause of Psychosis Associated with Parkinson's Disease?
Lewy body associated with 1) loss of raphe neurons 2) upregulation of cortical 5HT2a-R
46
What is currently the primary medication used to treat hallucinations and delusions of PDP?
Pimavanserin (SS 5-HT2A inverse agonist) - note: this drug IS associated with sudden cardiac death
47
What causes chorea, as seen in HD?
Over activity in dopaminergic nigrostrial pathways -increased responsiveness to PS dopamine receptors - deficiency of NT that normally antagonizes DA
48
Which drug has replaced DA receptor blockade in management of chorea?
Tetrabenazine
49
True or False: Haloperidol can suppress chorea and be used for treating psychosis in HD
True
50
In rigid Huntington's Disease, ___ can be more effective for treating psychosis and paranoia
clozapine
51
The most striking neurochemical disturbance in Alzheimer's Disease is a deficiency of ___, a neurotransmitter
Ach
52
Which three drugs can be used to treat AD?
Low dose clozapine Risperidone Haloperidol
53
True or False: Medications w/significant anti-cholinergic properties should be avoided in elderly patients, esp. those with dementia
True

Pharmacology (53 decks)

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