Pharm

Question 1

Interaction betw depakote and lamotrigine?

Answer 1

Depakote is an enzyme inhibitor and it increases level of other drugs, such as lamictal. When depakote is added to lamictal, the dose of lamictal should be reduced by 50%.

App- This concept was tested on my boards FOUR TIMES.

Question 2

70 y/o +HIV heroin abuser is treated with Lopinavir and Ritonavir and fluoxetine for MDD. Hep C was dx and treated 2 months ago. Since then pt is more irritable, insomnia, and diarrhea. Why?

Answer 2

DRUG-DRUG INTERACTION

Question 3

Class of medications w/ anti-cholinergic, anti-adrenergic, anti-histaminic and cardiac side effects?

Answer 3

TCAs
Anti-cholinergic (dry mouth, urinary retention), anti-adrenergic (hypotension), anti-histaminic (sedation, wt gain), cardiac (QT prolongation)

Question 4

Effect on lamotrigine levels in pt starting on OCP?

Answer 4

Lowers
steroid hormones increase break down, may make Lamictal less effective. Lamictal slightly increases clearance of OCPs but no reports of failure.

Question 5

A 34 yo patient is being treated for malaria after returning from a trip to Kenya. The patient has a history of schizoaffective disorder which has been well controlled for more than a decade with a combo of Risperdal and Lithium. The pt is given a single dose of mefloquine, however after 1 week the patient reports feeling anxious. This escalates over the next week to PMA and persecutory delusions. The most likely cause of the pt’s psychotic symptoms is:

Answer 5

UNCOMMON SE OF THE ANTIMALARIAL TREATMENT